We are all born with some imperfections, but most we learn to live with. If, when you look at yourself in the mirror or at your photographs and your attention gets attracted to your nose or an aspect of it that you don’t like, then Rhinoplasty surgery is something to consider. Rhinoplasty is about changing a few specific aspects of the nose with sensible and realistic expectations. On the other hand if you are of the opinion- “I don’t like my nose at all and want it completely changed” or want it to look like some celebrity, then your understanding and expectations from Rhinoplasty are unrealistic and I would council you against considering surgery. My Rhinoplasty philosophy is to allow you to be more comfortable and confident about your looks, address the aspects that attract attention to your nose and create balance and harmony between the face and the nose.
Numerous changes can be made to your nose. The nose can be straightened, narrowed, humps reduced, tip of your nose lifted or dropped, tip of your nose turned up or down etc etc. However, we would not set out to change all these aspects in everyone’s nose. A successful rhinoplasty is a meeting of minds- yours and the surgeons. You need to be clear about what aspects of the nose you would like to change and the surgeon should be honest about what kind of changes can be made. Only when the two understand and meet in the midline, is it appropriate to proceed to surgery. The mantra is – “realistic expectations”.
Fortunately, Rhinoplasty is safe surgery and not associated with serious or life threatening consequences. In the immediate post operation period, there is a potential risk of bleeding, which is usually less than 2%. In the longer term, if performed inadequately, can lead to functional problems such a septal perforation or reduced breathing through one or both nostrils. If performed by a surgeon who understands both the function and aesthetics of the nose, such an outcome can be avoided. The patient’s worst fear is that they don’t like what their nose looks like after surgery. The commonest cause for this is poor understanding and communication. The patient may have had a lack of understanding of the changes planned and what that would look like or the surgeon wasn’t clear in making the patient understand what changes were planned. In my practice, I will not proceed to surgery till that understanding and communication has been achieved. That may take two consultations or sometimes five. I will use photograph morphining technology to assist in understanding the changes the patient is looking for, and at the same time allow the patient to perceive what they might look like with the changes. Such a morphing exercise is only a tool for the surgeon and patient to understand each other, never a guarantee of the result.
You will be discharged the day after your surgery with an external nasal splint. It is not my practice to use nasal packing, so no dressings will need to be removed before you go home. You will be invited back a week after to have your external nasal splint removed (and sutures if an external approach has been used). This will be your first opportunity to see your new nose. The external nose may swell a little after the removal of the splint but 90% of this swelling will go away within four weeks. The external bruising settles over four weeks. Although your nose will look entirely “normal” at this stage, slow and subtle changes will occur over the following 6-9 months, as the results of Rhinoplasty take at least a year to mature.