1. How long will there be swelling after a rhinoplasty?
Swelling after rhinoplasty is dependent to a degree on how much surgery is being undertaken; for example, will the work be simply on the soft structures of the nose, or will it also involve the bones and septum. Most of the swelling is hidden by the splint which is worn for a week or so. By the time the splint is removed, the majority of the swelling has already subsided but a little swelling remains for some months and indeed the nose may continue to improve subtly for a year to 18 months.
2. Is there a non-surgical alternative to rhinoplasty?
This really depends on an analysis of the nose in relation to what you wish to achieve. More complex changes will require surgical correction but if the problem is limited to a specific concern such as a depression, a bump or irregularity then a medical alternative such as a dermal filler may be best for you. Dermal fillers can be placed simply with local anaesthetic in the outpatient department. I tend to use dermal fillers that are compatible with the body tissues but fillers are temporary and slowly dissolve away so they will need to be replaced or topped up from time to time. Interestingly, they can last longer in the nose than at other sites in the body.
3. How visible will rhinoplasty scars be?
There are two major approaches to rhinoplasty that is to say, closed and open. With the closed techniques the scars are all on the inside of the nose and therefore undetectable. An open technique may be used for more complex surgery and places scars on the inside of the nose too but with a small extension that is detectable but actually nearly always very inconspicuous on the undersurface of the columella, the strut of soft tissue that lies between the openings of the nostrils. I will usually use a closed approach for most noses and I also use something called an extramucosal technique, an approach that helps to minimise scarring further.
4. Can a rhinoplasty address breathing problems as well?
Yes, it can and it is important to take account of breathing problems during the assessment of the nose at consultation. Breathing problems can result from previous damage to the nose such as a deviated septum which is the partition inside the nose. The nose also has two valves which are important for the airway of the nose. It is important that your surgeon is aware of the internal structures and supports of the nose so as either to preserve or strengthen them, or if they are damaged, to reconstruct them. To be able to achieve the best result in terms not only of the cosmetic shape but also the airway, make sure your surgeon is experienced and comfortable with both cosmetic and airway-related rhinoplasty techniques.
5. What’s the most important question to ask a cosmetic surgeon in a rhinoplasty consultation?
Rhinoplasty is potentially one of the most demanding procedures in plastic surgery. So of course it is important to really think hard about what you want to achieve and communicate that to your surgeon. The nose sits in the middle of the face and there is a balance and harmony to be had with the other structures in the face so an artistic eye is essential in a competent rhinoplasty surgeon; feel free to ask about that. Apart from the actual specifics of the operation, ask your surgeon’s qualifications and experience in rhinoplasty, how many procedures does he or she do, how are the outcomes assessed; what about levels or figures of patient satisfaction with outcomes? Is he a member of a nationally recognised body of professionals. Finally, after your consultation, you have to ask yourself, do you feel comfortable with your surgeon.