Rhinoplasty is performed for three particular reasons: either to change the shape of the nose, to alterate a function or to restore the nose after an injury. Appearance and function are intimately related. However a change in the appearance can also affect the airflow and the other way around. Functional as well as cosmetic nose surgery is usually performed during light anesthesia. Full anesthesia can be offered in additional. The patient will be able to return home the same day.
The surgery is usually performed endonasaly without leaving any visible scars. In more complex cases however the nose is opened and leaves discrete scars that usually disappear with time. The patient will always be informed of this in advance. For functional surgery it is very important that the surgeon is familiar with the entire nasal physiology. Interventions may otherwise lead to disabling nasal congestion that may be worse to live with than a disfiguring nose.
The functional surgery usually takes place inside the nose by straightening a crooked nasal septum and / or decreasing the turbinate size. In more advanced cases one must also straighten the nasal bones and / or lowering the nose to widen and charter up the nostrils which will affect the nasal appearance. The goal is invisible change: To create a well-functioning nose in harmony with the face, character and constitution. Sometimes there is a need for a chin augmentation to get the right proportions.
The nose is very personal and it is therefore important that the patient is clear about what to change. Despite technically good results this could lead to disappointment. Even if a nose becomes just as the patient wanted it may take time to get used to the new look. On the week after the surgery, the nose will be protected by an external plastic splint. It rarely hurts after surgery but the first week the patient can get a temporary bruising around the eyes. Return to work can typically occur after 10-12 days. Sick leave is only obtained if it is a functional nose surgery.
How will people react? There is nothing to worry about. Usually most people see that something positive has happened, but cannot tell what.
Prior to an operation
Do not eat on the day of surgery. No food or drink may be consumed over the next 4 hours prior to surgery (if anesthesia is used then 6 hours).
It is forbidden to use any type of medication containing aspirin such as Albyl, Trombyl® or Aspirin a week before the operation. Paracetamol, Alvedon and Citodon® are allowed.
The patient washes the face thoroughly on the day of the operation. Normal shampoo is recommended for the hair. Do not use make-up, nail polish nor eye lenses on the day of surgery. Piercings are instructed to be removed. You should wear comfortable clothing and avoid a tight shirt neck that can apply pressure to your nose after surgery.
With light anesthesia the patient gets painkillers as premedication and an IV-sedative during surgery so the patient becomes heavily sedated before the local anesthetic is applied. Most people choose to do the operation using light anesthesia with sedation (full anaestesia may be obtained at an additional cost). The procedure itself usually takes about 1 hour.
After the surgery the patient will get a haemostatic tamponade which should stay for 1-3 days. The nose is taped with a plastic strip and external plastic splint is applied on the outside. If needed, septal plastic splints are being placed inside the nose on each side of the nasal septum as support.
The patient is under supervision at the clinic a few hours after surgery. He or she is not allowed to drive (for 24 hours) or to go home by public transportation. It is crucial to be picked up by friends or family by car or taxi.
There isn’t a lot of pain after the operation. Previous patients have described the feeling as catching a cold and this is due to the nasal passage being reduced the first week. It is therefore wise to use nose drops to reduce the swelling inside the nose during the first week. One can also take Renaissance normal saline spray and the Nozoil spray after surgery to diminish crust formation. The plastic splint should remain for one week. Some patients gets swollen around their eyes, but it will disappear within a week. In rare but serious cases an infection manifests itself as an increased, often throbbing pain, accompanied by swelling, redness and fever. If this is the scenario, the patient is instructed to take immediate contact for the prescription of antibiotics.
The tamponades are most appropriately pulled out while lying down at home and is done easiest with the help of a friend or relative. If this is done while lying down for 10 minutes, bleeding will be minimal. The internal and external splints are removed at the clinic one week after surgery. The patient should expect to be away from work for 10 days. Sick leave is only obtained for functional operations.
Follow up appointments happen after a week if nothing else has been discussed. You can usually return to work after 10 days and a free follow-up within 3-6 months is always included. Most of the swelling in the nose will have gone away but the real results will be visible after 1-3 years.