Rhinoplasty is normally undertaken under a general anesthetic and usually takes between 1.5 and 3 hours. Patients normally stay in hospital 1 night. The surgery may be performed in one of 2 ways, closed or open technique.
The closed technique involves incisions inside the nose only and the surgeon gains access to the nasal anatomy directly through these. As there are no external incisions no scars remain.
The open technique involves a small incision on the columella (the tissue between the nasal openings) which extends inside the nose. It provides excellent exposure of the nasal anatomy and for this reason some surgeons argue it gives better control of the outcome of rhinoplasty, especially in difficult cases. The incision usually heals very well and is often difficult to detect a few months after surgery.
With either approach, further procedures may then be used depending on the nasal abnormality to be corrected. Nasal humps may be removed or crooked anatomy corrected. A wide nasal bridge may also be narrowed. Saddling or depressions in the nose may be corrected with cartilage grafts taken from inside the nose, or less commonly the ear. The nasal tip can be refined or elevated to a more pleasing position.
In some rhinoplasties narrowing the nose may reduce the size of the nasal airway internally. Septoplasty and turbinate reduction surgery (link below) will be performed in these cases to maintain or improve the nasal airway and can be performed with both the closed and open techniques.
At the end of the surgery the nose is dressed carefully to minimise swelling and a splint applied to help maintain the final shape. The nose may require a gentle nasal pack to minimise any bleeding. If a pack is required it will be removed the day following surgery prior to leaving the hospital. Dr Semple will remove the splint and nasal dressing one week following surgery.