The slightest asymmetry or malformation of the nose can affect a person’s overall appearance and distract from other features. Because of its location, a nose that is crooked or out of proportion with a person’s face is difficult to conceal. Fortunately, nose surgery, also known as rhinoplasty, is available from our experienced cosmetic plastic surgeon, Dr Craig Layt, at our Gold Coast practice. Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.
What is a rhinoplasty?
A rhinoplasty is the medical term for nose surgery which may be either cosmetic or reconstructive. It is a procedure which aims to correct problems associated with the shape and function of the nose. It involves a general anaesthetic and can be performed as an inpatient or on a day stay basis.
The operation can sometimes be performed using only internal incisions but more usually involves an open approach where a small incision across the columella (strut between the nostrils) of the nose combines with internal incisions in order to give better access for a more accurate operation. This is particularly useful in more difficult noses outhouse requiring remodelling of the nasal tip. The nasal bones, cartilage, and soft tissues are reshaped to improve the external contour and maintain or improve breathing. The incisions are closed and dressings applied. A splint is applied to the outside of the nose. Occasionally an internal plastic splint is required to help keep the nose straight. Reduction of large nostrils can be done through tiny incisions at the base of the nostrils with either type of rhinoplasty but does result in a scar at the base of the nostril. When paired with facial procedures, such as non-surgical cosmetic enhancements, the final result can help create a more balanced appearance.
Rhinoplasty is a very complex and complicated surgical procedure. Revision rhinoplasty is sometimes performed after a primary rhinoplasty as a secondary procedure to refine results. It is well known that rhinoplasty surgery has one of the highest revision rates in cosmetic surgery due to the complexity of the surgery and the unpredictable nature of how the patients tissues will behave. This is often due to the fact that you are operating on a structure where minor irregularities are obvious due to its central position on the face and the relatively thin layer of skin. The surgery involved dealing with bone and cartilage which behave differently in the post operative period. Cartilage has memory and a tendency to warp whilst bone heals early and is relatively rigid. The behaviour of these structures in the post operative phase along with the effects of scar contracture are beyond the surgeons control. This can mean an excellent on table result in theatre can have some imperfections at a later date.
Dr Layt has performed many primary and revision rhinoplasty procedures and will discuss the benefits and risks of rhinoplasty surgery, both primary and revision surgery, with each individual patient.
It is important for both you, the patient, and your support network or family, to work together throughout this journey with your surgeon and the clinical team and to attend all post operative appointments and follow post operative directions after any surgical procedure.
Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified practitioner.
Who is a candidate?
To determine candidacy, patients who are considering nose surgery will have a rhinoplasty consultation at our Gold Coast or Ballina office. Patients who can benefit from this surgical procedure are those with an abnormal appearance of the nose as a result of birth defects, injury, genetics or disease. A nose that is cosmetically unattractive or does not fit with other facial features would also benefit from this procedure.
Nose Surgery Photos
These before and after photos are of patients that have had surgery performed by Dr Layt. These patients have consented to the photos being shown. These are actual photos and have not been altered or digitally enhanced. Every patient is an individual and therefore final surgical results will vary from patient to patient.
What can you expect after the operation?
Immediately after nose surgery you will have a splint on the outside of your nose and sometimes some inside your nose. These will be removed about one week after rhinoplasty. You will not usually have any packs in your nose but there will usually be a piece of gauze under the nose which will catch any fluid that may come out of your nose. This should be changed as required. The day after the nose surgery you will probably notice some bruising under your eyes. This is normal and should not alarm. When the splint is removed the final result will not be totally evident. There will be some swelling present and this will go down with time.
What are the potential risks?
Rhinoplasty is a common and reliable surgical procedure. However, surgery always involves some level of risk. The potential risks will be discussed thoroughly during your pre-operative consultation and Dr Craig Layt will provide a list of instructions to be followed before and after surgery to minimise the risk and encourage rapid healing.
Specific Pre-Operative Instructions
WASHING: Wash the evening prior to surgery and the day of surgery paying particular attention to the face. This decreases the bacterial count and should decrease the risks of infection.
PRODUCTS: Do not apply moisturisers, make-up, perfume/deodorant, nail polish or hair products after washing. Remove all jewellery.
