Rhinoplasty

As the Plastic Surgeon appointed to the Cleft and Craniofacial Transition Clinic at the Royal Melbourne Hospital Dr. Breidahl extended this work to adult patients – offering a wide range of surgical techniques to patients seeking cosmetic rhinoplasty.

Dr. Breidahl employs advanced plastic surgery techniques to:

• Increase or decrease the size of the nose
• Change the shape of the tip
• Change the shape of the bridge
• Decrease or increase the span of the nostrils
• Remove a hump
• Improve asymmetry (while surgery can often improve the symmetry of a crooked nose, it is not always possible to achieve perfect symmetry)
• Change the relationship between the nose and upper lip

• A birth anomaly
• Damage to the nose and its internal structures due to injury, infection, tumours or other disease
• Breathing passages to improve capacity to breathe through the nose

Nose reconstruction for severe deformity may require two or more operations, with lengthy periods of healing between operations.

Reshaping of the chin can be performed at the same time as a Rhinoplasty. This can assist facial balance. It is important to have an analysis performed of the whole face to make sure that the relationship between the nose, the chin and cheeks is appropriate.

Most of the incisions are inside the nose. Sometimes there will be a small incision in the columella, the narrow strip of skin between the nostrils. This incision usually heals well and is hard to see after a few months.If the patient has flared nostrils, part of the incision may be outside the nose. The techniques used to reshape the nose are planned before the operation. They involve reshaping of bone and cartilage to achieve the desired changes. Occasionally, cartilage grafts may have to be taken from the ears or ribs. Bone grafts may have to come from the ribs. This will be discussed before surgery. When the surgery is finished, soft plastic splints may be placed inside the nose to stabilize the septum. A splint is usually placed down the length of the nose to maintain its new shape. The surgery usually lasts for about one or two hours. Some cases take longer.

If the surgery is done inside the nose, no scar is visible. If incisions need to be made on the outside of the nose, they are usually placed at the base of the nose and nostrils in the folds of skin where they are harder to see.

Immediately after surgery, you will be transferred from the operating theatre to a recovery room. Nursing staff will monitor your heart rate; blood pressure, breathing and general recovery from the procedure.Before surgery, arrange for friend or relative to drive you to and from the hospital. After you return home, an adult should stay with you for at least 24 hours.

Swelling and Bruising

The face may feel puffy, and the nose may ache. You may have a dull headache and probably will not be able to breathe through the nose. You should stay in bed with your head elevated for the first 24 hours to help these side effects subside. The nose and the area around the eyes will be swollen and bruised and then begin to go down after four to five days. By 10 days, the bruising and swelling are usually greatly reduced. Some subtle swelling may remain for several months.

Breathing

It may be difficult to breathe through the nose for several days.

Dressings

External skin stitches are removed after four to seven days. All dressings, splints and stitches are usually removed in one or two weeks.

Bleeding

It is common to experience a little bleeding from the nose for the first few days after surgery.

Sensation

The skin of the nose may be numb. Sensation usually returns gradually.