Rhinoplasty also referred as a nose job, or a nose reshaping surgery is a procedure that reshapes the nose for both cosmetic and functional reasons. As well as correcting nose disharmonies, rhinoplasty can also improve breathing function by correcting nose structural defects. Nose deformities can be present at birth (congenital) or be acquired by trauma, infections, inflammation or tumours. No matter the deformity reason, nose reshaping surgery main goal is reaching a good aesthetic result without compromising or even improving breathing function.
|Local anaesthesia (tip surgery)
General anaesthesia (septum and bone reshaping).
Night Stay or Outpatient
|1 night stay is usually required|
|2 weeks to go back to work|
|Sleep facing up with elevated head, rest, use cool compresses across the eyes do not exercise or perform strenuous activities, take antibiotics and pain killers as prescribed.|
Aesthetic Rhinoplasty V Functional Rhinoplasty
An aesthetic Rhinoplasty is mostly performed when a patient wants to improve the appearance of the nose (redefine the tip, improve bumps on the bridge, reduce nose width or wide nostrils and reshape nose structure). The aesthetic rhinoplasty results in a better-looking nose and a more balanced look. A Functional Rhinoplasty is usually performed to correct nasal issues such as septum deviation that cause breathing problems. Following a functional rhinoplasty, you can expect to sleep better (without interruptions) and struggle less with breathing problems. Another set of people seeking Rhinoplasty is those who have had previous nose surgery with poor outcome. In inexperienced hands a Rhinoplasty procedure may have devastating results such as a deviated nose, a saddle nose a collapsing nose and even severe scarring and narrowing of the nostrils. Any patient can choose to combine aesthetic and functional rhinoplasty in the same procedure to improve both nose appearance and function.
Septoplasty is a specific nose surgery technique that corrects a crooked or deviated septum improving breathing function. Septum deviation is usually caused by injury or trauma and it can be present at birth or occur later in life. It can be understood as too big a septum with not enough space to grow and so it gets bent! Septoplasty can straighten the deviated septum and create more open airways for a normal breathing function. If you are unsure whether a rhinoplasty or septoplasty is the right procedure for you, schedule your appointment with Dr. Zia ul Islam who has expert knowledge in facial and nasal surgery. Although the main goal of a septoplasty is correcting crooked or deviated septum, it can also be a useful opportunity to improve the appearance of your nose by combining this surgery with elements of rhinoplasty and improve large or bulbous nasal tips, dorsal humps or other aesthetic concerns.
What changes can I make to my nose?
Nose reshaping is a complex procedure and no two are the same. Each rhinoplasty is tailor-made to each patient´s nose characteristics and desired results. By reshaping nasal structures, rhinoplasty will help you achieve one or more of the following:
- Straighten a crooked nose or deviated septum.
- Straighten a nose with a dorsal hump.
- Improve tip projection.
- Reduce and refine a bulbous nasal tip.
- Reduce the size and narrow a nose.
- Correct or improve impaired breathing.
- Restore symmetry or correct other deformities following injury.
Suitable Noses for Rhinoplasty
Noses come in different shapes and sizes and can be influenced by genetics, ethnic group and other factors. Some people wonder whether their nose is suitable or not for a nose reshaping procedure. Below are the common characteristics often improved through plastic surgery:
Irregular nasal tip: in some people, one side of the nasal tip looks different from the other side (one side smaller or larger than the other, higher or lower or have different shapes). Irregular nasal tip is usually caused by genetics or trauma.
Bulbous rounded tip: this is one of the most common reasons why patients perform rhinoplasty. A bulbous nasal tip is considered a genetic characteristic where the tip is usually round and big and poorly defined.
Nasal tip projection: the nasal tip projection must be assessed in relation to the dorsum and in relation to the overall face proportions. In some cases, there is no projection and cartilage grafts can help to lengthen the tip and increase its projection. In other cases, excessive nasal tip projection can make the nose look bigger than it is. In these cases, the nose bridge can be elevated to make the tip look smaller or the tip can be reduced itself.
