Rhinoplasty (Nose Job)

Rhinoplasty surgery is performed to change the shape of the nose. It is also known as a nose job and may be performed by plastic surgeons, ENT surgeons (also known as otolaryngologists) and facial plastic surgeons. It may be performed as a procedure by itself or in combination with other procedures such as a septoplasty and/or turbinoplasty to help with improving nasal obstruction or a mentoplasty to help balance the shape of the nose with the remainder of the face.  Rhinoplasty surgery is more often a collection of many smaller nose operations and techniques grouped together and called a rhinoplasty and is one of the most difficult and challenging operations performed by surgeons. 

What are the reasons to have a rhinoplasty?

A rhinoplasty may be performed for either cosmetic, functional or both functional and cosmetic reasons.

Cosmetic rhinoplasty

A rhinoplasty can change the shape of a nose to make it smaller and is termed a reduction rhinoplasty, to increase the size and structure of the nose which is termed an augmentation rhinoplasty or to refine the direction or shape of the nose either from a front on, side view or a view from looking below or above the nose.

Reduction rhinoplasty is typically undertaken for noses that have a bump (termed a dorsal hump) on a side view, overly broad noses or nose that are over projected.

Augmentation rhinoplasty uses a variety of grafts and techniques. They are typically performed on noses that have lost parts of their structure due to injuries, previous operations, infections and rarely malignancies. They are also carried out on people whose nose is too small in relation to their face. Especially in the case of previous injuries, a septoplasty may also need to performed at the same time.

Refinement rhinoplasty may not need removal or replacement of the tissue structure of the nose but in some aspects can be considered to be more challenging procedures to reshape the nose. For example, if the tip of the nose is drooping or asymmetrical. 

Functional rhinoplasty

In some individuals, the external shape and support structure of the nose may be causing a sensation of a blocked nose. The feeling of nasal blockage may affect one or both nasal passages. Occasionally, these cases may benefit from an augmentation rhinoplasty or a reduction rhinoplasty dependant upon the shape of the nose and its supporting elements. However, nasal blockage may also be due to deviations of the nasal septum which needs to addressed through a septoplasty operation or increased swelling of structures called the nasal turbinates the size of which can be reduced through a turbinoplasty procedure. These operations may be undertaken together with the rhinoplasty.

Revision rhinoplasty

Revision rhinoplasty can be undertaken for noses that are not satisfactory from a cosmetic and/or functional perspective. These cases are amongst the most challenging of rhinoplasty operations as the tissue and structures that make up the nose can be very scarred or absent. In these cases grafts are typically required. These grafts are usually made of cartilage but occasionally bone. They are best taken from any residual nasal septum further back in the nose but can also be taken from the ear or rib. 

Structural rhinoplasty

A variety of techniques may be used to achieve the desired result in a rhinoplasty procedure. However, while removal of structures is one method utilised to change nasal shape and function, Dr Michael favours a methodology termed structural rhinoplasty. This involves minimising the degree of removal of nasal tissue and instead reshaping and supporting nasal structures. Although this approach may take longer than other rhinoplasty techniques, it aims to improve longer-term outcomes of rhinoplasty surgery from both functional and aesthetic perspectives.

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