FAQ rhinoplasty

Q. In rhinoplasty, who decides the shape of the nose? The patient or the plastic surgeon?
A. The choice of the shape and the size of the nose is usually made by the plastic surgeon in tune with the patient, trying to respect the appearance of the face and the physical features of the patient as much as possible. For example, if a woman is very tall, it is not appropriate to make an upturned nose, that is with a very high tip because most people, being short or of medium height, would see only her nostrils. Besides, with a man it is preferable to make a straight nose - even if it is a bit larger - rather than a small and snub nose. Sometimes, the surgeon may also propose slight modifications to the chin or the cheekbones, in order to make the face more shapely and well-proportioned.

Q. Can rhinoplasty correct breathing difficulties, too?
A. Yes. If necessary, rhinoplasty can be associated with septoplasty in order to correct the nasal deviation or other breathing difficulties.

Q. How long should I wait before resuming my sports activity?
A. After rhinoplasty surgery, it is advisable not to risk traumas for at least one month, which is the time needed for the completion of the ossification process of the nose.

Q. I would like to go for nose surgery but I don’t know whom I should apply to. How can I choose a good plastic surgeon?
A. Nose contouring surgery is one of the most difficult and complex operations of cosmetic surgery. When this kind of operation is performed by a specialist in plastic surgery, experienced in nose contouring and in qualified facilities, the results are usually very good. In choosing the plastic surgeon, the essential factors are experience, seriousness, skill and aesthetic sense. To this end, it can be useful to enquire about the number of the operations performed by that surgeon, to see the photos of the patients who have undergone surgery with him/her (before and after the operation) and to agree upon the possible modification of the shape, the profile and the appearance of your nose. Such corrections may be displayed through computer processing of digital pictures of your face, although no surgeon will ever assure you hundred per cent that such a specific result will be achieved.

Q. I would like to know if, in rhinoplasty surgery, it is necessary to use swabs and if they are painful.
A. Personally, when performing rhinoplasty, I don’t use internal swabs (which can be very painful when being removed), not even when I have to perform septoplasty together with rhinoplasty. Seldom (in about 2% of the cases) can it be necessary to apply swabs in order to stop an unexpected bleeding.

Q. Is rhinoplasty painful? What kind of anaesthetic is given?
A. Rhinoplasty is not a painful kind of surgery. Some patients say that they felt pain during the operation or when they had the swabs removed. Actually, the operation is definitely painless because it is performed under general anaesthesia (that is, the patient is put to sleep) or under local anaesthesia with sedation (which means that the patient is awake but relaxed and insensitive to pain). Further, I prefer not to use swabs, unless it becomes necessary to stop an unexpected and excessive bleeding.

Q. In what facility can rhinoplasty be performed?
A. Rhinoplasty is normally performed under general anaesthesia with one or two-day hospitalization. Sometimes, very simple kinds of rhinoplasty may be performed under local anaesthesia with sedation (which means that you will be awake but relaxed and insensitive to pain) and in outpatient care.

Q. After rhinoplasty, can the nose be operated on again? And how many times?
A. After nose surgery, it is possible to perform some retouch-jobs, even though the next operations are more and more difficult to do and the cosmetic improvement is less and less sure, especially when it comes to reconstructing a nose which, because of the first operation, has become too small or sunken.

Q. How long must I wait to appear in public?
A. The answer is very personal. Some people don’t worry about going out with band-aids and plasters on their noses (these will be removed 7 days after the operation), while others prefer to wait for the complete disappearance of the puffiness and the haematoma that often occur immediately after the operation and that can persist for about 7-10 days. Anyhow, most patients are already presentable after plaster removal.

Q. When will I be able to wear glasses once again?
A. The use of glasses should be avoided for at least one month. If you can’t wear contact lenses, you’ll have to hold the glasses with your hand, making sure that the frame doesn’t rest on your nose.

Q. After plaster removal, will my nose show its definitive shape or will it still have to stabilize?
A. After plaster removal, the nose will look much puffier and oedematous than it was agreed upon before the operation, especially on the tip. The final shapely result, already observable after the first two weeks, will be definitively achieved about one year after the operation.

Q. I would like to have a nose-piercing. Is it safe? If later I should change my mind, will the hole heal up by itself or will a mark be left?
A. Being a foreign body, a piercing may be the carrier of slight bacterial infections that could damage the subcutaneous tissues and the cartilages of the nose. Once the piercing has been made, a small mark will remain forever which can be corrected under local anaesthetic, but which will leave anyhow an inevitable scar on the nose.

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Prof. Mario Dini
Chairman and Director of Plastic Surgery Dept. - University of Florence
Prof. Mario Dini - Chairman and Director of Plastic Surgery Dept. - University of Florence
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