Wide nose: wide bone structure will often make your nose look wide and without definition. In order to change the shape of a wide nose and give it a thinner appearance an osteotomy must be performed (make small breaks on the upper bones for a thinner look). If the skin around your nose is very think the plastic surgeon will make it slightly thinner but maybe not as thin as you would like to.
Big nose: if the size of your nose is too large for your face, there is a high change that you can get it very reduced. Most large noses have wide bone structures which make it easy for plastic surgeons to reshape bones for a smaller size nose.
Long nose: a long nose usually looks better from the front but longer from the side. Rhinoplasty can shorten a long nose by reducing the cartilage length, shortening the nasal septum or removing skin from the nose centre.
Nasal Hump: the dorsal hump consists of a mix of both bone and cartilage and can be less or more prominent. Most patients with a prominent dorsal hump desire a flatter and smoother nasal bridge. Dorsal hump reduction will make the dorsal line smoother and straighter by reshaping the bone.
Wide nostrilis: wide nostrilis are most common in certain ethnic groups such as African, Latinos or Asians. Nostrilis reduction involves removing skin and tissue from the base of the nostrilis making them look smaller.
Crooked nose: a crooked nose is a nose that does not follow a straight vertical line to the centre of the face. Nose crookedness can be a genetic or acquired condition and it can vary from mild to more severe. More than being only an aesthetic concern, a crooked nose can affect breathing function.
Nose depressions: a depressed nose usually has an area of depression along the nasal bridge. Nose depressions are usually corrected through cartilage grafts, implants or fillers to fill in the “empty” space. The right technique will depend on the depression severity.
OPEN & CLOSE APPROACH
Types of Rhinoplasty
Rhinoplasty is a highly customized procedure and each patient can require completely different techniques. No matter what the goal is, rhinoplasty techniques will fall under one of the following approaches:
Open Rhinoplasty: open rhinoplasty also referred as external rhinoplasty is performed by making an incision in the columella – the tissue that separates the nostrils. An open rhinoplasty is usually performed with general anaesthesia and will allow the plastic surgeon to have complete access to nasal structures, where he or she can reshape the nasal structures into the desired shape. The main benefit of an open rhinoplasty is the improved accuracy for bone reshaping as it allows for a clearer view.
Closed Rhinoplasty: closed rhinoplasty also referred as endonasal rhinoplasty is usually performed with general anaesthesia by making small incisions inside the nostrils. This approach is often performed in patients that need minor adjustments without drastic bone reshaping required. This is a less invasive procedure and creates no visible scaring.
Tip Plasty: a tip plasty refers to nose tip reshaping procedure. It is a less complex procedure than an open or closed rhinoplasty. Tip plasty is performed under local anaesthesia and it reshapes nasal tip only without affecting nasal structures.
STEP BY STEP
Rhinoplasty – the surgery step by step
Step 1: Markings
Before administrating the anaesthesia, the patient’s nose is marked. Standardized photographs are taken before and after marking.
STEP 2: Anesthesia
Local or general anaesthesia is administered according to the type of nose surgery that will be performed.
Step 3 – Preparation
Skin is disinfected and blue wraps are placed to protect the surgical spot from external environment.
Step 4 – Incisions
According to the rhinoplasty technique, incisions are made in the columella or inside the nose.
Step 5 – Nose reshaping
Nose is reshaped according to what was discussed during the rhinoplasty consultation and whether is an aesthetic or functional correction.
Step 6 – Closing incisions
Once reshaping has been completed, incisions will be closed with tiny stitches.
Step 7 – Checking final results
Final results are checked, and small corrections are made if necessary. Before being taken to the recovery room, patient is woken up, nose splint and bandages are placed.
Rhinoplasty scars are based on the chosen technique – closed or open rhinoplasty. In an open rhinoplasty, incisions are made in the columella (soft tissue between the nostrilis) and in a closed rhinoplasty incision are made inside the nostrils. The appropriate technique for your particular case will be decided following your rhinoplasty consultation with Dr Zia.
It is possible to get a non-surgical nose job?
