After the detailed consultation process which has resulted in a clear understanding of your goals, the next stage is the rhinoplasty operation itself.
As rhinoplasty is a highly delicate and skilled operation, it’s normal for patients to feel a little apprehensive. Mr Rowe-Jones’s aim with his hospital team is to make you feel safe and confident throughout your journey which is why he and his Consultant Anaesthetist will see you in your room before your operation to review what will happen.
In the anaesthetic room itself, Mr Rowe-Jones’s calm and reassuring team will ensure you’re feeling relaxed and comfortable, as the general anaesthetic takes effect. Once you are asleep, the operation typically takes around two and a half to three hours – although this can of course vary depending on the complexity of your nasal anatomy and the results Mr Rowe-Jones is aiming for.
You will have a small, light dressing or cast over your nasal bridge and you may have some very fine, dissolvable stitches in the skin between your nostrils. The anaesthetist will administer painkillers before you wake and Mr Rowe-Jones aims to avoid routinely putting packing in your nose so you are able to breathe easily.
In some cases, patients are able to return home the same day, other cases may call for an overnight stay. Before your discharge home Mr Rowe-Jones will have explained how your operation went, and made sure that everything is in order before you go home. You will be given detailed and careful guidance about aftercare, and information about seeing you to check on the healing process.
This approach is generally used by Mr Rowe-Jones for less complex operations on the nose or small revision refinements. Cuts are placed inside the nose where they cannot be seen. Through a combination of looking and feeling, the rhinoplasty surgeon’s skill enables him to make appropriate changes to the bone and cartilage under the skin of the nose.
Open approach rhinoplasty
Open approach surgery allows a greater view of the internal structures of the nose and gives Mr Rowe-Jones what he believes is greater precision in surgery, enabling us to undertake more complex surgery. In addition to the cuts just inside the nostrils (which cannot be seen), a small incision is made across the skin between the nostrils. This allows better internal access to the nose.
This surgery results in making the patient’s nose smaller. The following outlines classic, traditional steps in the reduction rhinoplasty approach. Mr Rowe-Jones modifies these steps when he is making the nose smaller as part of performing a more contemporary, sophisticated procedure.
When the bump has been removed, the bridge or roof of the nose is flat, wide and ‘open’ as if the ridge tiles have been removed from the roof of a building. The bony bridge of the nose is then very carefully examined for little irregularities to smooth off using ultrasonic rhinoplasty. The hump that has been removed from the nasal bridge is part cartilage from the top of the nasal septum and the upper lateral cartilages – and part bone, from the nasal bones.
The bones are then broken and brought together to close the roof where the bump was removed. The nasal tip cartilages are made smaller by removing very small strips from their upper edges and are made less bulbous by reshaping them with stitches or grafts. Mr Rowe-Jones is using and pioneering the latest technological advances to increase accuracy and predictability and lower risk in reduction rhinoplasty. He is using powered instruments to remove bone and sculpt bone rather than using chisels and bigger manual rasps. Mr Rowe-Jones uses vibrating crystal piezo technology sometimes with small diamond tips, to sculpt and to cut bone – this is called piezo rhinoplasty or ultrasonic rhinoplasty.
For more information, please see our information on Types of Cosmetic Rhinoplasty.
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