Nose reduction surgery: rhinoplasty
	A "tailor-made" nose
	Structures that can be modified during rhinoplasty
	Treating a problem of the septum at the same time
	Preoperative consultations
	Age of patient
	Anaesthesia
	After surgery
	Scars
	Judging the definitive result
	Conclusion

A "tailor-made" nose

Rhinoplasty is still one of the most delicate of cosmetic surgery operations. The result depends on the size of the surgical reduction and the skin's ability to adapt to the new shape. A general examination of the patient and especially the face is still primordial, as the nose must be in harmony with the rest of the face with the patient's personality. There cannot be a standard nose.

Moreover, there are fundamental bases in the architecture of a nose that it is not always possible or even advisable to modify.
In fact, in most cases the main characteristics of the nose must be maintained while its defects are corrected.

The nose will be tailor-made, but it must be kept in mind that different elements such as the elasticity of skin sometimes limit the possibilities of transformation.
A nose should be made to measure, but above all made to suit the patient.

Structures that can be modified during rhinoplasty

Bridge
Too rounded (bump), it must be reduced; too flat, it must be built up (with a cartilage or bone graft or an implant) to give a fine bridge to a nose that is too flat.

Tip
A tip that is too wide or too square may in many cases be remodelled alone, without touching the rest of the nose.

Nostrils
Too wide or too thick, can be reduced at the cost of a small scar.

Deviation
Can be corrected by straightening the entire nose.

Nose that is too long
It can be shortened.

Treating a problem of the septum at the same time

It is sometimes necessary to straighten a deviated septum, which can be responsible for breathing difficulties. It is even highly advised to associate cosmetic surgery with functional surgery.

Preoperative consultations

You will need at least two consultations:

- The first is to ascertain all the information required and to carry out a preliminary morphological analysis; digital photos are taken to allow an appreciation of the type and degree of modification possible.

- At the second consultation all the points evoked at the first will be reviewed, with special attention to details of the surgery. An estimate in duplicate is drawn up and signed.

Age of patient

Rhinoplasty can be practised from the age of 15 or 16, when growth is complete and the nose is fully developed. It is nevertheless advisable to wait until the age of 18 or 20 before making this type of decision, in full awareness of the facts and not in the middle of a teenage crisis.

Similarly, rhinoplasty is very effective as a complement to a facelift, with the objective of looking younger, up to the age of 65 or 70.

Anaesthesia

The most commonly used is general anaesthesia, but rhinoplasty may sometimes be carried out under deep sedation (neuroleptic analgesia) in association with a local anaesthetic. In some cases of very localised modification (to refine the tip of the nose for instance), local anaesthesia alone may be envisaged.

After surgery

Hospitalisation is of short duration (maximum 24 hours). There is very little pain. When you wake up you will have oiled gauze wicks in both nostrils, and these will be removed before you leave the clinic. The plaster cast on the nose is removed one week later.

During this period the lower eyelids and the top of the cheeks will be swollen and there will be marked bruising.

Scars

The scars are generally concealed inside the nose, and the stitches are of the resorbable type.

Sometimes in cases where the nostrils are too long or too wide, they can be reduced and the scar will then be practically invisible, hidden in the hollow crease around the nostril.

Judging the definitive result

The corrected nose develops over a long period, between six and 12 months. After two months, the result is close to the final appearance.

Only tiny details continue to be gradually refined. The nose is normally strong two months after surgery. Exposure to the sun is prohibited for one month following the operation. If small irregularities appear, a simple correction under local anaesthetic may be considered one year later.

Conclusion

Rhinoplasty is now a well-codified operation, fully mastered and planned by means of a precise preoperative plan.

The image of stereotyped nose corrections that are patently obvious must now be forgotten; now everybody has the right to a natural looking nose suiting his or her personality.