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Purpose: To improve the profile of the nose and give the face a more harmonious appearance
Length of operation: 1-2 hour
Anaesthesia: General anaesthetic
Inpatient stay: 1 day
Followup: 1 week, 3 months, 6 months, 1 year
Time off work: 2 weeks
Recovery: 2-3 weeks
Risks: swelling, bruising, irregularity, further surgery
Introduction
This is a common plastic surgery operation for the nose. The operation involves a range of procedures which including removal of excess bony hump, removing and rearranging the deformed cartilage and also dealing with any problems related to the septum. The aim of the procedures is to produce a shapely nose. The procedure can be carried out through two approaches:
- Closed approach (no external scar on the nose)
- Open approach (scar on the column of tissue separating the two nostrils)
The approach will depend on a number of factors and this will be discussed with you by the surgeon.
Mr Sanjay Azad will carry out a detailed assessment of the face and then discuss the most appropriate procedure/s with you. Sometimes it is the chin which could be the issue and this will be discussed in detail.
The results are generally excellent with high satisfaction rates. In this description I shall take you through the operation, hospital stay, recovery and the complications. Once you have met me for the initial consultation, I would be quite happy to see you again for a second consultation, so that you can clarify any of your doubts.
Procedure / Hospital Stay
It is advisable to stop smoking for 4 weeks. Aspirin needs to be stopped for at least 10 days before the procedure, as it thins the blood out and can make for more bruising. If you are hypertensive then it is particularly important that this is well controlled prior to the procedure. Photographs for documentation and teaching purposes are standard and will be discussed. The procedure is done under general anaesthetic and takes a couple of hours to perform. The nose shape is corrected and an external splint is applied to hold the nose in position.
While you are in hospital you will have blood tests, fluids through a drip and pain killers. The stitches are non-dissolving in the open approach and need to be removed after 5 days. You will feel quite bruised and swollen after the operation and this settles in due course. The hospital stay is typically overnight and depends on your recovery.
Recovery After Surgery
At discharge, the splint remains in place and you need to attend the dressing clinic in a weeks time. You will be given some pain killers to take home. Keep an additional pillow under your head for a few days, as this helps to reduce swelling. The bruising typically takes 2-3 weeks to disappear. Initially the bruise becomes tan coloured and this fades in due course. You will be seen again in 3 months time. Photographs will be taken at this stage.
You should avoid smoking for 4 weeks after the procedure. Recovery is individual, but most patients get back to work and driving in 3-4 weeks time.
Complications
Overall results are excellent but there are some well known limitations, risks and complications which you should be aware about. Scar, infection and blood clots are risks of any procedure. The nose may feel quite blocked at first but this clears in due course. The final nose shape will depend to an extent on the skin, bone and cartilage framework. Further procedures may be occasionally necessary to get the desired result.
Before Surgery
- Mr Sanjay Azad advices his patients to take Tablet Arnica (30 strength) once a day prior to surgery. This is a homeopathic remedy which has been found to reduce bleeding and bruising after surgery.
- No make up should be applied on face prior to the operation.
- Do not cut your hair prior to surgery so that the incision can be well hidden.
- Do get a scarf and sunglasses which will be useful after surgery.
After Surgery
- Continue taking Arnica tablet once a day for 2 weeks after surgery.
- Pain killers after surgery are typically a combination of codeine and paracetamol. Avoid any tablets like ibuprofen or diclofenac which can potentially thin the blood and cause more bleeding or bruising. If you have any allergies please highlight this to Mr Sanjay Azad.
- If there is any bleeding through the bandage, please contact the team.
- Do not consume alcohol for 2 days after surgery.
- It is useful to apply ice compresses to the exposed area of the face during the first 2 days to reduce swelling.
- You can wash your hair 3 days after surgery.
- Try not to do too much after surgery and take a soft diet for the first three days. Limit activities such as bending, straining and lifting. Avoid excess neck movements and heavy exertion for the first month. Aerobics should only be done 3 months after surgery.
- While sleeping keep your head elevated (to 45 degrees) by using an additional pillow. This should be used for the first week after surgery.
- Do not go into direct sunlight for first 6-8 weeks after surgery. Also use sunblock daily.
- It is common to have swelling of the face and sometimes bruising of the neck and chest. Bruising typically settles down in 2-3 weeks time. It is safe to apply makeup after the first week to mask the bruising.
- It is useful to massage the face with moisturizing cream after surgery which helps in the settling down process.
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