If a patient only needs minor adjustments, the nose can be reshaped with dermal fillers. By injecting fillers in certain parts of the nose, it is possible to smooth out bumps and improve symmetry and nasal tip appearance. Nose fillers do not substitute a rhinoplasty and do not reshape nasal structures or correct breathing problems. Fillers can also be used after a rhinoplasty to improve minor issues. Whereas a rhinoplasty provides long-lasting results, fillers last between 9 to 12 months.
Rhinoplasty Preparation – Get ready for surgery
As in any other surgery, preparation is important for both surgery and recovery. Take time to get everything ready for the day. Here are some tips on how to prepare for a rhinoplasty:
- Get your medical tests done according to your plastic surgeon indications.
- Speak to your plastic surgeon about any illness or medication you take – you may need some adjustments prior to surgery.
- Stop smoking before and after surgery to promote a good healing process.
- Avoid taking aspirin or anti-inflammatory drugs as they can increase bleeding.
- Prepare to be off work for 2 weeks.
- Organize for someone to pick you up at the clinic as you will not be able to drive.
- Also organize to have someone at home to help you with daily routines (cleaning, driving, looking after the kids, etc).
Tips for a Good Recovery
As with any surgery, rhinoplasty recovery takes some time, but time also depends on the technique used. When you decide to undergo a rhinoplasty, it is important to know what to expect so that you have a smoother and quicker recovery. Here are some tips to speed recovery from nose reshaping surgery:
- Take 2 weeks off work.
- Rest completely during 24 to 48 hours.
- Start light activities as soon as you feel ready (light home cleaning, cooking, going for a walk, etc).
- Sleep on you back with elevated head.
- Do not bend or rube your nose.
- Avoid anti-inflammatory medications.
- Use cold peas around the nose area to reduce swelling.
- Follow post-operative instruction and take prescribed medication.
- Attend your follow-up appointments.
- Splint is removed after two weeks but you still need to take it easy.
- You can go back to strenuous activities after 30/45 days.
Rhinoplasty results - What to expect?
An attractive face is about balance and proportion so having a nose shape/size that blends well with your face features will provide a better overall appearance. Immediately after surgery you will have bruising and swelling so you don’t need to worry if you don’t see much difference. After initial swelling and bruising dissipates, you will start seeing results (usually after 4 weeks). It is normal to have residual swelling for up to one year so your nose appearance will continue to improve during months following surgery. If you have performed a functional rhinoplasty you will experience improvement on quality of life as you will be able to breath and sleep better.
Rhinoplasty risks and complications
Although unlikely, as in any other surgery rhinoplasty also involves risks but is very important to weigh them up against the benefits. The most common complications associated with rhinoplasty are anesthesia risks, bleeding, bruising and pain, healing problems, scars, infection, asymmetry, sensitivity changes and altered sense of smell. During your rhinoplasty consultation with Dr. Zia, surgery risks will be discussed in detail and you can ask all your questions.
Price of a Rhinoplasty in Karachi
Nose reshaping surgery is a complex procedure and no two are the same, prices will vary on surgery complexity and surgery time required. However, the price of a rhinoplasty in Karachi starts at Rs 175.000- includes medical and nursing fees, the cost of the surgery room and It also includes other costs, such as medical examinations, medication, follow-up consultations and splint. The exact price of your rhinoplasty will be confirmed following your medical consultation with Dr Zia. To schedule your rhinoplasty consultation in Karachi or for more information on prices and conditions, please contact us today on the following numbers:
- Aga Khan Hospital: +92 21 111 911 911
- Cooper Consultants Clinic: +92 21 35 37 0671 4
Why choose Dr Zia ul Islam for my Rhinoplasty?
Dr Zia is a qualified and experienced plastic surgeon from Karachi with over 10 years of experience in performing nose reshaping surgeries – aesthetic and functional approach. Not all plastic surgeons perform nose surgeries. Rhinoplasty is a complex procedure that requires knowledge, experience and attention to detail to achieve good results.
- Zia routinely performs nose reshaping procedures – aesthetic and functional.
- Proven results by before and after gallery.
- Top rated rhinoplasty plastic surgeon in Karachi.
