Rhinoplasty

RHINOPLASTY | QUESTIONS AND ANSWERS

• What is a rhinoplasty?
  A rhinoplasty is aesthetic surgery of the nose. Patients’ complaints may be above all functional, as in the case of nasal obstruction. Their request may also be motivated by purely aesthetic considerations, such as a bump, deviation of the nasal pyramid, and a tip that is too thick or dropping. Most frequently, a combination of both reasons is involved. The base of the nose consists of an osteo-cartilaginous framework. A rhinoplasty only intervenes on the base and never touches the skin (except for a nostrilplasty to reduce the size of the nasal orifices). The surgeon will remodel the osteo-cartilaginous framework to achieve the desired nose shape. The skin then shapes over this to give the nose its final form.
• Is this painful?
  A rhinoplasty is not a painful intervention. The nose is immobilized in a plaster cast, which causes discomfort rather than real pain.
• General or local anaesthetic?
  A rhinoplasty can only be done under general anaesthetic.
• When should the plaster cast be removed?
  In most cases, the plaster cast is removed 7 days after the intervention. In some cases (especially for cartilage grafts), the plaster cast can remain for up to 15 days.
• How long does it take to obtain the definitive result?
  The eyes are swollen for about 10 days, with haematomata and ecchymoses disappearing in 2-3 weeks. The final result is partially achieved and you can start socializing again. The swelling will subside somewhat sporadically over several weeks. The bone fractures take 6 weeks to consolidate, although nothing can move during this period except in the event of trauma. It takes quite a long time for the skin to retract and the nasal tip to soften, which explains why the final result is only obtained after 6 months to 1 year.
• Can you ‘choose’ your new nose?
  Surgeons must be attentive to the expectations, desires and apprehensions of patients’ requests. Nevertheless, not everything is feasible and it is important for surgeons to fully explain what the outcome of their intervention will be. Otherwise patients will be very disappointed and frustrated. Computer simulation can create typical examples, but these do not always reflect future reality. If patients are informed clearly and honestly, there is no reason for them to be disappointed.
• Can you see that a rhinoplasty has been carried out?
  When the plaster cast is removed, patients immediately see their new nose shape. Nevertheless, the nose is ‘harder’ and slightly stiff due to the oedema. The nose’s contours form gradually and it slowly regains mobility. Breathing will also gradually become normal or even improve if this aspect has been corrected. Ultimately, you cannot tell that the final nose has been operated on, even though it has undergone major, obvious transformations.
• Is this intervention covered by state health insurance?
  In some cases of post-traumatic nose and of deviated septum causing nasal obstruction, a surgeon can make a pre-treatment request for state health insurance to help with costs. Patients send this request to the medical advisor of their state health insurance office. Most often, patients will be summoned and examined by this medical advisor, who will decide whether or not to cover the cost.