Rhinoplasty

Rhinoplasty changes the shape of the nose to harmonise it with the other features of the face. Depending on the situation, the alternatives are having no procedure, correcting the septum alone to improve breathing, medical treatment for a blocked nose or, in very limited cases, correction with an injectable product. These options do not have the same aims, possibilities or risks as surgical rhinoplasty.

Complication rates observed for rhinoplasty are listed in the table below, according to Sharif-Askary B and colleagues, 2020 (systematic review, 36 studies) and Spataro E and colleagues, 2016 (large cohort, 175,842 procedures, including 172,324 primary and 3,518 secondary procedures).

Further operation after a first septorhinoplasty

About 3.1%

Further operation after a revision septorhinoplasty

About 11.0%

Further operation, systematic review

0 to 10.9%

Infection

0 to 4%

Bleeding

0 to 4.1%

Reopening of the scar (dehiscence)

0 to 5%

Hole in the septum (septal perforation)

0 to 2.6%

Blocked nose needing a further operation

0 to 3%

Thickened scar (hypertrophic)

0 to 1.5%

Before rhinoplasty, Dr Manon Belhoste studies the nose from the front, in profile, three-quarter view and below, analyses how it relates to the face and takes medical photographs. An examination inside the nose by an ENT specialist is possible, to look for a deviated septum, a blocked nose or an abnormality of the turbinates. The requested pre-operative assessment must be completed, and the anaesthesia team's fasting instructions strictly followed. No medicine containing aspirin should be taken in the 10 days before the procedure, unless a doctor advises otherwise, and an anticoagulant or antiplatelet drug is never stopped on its own: the decision is made with the prescribing doctor, Dr Manon Belhoste and the anaesthetist. Stopping all smoking and nicotine is strongly recommended before and after the procedure.

After rhinoplasty, recovery is more uncomfortable than painful: the packing inside the nose prevents breathing through the nose in the first few days, swelling of the nose and eyelids and bruising around the eyes are common, and a small amount of blood-stained discharge is usual at first. Rest with the head and upper body raised, avoiding strenuous activity, heavy lifting and sudden forward movements of the head. Once the packing is removed, regular saline nasal rinses are needed, and the nose may stay blocked for several weeks because of swelling and crusts.

Yes, sensitivity may be altered after the operation. The skin of the nose, especially the tip, may be less sensitive for several weeks or several months.