Nose augmentation
What is it?
Nasal augmentation / tiplasty is reshaping of the nose to achieve a natural appearance. The problem may have been present from birth or have been the result of trauma or previous surgery.
The operation
The operation is usually performed under general anaesthesia.
Depending on the exact type of surgery to be performed, it may be necessary to take some spare cartilage from the ear (the gristly hard part under the skin) in order to build up areas of the nose that may be deficient.
The operation will last between one to two hours depending on the extent of surgery to be performed.
Any alternatives?
Some minor deformities of the nose may be helped by injections beneath the skin (subcutaneous) but more lasting results require surgery.
Some of the nasal bridge problems may be disguised by wearing glasses but no external prosthesis will adequately disguise nasal deformities.
Before the operation
Your surgeon will assess the type of surgery that needs to be performed and will give advice about your pre-operative medication.
It is useful to avoid smoking and stop taking any aspirin or tablets containing aspirin for a week before the operation. This helps to prevent bleeding during and after surgery.
Your surgeon will assess if there is problems with the internal area of the nose. It may be necessary to remove some of the middle cartilage of the nose at the time of surgery to improve the airway. This is called a septoplasty.
If you know that you have problems with your blood pressure, your heart, or your lungs, ask your family doctor to check that these are under control.
Check the hospital's advice about taking the Pill or hormone replacement therapy (HRT). Check you have a relative or friend who can come with you to the hospital, take you home, and look after you for the first few days after the operation. Bring all your tablets and medicines with you to the hospital.
On the ward, you will be checked for past illnesses and will have special tests, to make sure that you are well prepared and that you can have the operation as safely as possible.
You will have the operation explained to you and will be asked to fill in an operation consent form.
Before you sign the consent form, make sure that you fully understand all the information that was given to you regarding your health problems, the possible and proposed treatments and any potential risks. Feel free to ask more questions if things are not entirely clear.
Any tissues that are removed during the operation will be sent for tests to help plan the appropriate treatment. Any remaining tissue that is left over after the tests will be discarded.
Before the operation and as part of the consent process, you may be asked to give permission for any ’left over’ pieces to be used for medical research that have been approved by the hospital. It is entirely up to you to allow this or not.
Many hospitals now run special preadmission clinics, where you visit a week or so before the operation, where these checks will be made.
After – in hospital
You are likely to have a protective splint over your nose, which will stay on for between a week and ten days.
If it has been necessary to take cartilage or skin from your ear, you may also have a bandage around your ear.
You may well have a blocked nose because of the surgery and also because of the use of packs in the nostrils, which may be required to support the new shape of the nose. If the surgery is to the tip of the nose only, packs may not be required.
If the surgery is of a delicate nature, not involving the bones, an external plaster splint may also not be required.
After the surgery the nurse will take your pulse, blood pressure and temperature and check that there is no excessive bleeding. It is likely that your face will be bruised afterwards and you may develop black eyes. The bruising will take two to three weeks to resolve.
If you have packs they are usually removed twenty-four hours following surgery at which time minor amounts of bleeding can occur.
Painkilling tablets are usually sufficient but injections may very occasionally be required.
You will be nursed in a semi-upright position and should avoid stooping, straining, bending and coughing if possible.
You should also not blow your nose after surgery as this can cause bleeding.
Gentle sniffing is usually enough to clear the airways. You will probably notice however that there is swelling inside and you may have a feeling of a blocked nose for two to three weeks following surgery. In some situations it can take longer to resolve.
After – at home
Depending on the exact amount of surgery that was required, the type of protective bandaging over the nose may vary from a plaster type splint to only some paper stitches.
Again depending on the extent of surgery that was required on the inside of the nose, the nose may be blocked. This can last for two to three weeks following surgery.
Your doctor will have advised you on how to avoid doing activties which can cause exertions such as stooping, straining or bending for a few weeks following surgery.
Possible complications
As with any operation under general anaesthetic there is a very small risk of complications related to your heart or your lungs.
