Rhinoplasty (Nose Job) in India

Rhinoplasty is the surgery used to alter the shape of the nose in order to help you breathe properly or for cosmetic purposes. The upper part of the nose is made of bone, while the lower part is made of cartilage. With Rhinoplasty, your surgeon can make changes in your bone, cartilage, skin, or all three at the same time. Your surgeon will evaluate your other facial characteristics, the skin on your nose, and what you want to change while considering rhinoplasty. 

Rhinoplasty can help you in the following ways:

• As a treatment to fix an injury or trauma to your nose
• To treat breathing problems 
• To correct congenital disabilities in the nose
• To change the appearance of your nose

Rhinoplasty can be done for both cosmetic as well as medical reasons. These include:

• Asymmetrical nose
• Nose with a large bridge
• Nostrils that are large or upturned
• Humped or hooked nose
• Inpropotionate nose
• Bulging or drooping nose tips
• A broken nose
• Deviated septum 
• Crooked septum

• Rhinoplasty is a surgery that can be done under general anaesthesia or local anaesthesia. 
• Once you have received the anaesthesia, the surgeon will make minor cuts between or inside your nostrils. 
• The skin is removed and separated from the bone and the cartilage.
• The nose is then reshaped. 
• If the surgeon feels the need to add extra cartilage for shaping your nose, then the cartilage is taken from your ear or deep inside your nose. 
• If you need more cartilage, you may require a bone graft or an implant. 
• After the shape and size of your nose are altered, the surgeon will put the skin back on your nose and stitch the cuts made on your nostrils. 
• The surgery usually takes about one to two hours. It may go on for a longer time if there are any complications.

What to expect before surgery? 

• Your surgeon will write you a prescription with all the basic tests that need to be conducted before your surgery. 
• The tests, along with a general examination, will help decide if you are physically fit for the surgery.
• Your surgeon will refer you to a general physician to confirm physical fitness for surgery.
• Your physician will ask for your medical history and results of all the tests and then provide you with a fitness certificate.
• The surgeon will fix a date for your surgery based on this certificate. 
• Inform your surgeon if you are under certain medicines, like blood thinners (e.g. warfarin, clopidogrel; or painkillers like aspirin, ibuprofen, and naproxen). To avoid complications, stop taking these medicines at least two weeks before surgery.
• You will have to fast for at least four hours before surgery. This means that you cannot eat or drink anything from four hours before the rhinoplasty surgery. 
• If you have any other additional surgery that needs to be done, the surgeon will consider performing that. For example, some people go in for chin augmentation surgery. In such cases, your surgeon will do both surgeries together. 
• If you are a smoker, your doctor will ask you to stop smoking before the surgery.

What to expect on the day of surgery? 

• Once you get admitted, you will need to sign a few forms that include consent for the surgery, any untoward complications during the surgery, and consent to perform emergency care during the surgery in case of any complications. 
• Your family member is also asked to sign the form to provide their consent.
• You will be asked to remove your clothes, jewellery, dentures, and other accessories, if any, before your surgery. 

What to expect during surgery? 

• The surgeon will ask you to lie down on your back and add IV lines for receiving fluids and medicine during the procedure. 
• Once you are in the set position, the anaesthesiologist will give you the anaesthesia that has been decided.
• Based on the anaesthesia you receive, you will be awake (local anaesthesia) or unconscious (general anaesthesia) during the procedure. 
• The surgical site is then cleaned with spirit and betadine and then draped with an aseptic cloth to be ready for the surgeon.
• Your blood pressure, pulse, and respiratory rate are measured throughout the procedure. 
• The surgeon will make the necessary cuts and changes to your nose and add the bone grafts if needed.
• After the surgery, the surgeon will stitch the incisions and cover your nose with adequate dressing.

1. After the surgery, you will be taken to the recovery room for observation.
2. The surgeon will monitor for post-surgical complications, wearing off of anaesthesia effects, and your vitals. 
3. You will be made to rest in bed with your head raised higher than your chest level. This helps reduce the bleeding and the swelling.
4. Your nose may feel congested due to the surgery and the swelling.
5. The internal dressings and splints will remain for seven days after the surgery. This is to protect and support your nose. 
6. Mild bleeding and drainage of mucus from your nose may be common for a few days after the surgery. The surgeon may place a ‘drip pad’ to absorb all the drainage. This is a small gauze piece that is held with tape under your nose. 
7. The ‘drip pad’ is changed as directed by your doctor. Do not place it tightly against your nose. 
8. Post-surgery, your doctor will advise the following:

• Avoid activities like jogging, running, aerobics.
• Do not take a shower. Bathe yourself below your neck to avoid the bandages from getting wet. 
• Do not blow your nose or touch your nose.
• Drink plenty of water to improve your bowel movement.
• Eat high-fibre foods to improve bowel movement and avoid constipation. 
• Avoid smiling, laughing, or any other extreme facial expressions.
• Gently brush your teeth to reduce the movement of your upper lip.
• Do not wear pull-on clothing like t-shirts or sweaters that must be worn over your head.
• Avoid wearing your glasses for at least four weeks after the surgery to prevent any pressure on your nose. 
• Resume the medication you stopped before surgery only after checking with your doctor.
• Do not put ice or cold packs on your nose after the surgery.

First follow-up appointment 

The first follow-up is due in about seven to ten days post-surgery.

If you have any of the following complaints, visit your surgeon earlier.

1. Persistent pain
2. Bleeding
3. Inability to breathe
4. Infections
5. Fever with chills

If you experience any symptoms following the rhinoplasty surgery, you must consult your doctor immediately:

1. Bleeding 
2. Infection
3. Difficulty in breathing through your nose
4. Persistent pain around your nose
5. Discoloration or swelling around your nose
6. Permanent numbness in and around your nose
7. Your nose looks uneven or feels weird
8. Scarring around the surgical site
9. Septal perforation – a hole in the septum