- Performs rhinoplasties in state of art clinics in Karachi with all the safety conditions for his patients such as Aga Khan Hospital and Cooper Clinic.
SCHEDULE YOUR RHINOPLASTY
APPOINTMENT IN KARACHI
Aga Khan Hospital
+92 21 111 911 911
Cooper Consultants Clinic
+92 21 35 37 0671 4
If you have decided on performing your Rhinoplasty surgery in Karachi or you simply want to learn more about the procedure, please schedule your appointment with Dr. Zia.
Rhinoplasty – Frequently Asked Questions
What is the biggest limitation of rhinoplasty?
The biggest limitation is thick/dense skin because it’s difficult to make it thinner (almost impossible). It is possible to reduce big or wide noses and improve bulbous tips, but it is very difficult to shrink skin. It is very important to manage patient´s expectation before surgery to avoid disappointment.
Will I need touch-ups after surgery?
Because rhinoplasty is a complex procedure and it may take up to a year to see final results there is a chance you may need minor adjustments.
What are the alternatives to rhinoplasty?
The only alternative to rhinoplasty is nose fillers (non-surgical rhinoplasty). However, this is a non-invasive procedure that can only improve minor issues and will not change your nasal structure or improve breathing function. Drastic changes are only possible with surgical methods. While rhinoplasty results are permanent, nose filler only last for 9 to 12 months.
It is possible to have a nose surgery without that fake look?
Certainly yes. Dr Zia´s goal is to improve your nose appearance respecting your other facial features. Your “new nose” will appear untouched and will blend well in your face to bring harmony and proportion.
Will there be nasal packing?
Dr. Zia carefully closes incisions with a few stitches in the columella – removed after a few days. Nasal packs are put in to minimize blood collection and swelling in the operated area. They are removed on the morning after surgery. Stitches will also be present at cartilage donor sites if applicable.
Will I bruise after surgery?
Bruising is common after a rhinoplasty, but it mainly depends on techniques and type of skin. Thin and fair skins usually bruise easier. There is increased risk of bruising in smokers and patients on blood thinners. Most bruising resolves after 10 days.
Are there any age restrictions for undergoing rhinoplasty?
There are no age restrictions but it´s advisable to wait until the nose complete its growth. For girls this usually happens at 15 and for boys a bit later. Some times the deformity is so obvious that it interferes with the child’s social growth. In such cases it is advisable to correct the deformity at whatever age the child presents. Each patient is different and there is no standard answer.
Are there scars after rhinoplasty?
As in any other surgery rhinoplasty involves scars. On closed approach incisions are made inside the nose which will make scars invisible. For the open approach scar will be located at the columella – soft tissue between the nostrils. At an early stage the scar will look pink, but it will get better and fade away with time. However, genetics play a big role in healing and scaring so we cannot predict exactly how your scar will look.
Is there much pain with rhinoplasty?
Most patients experience discomfort as they can´t breathe through the nose for a few days. Mild pain can also be experienced but it can easy be controlled with prescribed medicines.
When can I start exercising?
You can start with light activities and walks after 2 days but you must wait 4 weeks to perform strenuous activities.
Can you fix my nose if I already had a rhinoplasty and not happy with the results?
Revision rhinoplasty is the process of improving aesthetics and function of a nose that has already been done. Revision surgeries are usually more complex than first time rhinoplasty. The first step is evaluating what has been done is the past and design a rhinoplasty plan that suits your needs. Dr Zia frequently performs revision rhinoplasties after surgeries done elsewhere.
What is an ethnic rhinoplasty?
Ethnic rhinoplasty is a term used to describe rhinoplasty procedures on non-Caucasian patients. Each ethnic group has different nasal proportions and characteristics and the goal of a nose reshaping surgery is not to drastically change the appearance. The current trend is improving features and proportion while maintaining the ethnic look.
Note: Dr Ziaul Islam is doing research on the nasal shape and proportions in the Pakistan population. He strongly believes that a nose should blend in with the local culture and the perception of beauty among the local population. The results of this extensive research will be published soon.