The tests that you will have before the operation will ensure that you can have the operation in the safest possible way and will bring the risk for such complications very close to zero.
Surgery for tiplasty or nose augmentation should be avoided in people who a have a cough, colds or have evidence of infection in and around the nose at the time of the surgery.
Bleeding does occur during surgery but this is usually stopped on return to the ward. Occasionally it can occur again while the patient is in hospital and this may necessitate a return to theatre.
Should any infection intervene at the time following surgery this is another cause of bleeding. This tends to occur between seven and ten days following surgery. It may necessitate packing of the nose and very occasionally a return to theatre.
If infection happens (is not common but is does happen) you will need to take antibiotic tablets for one to two weeks.
If the infection is more serious, you will need to come back to hospital and have it treated with intravenous antibiotics – through a small plastic tube placed in a vein in your arm.
Due to the narrowness of the nasal passageways, swelling after surgery causes them to become even narrow. This can cause some difficulty with breathing which can take a few months to settle.
Removal of some of the cartilage in the centre of the nose may be performed at the time of tiplasty in order to improve the nasal airways.
Examination of the nose prior to surgery would indicate whether this was necessary. This would be discussed with your surgeon prior to the operation.
Minor irregularities over the tip of the nose can occur following tiplasty type procedures. These may become apparent and in a small number of cases, need surgical correction at a later date. This can be performed when the swelling following surgery has returned to normal. These minor irregularities may be less noticeable in those who have thick-skinned noses.
Some patients also find that they may have an altered smell after the surgery.
General advice
Depending on the extent of surgery the swelling after augmentation/tiplasty depends on the extent of the surgical procedure.
Surgery to the tip of the nose itself may produce minimal swelling. However extensive surgery involving the bones of the nose may produce significant swelling, cause bruising to last for a few weeks following surgery.
The exact end result can depend on the quality of the tissue and occasionally there are minor irregularities underneath the skin that may become apparent when the swelling resolves. On occasion these irregularities may benefit from re-operation.
Nasal augmentation / tiplasty is reshaping of the nose to achieve a natural appearance. The problem may have been present from birth or have been the result of trauma or previous surgery.
The operation
The operation is usually performed under general anaesthesia.
Depending on the exact type of surgery to be performed, it may be necessary to take some spare cartilage from the ear (the gristly hard part under the skin) in order to build up areas of the nose that may be deficient.
The operation will last between one to two hours depending on the extent of surgery to be performed.
Any alternatives?
Some minor deformities of the nose may be helped by injections beneath the skin (subcutaneous) but more lasting results require surgery.
Some of the nasal bridge problems may be disguised by wearing glasses but no external prosthesis will adequately disguise nasal deformities.
Before the operation
Your surgeon will assess the type of surgery that needs to be performed and will give advice about your pre-operative medication.
It is useful to avoid smoking and stop taking any aspirin or tablets containing aspirin for a week before the operation. This helps to prevent bleeding during and after surgery.
Your surgeon will assess if there is problems with the internal area of the nose. It may be necessary to remove some of the middle cartilage of the nose at the time of surgery to improve the airway. This is called a septoplasty.
If you know that you have problems with your blood pressure, your heart, or your lungs, ask your family doctor to check that these are under control.
Check the hospital's advice about taking the Pill or hormone replacement therapy (HRT). Check you have a relative or friend who can come with you to the hospital, take you home, and look after you for the first few days after the operation. Bring all your tablets and medicines with you to the hospital.
On the ward, you will be checked for past illnesses and will have special tests, to make sure that you are well prepared and that you can have the operation as safely as possible.
You will have the operation explained to you and will be asked to fill in an operation consent form.
Before you sign the consent form, make sure that you fully understand all the information that was given to you regarding your health problems, the possible and proposed treatments and any potential risks. Feel free to ask more questions if things are not entirely clear.
Any tissues that are removed during the operation will be sent for tests to help plan the appropriate treatment. Any remaining tissue that is left over after the tests will be discarded.