CLOTHING: Wear loose, comfortable clothing and footwear. A shirt with a button or zipper opening is ideal for removal.
HAIR: If you have long hair it should be tied up in a pony tail using a simple elastic band. This will keep it out of the way during surgery.
FASTING: You should have nothing to eat or drink for 6 hours before your operation. If you are required to take medication during this time please speak with your physician to check if this can be taken before the 6 hour fasting period or after your procedure.
SMOKING: Smoking increases the risks of complications significantly and should be ceased 6-8 weeks prior to surgery.
MEDICATION: If you are having the operation as a day case, you will be given a script for antibiotics and pain relief tablets that you will need to purchase from the chemist and bring with you on the day of your procedure. Do not take these prior to surgery. The nursing staff will advise you and your carer after your procedure on how to administer them.
Certain over the counter products and prescription medicines can cause complications before and after surgery. They can reduce the ability of your blood to clot and could increase your tendency to bleed during and after surgery. Do not take any medication containing or related to aspirin 2 weeks prior to your procedure. This includes NSAID’S, anti-Inflammatory medications, blood thinning medications. Please see your doctor regarding if and when to cease medications. *This is not an all inclusive list*.
Also avoid Vitamin E supplements and red wine. Stop all herbal medications before surgery. The most common herbs used are Echinacea, Ephedra, Garlic, Ginseng, Ginkogo, Kava, St. John’s Wort, and Valerian. They may adversely effect anaesthetic drugs, prolong bleeding and impair healing after surgery. Please consult your physician before ceasing any medication.
ADMINISTRATION: Unfortunately, paperwork is a necessary evil. Each theatre complex has its own procedures. We have attempted to make it all easy by providing a simple series of steps to follow titled “THINGS TO DO FOR YOUR PROCEDURE” specific to the surgery centre you are attending. If you have any queries about this or anything else, don’t hesitate to contact us on (07) 5597 4100.
Specific Post-Operative Instructions
NASAL PACKING: Dr Layt usually is able to avoid nasal packing after surgery. If you have bled slightly more than usual during your operation, or if there is some other reason, he may occasionally use packing. With packing in place, you will have to breathe through your mouth, and you will have somewhat more swelling than usual. If nasal packing is in place it will usually be removed in 24 – 48 hours.
INTERNAL SPLINTS: If you have had surgery on your septum as part of your rhinoplasty, plastic splints will be sutured inside your nose. Although these take up some room, your nasal passages should not be totally obstructed. Dr Layt or one of his nurses will usually remove the splints from 7 to 10 days after surgery.
SPLINT: The splint put on your nose at the end of surgery is intended to provide protection, serving as a sort of small external skeleton. It will be removed in 7-10 days.
POSITION: Keeping your head (and nose) elevated tends to reduce swelling. If possible, sleep on two or three pillows.
CLEANSING: After surgery, some oozing and bleeding usually occurs for a day or two, and dried blood will collect in the nostrils. Keep the nostrils clear using wet cotton buds to gently wipe away any crusts. You may want to carry some tissues with you for a few weeks after surgery, as your nose may “drip.”
ACTIVITY: You should limit any strenuous activity during the first 2 – 3 weeks. Thereafter, you can steadily increase your activity level within the limits of discomfort. Heavy exercise or straining can cause bleeding or swelling during the first few weeks.
TED STOCKINGS: You may be required to wear TED stockings for compression to prevent DVT (blood clotting) post-operatively. If required these will be fitted at the hospital on your admission day. The nursing staff will advise you on how long you need to wear these for.
MEDICATION: Take your pain relief and antibiotic medication as directed. Any medication you ceased prior to surgery must not be taken after your surgery until you are completely healed or as directed by your physician.
Rhinoplasty is just one of many facial rejuvenation procedures we offer here at The Layt Clinic. Other options include facelift, brow lift, eyelid surgery, and more. If you are looking for more comprehensive rejuvenation, Dr Layt can talk with you about your goals and help you determine the options that can help you meet your needs.
To schedule a consultation with Dr. Craig Layt or to learn more about rhinoplasty (nose surgery) contact our practice on the Gold Coast. Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.