The goal is to replace resection with preservation, excision with manipulation, and secondary reconstruction with minimal revision.
Preparing for preservation rhinoplasty surgery
All preservation rhinoplasties require a general anaesthetic. Your health is of prime importance and any cosmetic surgery should be postponed if you are unwell for any reason. It is important that if anything changes with your health that you make contact with us. You should ideally stop smoking at least 6 weeks prior to surgery and stop taking aspirin, anti-inflammatory drugs and herbal supplements before surgery.
You may need pre-operative tests prior to surgery, which we will arrange if required. Following the surgery, it is not as painful as you expect, analgesia will be prescribed. You should aim to be off work for 1 to 2 weeks depending on the type of work you do.
Structural rhinoplasty still plays a large part in my rhinoplasty practice, in the management of difficult primary rhinoplasties, post-traumatic noses and secondary cases. It is essential to have all tools in the toolbox. Please visit our page here for details about our standard Rhinoplasty treatment.
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The Results
I am incredibly pleased with the result of my rhinoplasty. The care I have received from Mr Wilson and his team has been and continues to be fantastic.
Frequently Asked Questions
If you haven’t had a rhinoplasty before, this could be for you. Preservation rhinoplasty is considered for all primary rhinoplasties and some secondary cases. Ideal candidates for preservation rhinoplasty include men, and women with the following features: Straight noses, deviated noses, short nasal bones, teenagers(>18y), tension nose, small bony hump.
If you have had a rhinoplasty before and need another one, you will most likely need an open structural rhinoplasty, possibly with the addition of rib or ear cartilage grafts, fat or fascia grafts. Those with a significant medical history should disclose this in the initial consultation to see whether you’d be a good candidate. Anyone who has been encouraged to undergo surgery by others, should reconsider.
The fee for a preservation rhinoplasty is the same as for a standard structural rhinoplasty. Secondary rhinoplasties may be more expensive. After a consultation you will be given a quote for surgery that includes all applicable fees. A CT scan of your nose and sinuses may be required and there is a cost associated with this. Additional costs may be incurred if an endoscope is used at the consultation. This will also include all the benefits of the Nuffield health promise or Spire cosmetic surgery policy. We ensure that you receive a clear and transparent, competitive price for your treatment, the very best in clinical care, and with no limits on your care.
The success of the consultation depends on your openness and honesty in relation to what troubles you and your expectations of surgery. You will be asked questions about your health, desires and lifestyle. Different operations can be tailored to your needs and the potential outcomes and the risks and complications will be discussed with you. The preservation rhinoplasty operation reshapes your nose into the shape you desire(within the normal range) and improves your breathing if you have problems with your airway. 3D photographs will be taken during your consultation and morphed to give you an idea of what your nose could possibly look like. These are for planning purposes only and do not guarantee or endorse an aesthetic outcome. For some patients, especially following trauma, other adjunctive procedures may be required. A consultation regarding the risks and limitations of surgery will help you to choose a procedure that will meet your expectations.
Preservation rhinoplasty surgery often takes between 1 and 2 hours. Usually, an incision is made within the columella (bridge of skin between your upper lip and nose) and then extends into the nostrils. Additional incisions may be required around the base of the nostrils.
If your nose is too big (the most common indication), cartilage will be removed from under the bridge of the nose to provide an improved nasal shape. Osteotomies (controlled bony breaks) are performed to narrow the nose and reshape the side walls. The tip cartilages are trimmed, reshaped with sutures, and repositioned to improve your nasal tip. Additional graft material may be applied. The skin is repositioned and the incisions are closed with dissolvable stitches. Tape will be applied to the nose at the end of the procedure as well as a splint. Your nose is unlikely to be packed.
You will usually return to the ward within an hour following surgery and you will be encouraged to mobilize. You will be able to eat, drink and mobilize as soon as the anaesthetic wears off. You will feel swollen and have generalized discomfort that will usually require analgesia. You will be in hospital overnight or can be a day case if you wish. Keep your dressings dry in the first post-operative week. You should arrange for someone to pick you up following surgery and have some support at home on discharge.
Analgesia and nasal decongestant spray will be prescribed on discharge. You will be reviewed in clinic and the wounds checked at a week. You should avoid strenuous exercise for the first 2-3 weeks and avoid bending and stooping. Your nose will be taped for 2-3 weeks after your splint is removed. You will be able to resume light exercises after a week and normal exercise by 4-6 weeks. If you have any problems following your procedure please contact the hospital(anytime) or Mr. Wilson’s secretary(in hours).