Before the operation and as part of the consent process, you may be asked to give permission for any ’left over’ pieces to be used for medical research that have been approved by the hospital. It is entirely up to you to allow this or not.
Many hospitals now run special preadmission clinics, where you visit a week or so before the operation, where these checks will be made.
After – in hospital
You are likely to have a protective splint over your nose, which will stay on for between a week and ten days.
If it has been necessary to take cartilage or skin from your ear, you may also have a bandage around your ear.
You may well have a blocked nose because of the surgery and also because of the use of packs in the nostrils, which may be required to support the new shape of the nose. If the surgery is to the tip of the nose only, packs may not be required.
If the surgery is of a delicate nature, not involving the bones, an external plaster splint may also not be required.
After the surgery the nurse will take your pulse, blood pressure and temperature and check that there is no excessive bleeding. It is likely that your face will be bruised afterwards and you may develop black eyes. The bruising will take two to three weeks to resolve.
If you have packs they are usually removed twenty-four hours following surgery at which time minor amounts of bleeding can occur.
Painkilling tablets are usually sufficient but injections may very occasionally be required.
You will be nursed in a semi-upright position and should avoid stooping, straining, bending and coughing if possible.
You should also not blow your nose after surgery as this can cause bleeding.
Gentle sniffing is usually enough to clear the airways. You will probably notice however that there is swelling inside and you may have a feeling of a blocked nose for two to three weeks following surgery. In some situations it can take longer to resolve.
After – at home
Depending on the exact amount of surgery that was required, the type of protective bandaging over the nose may vary from a plaster type splint to only some paper stitches.
Again depending on the extent of surgery that was required on the inside of the nose, the nose may be blocked. This can last for two to three weeks following surgery.
Your doctor will have advised you on how to avoid doing activties which can cause exertions such as stooping, straining or bending for a few weeks following surgery.
Possible complications
As with any operation under general anaesthetic there is a very small risk of complications related to your heart or your lungs.
The tests that you will have before the operation will ensure that you can have the operation in the safest possible way and will bring the risk for such complications very close to zero.
Surgery for tiplasty or nose augmentation should be avoided in people who a have a cough, colds or have evidence of infection in and around the nose at the time of the surgery.
Bleeding does occur during surgery but this is usually stopped on return to the ward. Occasionally it can occur again while the patient is in hospital and this may necessitate a return to theatre.
Should any infection intervene at the time following surgery this is another cause of bleeding. This tends to occur between seven and ten days following surgery. It may necessitate packing of the nose and very occasionally a return to theatre.
If infection happens (is not common but is does happen) you will need to take antibiotic tablets for one to two weeks.
If the infection is more serious, you will need to come back to hospital and have it treated with intravenous antibiotics – through a small plastic tube placed in a vein in your arm.
Due to the narrowness of the nasal passageways, swelling after surgery causes them to become even narrow. This can cause some difficulty with breathing which can take a few months to settle.
Removal of some of the cartilage in the centre of the nose may be performed at the time of tiplasty in order to improve the nasal airways.
Examination of the nose prior to surgery would indicate whether this was necessary. This would be discussed with your surgeon prior to the operation.
Minor irregularities over the tip of the nose can occur following tiplasty type procedures. These may become apparent and in a small number of cases, need surgical correction at a later date. This can be performed when the swelling following surgery has returned to normal. These minor irregularities may be less noticeable in those who have thick-skinned noses.
Some patients also find that they may have an altered smell after the surgery.
General advice
Depending on the extent of surgery the swelling after augmentation/tiplasty depends on the extent of the surgical procedure.
Surgery to the tip of the nose itself may produce minimal swelling. However extensive surgery involving the bones of the nose may produce significant swelling, cause bruising to last for a few weeks following surgery.
The exact end result can depend on the quality of the tissue and occasionally there are minor irregularities underneath the skin that may become apparent when the swelling resolves. On occasion these irregularities may benefit from re-operation.
