Is Nose Surgery The Most Complex Cosmetic Procedure?

Of all the surgical procedures performed by plastic surgeons, a rhinoplasty (or nose job, nose surgery) is most likely the most complex. A nose reshaping operation can be implemented with all the surgical incisions on the inside or with some on the skin; the operation can be performed with or without using cartilage or bone grafts; it can be performed for breathing difficulties and can also be carried out completely non-surgically using injections of skin fillers to fill out some of the nose skin to hide minor imperfections in the nose.

Assessment Before Nose Surgery
A full assessment of the nose is carried out before rhinoplasty surgery. You will need to say what you would like to achieve and what you do not like about your nose. It is quite important to be very clear about this, because there is so much we can do on a nose, and being very specific is important to the surgeon. Your surgeon will ask you about your physical health and whether you have any previous relevant concerns with your nose (operations, injuries, breathing difficulties, and so on). The review involves looking and feeling the nose internally and externally along with a breathing assessment. Your rhinoplasty surgeon will also have a look at the skin of the nose and will assess the size and shape of the rest of your face. Most people are looking for a nose that is in consistency with the face. If, for example, the chin is too small, this may give the nose an apparently prominent appearance in the face. In some cases, additional cosmetic work may be recommended.

How Does Nose Surgery Work?
To do a rhinoplasty, we need to get access to the cartilages and bones that form the structural framework of the nose. Together, the cartilages and bones form the skeletal support of the nose, and nose job surgery changes these structures. Your skin then re drapes across the new skeletal framework. A "closed rhinoplasty" is one in which the incisions are made on the inside of the nostril, and an "open rhinoplasty" is one in which a small incision is made in the skin under the tip of the nose which separates the two nostrils. Some nose reshaping surgeons do more open rhinoplasties as they feel they can predict the final outcome more readily, but other surgeons do more closed rhinoplasties as the final result is achieved with less swelling and a shorter recovery period in a procedure that already has a notoriously long recovery period before the final results are seen. Usually, the nose requires a plaster on it for a week or so, and have a couple of packs inserted to prevent nose bleeds for a day or so.

Expected and Unexpected Results
Although the final results are not seen for at least a year after nose job surgery, there are some things we expect during the rehabilitation and some things we hope not to see. Of course, we expect a change in the look of the nose; we want this to be your expected outcome, but everyone needs to be realistic about the specificsize and shape of the final result. Most of the time we cannot give a patient the ideal nose they have pictured in their mind as their perfect nose. We are looking for improvement rather than idealism. Some of the after effects we hope not to see include things like infections, abnormal bleeding and swelling, over and under-correction, cartilages and bones moving after they have been set in a particular position, asymmetry, healing problems and breathing difficulties. Occasionally, the final results of any nose surgery do require further surgery. And remember, your nose actually doesn't stop to grow throughout your life so it will change shape as the years go by.

Conclusion
With all the complexities and intricacies involved in nose surgery, it is most likely one of the most challenging plastic surgery procedures to do well. Most nose surgery surgeons will be happy with a patient who makes a considered judgement about whether to go ahead with surgery. If a surgeon charges for the consultation then it is a small amount in comparison to the cost of surgery, so don't let that put you off making an informed decision.