Mr John Marshall - Consultant Otolaryngologist
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Many people would like to improve the appearance of their nose. Common concerns include:
This leads some people to consider an operation to improve the appearance. This operation is called rhinoplasty, cosmetic rhinoplasty, nose-reshaping or “nose-job”. These all have the same meaning, but the operation is tailored to address to the underlying problem. As well as dissatisfaction with the appearance, there may be other problems with the nose such as blockage, congestion, facial pain, sinus problems and snoring. No two noses are the same. In suitable cases, rhinoplasty is an excellent operation which can improve the appearance of your nose. It may help improve other problems at the same time. Sometimes problems can be due to previous injury, but often this is not the case. Rhinoplasty is not for everyone and sometimes a person’s wishes cannot be achieved in which case surgery is best avoided. Whilst this may be disappointing at the time, it is much better than undergoing surgery with unrealistic aims. If you are considering rhinoplasty, I will be happy to see you for a consultation to discuss your concerns and aims.
During an unhurried pre-operative assessment a person’s concerns about their nose are discussed fully in a relaxed and confidential environment. The nose is examined and any problems are discussed. Examination includes an assessment of the inside of the nose including inspection of the nasal septum and turbinates. Surgery is only considered if the aims of surgery are realistic and achievable. Often a second consultation is arranged to ensure that both surgeon and patient are happy with the aims of surgery and what will be involved. Failure to take the internal nasal structure into account is one of the reasons for unsatisfactory outcomes in rhinoplasty. As an ENT surgeon specialising in rhinoplasty, I am fully trained to consider the external and internal factors that may affect rhinoplasty outcome. Searching the internet for information about rhinoplasty can be confusing and you may come across some words that aren’t fully explained. Here is a short glossary: Rhinoplasty. Surgery in which the appearance of the nose is altered. Also called “nose-reshaping”, “cosmetic rhinoplasty” and “nose job”. Septoplasty. An operation to straighten the nasal septum. Nasal Septum. The vertical partition that divides the nose into two halves. Columella. The bridge of skin that separates the nostrils. Septo-rhinoplasty. A rhinoplasty which includes some adjustment to the nasal septum. External rhinoplasty. (also called ‘Open Rhinoplasty’) Rhinoplasty involving a small incision at the base of the nose, often used for good access to the tip of the nose during surgery. Tip-plasty. A rhinoplasty that focuses on the tip of the nose. Turbinates. These are bony structures with a fleshy lining that we all have inside the nose. They help to warm and moisten the air we breathe in, but can cause nasal blockage if enlarged. They can be easily reduced in size if required during rhinoplasty surgery. Revision rhinoplasty. Rhinoplasty performed in someone who has had one or more previous rhinoplasty operations or other nasal surgery. Such surgery is more challenging for a number of reasons but in selected cases can be effective. This is also sometimes called ‘secondary rhinoplasty’.