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What Is A Rhinoplasty?

A rhinoplasty procedure reshapes, corrects or reconstructs the nose to achieve more aesthetically pleasing proportions and to enhance ones' physical appearance.

The nose develops its final shape only after puberty and this development is complete by the age of 16. This determines the earliest age at which one can reasonably carry out a rhinoplasty.

Whilst this is most commonly carried out for aesthetic reasons, a nose job can also be performed as a procedure to improve function by correcting breathing issues and help alleviate the symptoms of sleep apnoea and snoring. In these cases, one is likely to also be operating on the septum or turbinate which are blocking the airway, otherwise known as a septoplasty or submucosal resection ('SM Resection').

There is also the large group of patients who have suffered injuries to the nose, very often a nasal fracture, playing sport or as a result of physical assault. These are the few patients that medical insurance companies may accept for reimbursement.

Whatever the motivation, our surgical approach is designed to work with a patient's natural features, sculpting the nose to harmonise the face and give a natural-looking result. This requires a delicate balance between the size, shape, contours and definition of the nasal bridge and tip. Nose reshaping requires skill and surgical finesse as millimetres make the difference between a natural-looking result and one that has obvious trademarks of surgery.

A Rhinoplasty, or a 'nose job', is one of the five most common cosmetic surgery procedures in the UK, accounting for roughly 10% of all cosmetic procedures in 2019 alone.

As the central feature of the face, the size and shape of the nose is a key determining factor in how we feel about our overall appearance and attractiveness. If, for whatever reason, you are unhappy with it, a rhinoplasty procedure is the most effective solution to change it.

Our surgeons are leading experts in their field, and via a rhinoplasty procedure, can make your nose smaller, more prominent, slimmer, or wider, or simply smooth away unwanted lumps or bumps.

At A Glance

Rhinoplasty

At A Glance

  • Surgery Time

    1 - 3 hours

  • Exercise Including Gym

    6 weeks

  • Time Off Work

    2 weeks

  • Sexual Activity

    Restricted activity after 4 weeks

  • Hospital Stay

    Day case

  • Full Recovery

    6 - 8 weeks

  • Washing

    Shower fully after 1 day keeping area completely dry

  • Sleeping Position

    Sleeping on back recommended for 4 weeks

  • Reasonably Mobile

    After 48 hours rest

  • Driving

    2 weeks

Before & After
Nose Job Gallery

See what is possible by clicking the button below.

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Patient Stories

"After years of to-ing and fro-ing over my bumpy nose, I decided in 2019 I would take the next step."

Read Alex Green's Story
My Face My Body Awards Finalist 2017 Aesthetics Awards Winner 2017 Highly Commended 2018 My Face My Body Awards Winner 2016

Rhinoplasty Surgeons

We have invited a selection of the country's very best consultants to join us at the Cadogan Clinic so that you can be sure that whatever the nature of your treatment, you will be seeing one of the top practitioners in the country.

Mr. Duncan Atherton

Aesthetic Plastic And Reconstructive Surgeon / GMC: 4728485

Mr Duncan Atherton is a Consultant Plastic Surgeon with a special interest in primary and secondary rhinoplasty, facial plastic surgery and cleft lip and palate surgery....

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Mr. David Gateley

Consultant Plastic And Reconstructive Surgeon / GMC: 2939470

Mr. David Gateley is a Consultant Plastic and Reconstructive Surgeon with a special interest in facial aesthetics, rhinoplasty and complimentary surgical and non-surgical rejuvenation techniques......

See Full Profile

Mr. Naveen Cavale

Plastic, Reconstructive & Cosmetic Surgeon / GMC: 4190952

Mr. Naveen Cavale is a fully qualified and fully accredited UK Plastic Surgeon who graduated from University College London and the Royal College of Surgeons in Edinburgh...

See Full Profile
See all Plastic Surgeons

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Types Of Rhinoplasty Procedure

The nose is supported by a skeleton. In the upper third, it is a bony skeleton and the lower two-thirds are nostrils, flexible cartilage of the same type as we have in the ear. Dividing the two airways running back from the nostrils, we have another sheet of cartilage, covered with mucosa, called the septum. This is a strut which stops the cartilaginous part of the nose from collapsing.

Most operations on a Caucasian nose involve a reduction in size and therefore both the bony and cartilaginous skeleton are reduced, allowing the skin to retract, often without trace of a scar.

An incision is made across the columella (the skin of the central strut of the nose separating the two nostrils. The incision is carried up and around the rim of the nostrils, allowing the skin on the nose to be peeled back. The surgeon then has a direct view of the cartilage, which they can then refashion. This technique is used for the very complicated, difficult and injured nose but is also used exclusively by some surgeons.

The closed rhinoplasty does not have an incision across the skin of the columella between the nostrils, but is carried out through the mucosa of the inside of the nose. The surgeon does not have the direct view of the nasal skeleton and therefore it is a technique for the more experienced surgeon.

A septo-rhinoplasty is commonly done to improve the way you breathe through your nose. This is often done for patients who suffer from a deviated septum. The septum is the cartilage and bone inside your nose that divides the nostrils.

Your surgeon will make an incision in the mucosa (the lining inside your nose), and lift it off the bone and cartilage in order to remove any parts that are bent, putting them into a straight position allowing for clear breathing. This procedure will improve the way you breathe, and the appearance of your nose can be adjusted as well.

Rhino-tip surgery is done to change the shape of the nose by modifying the structure of the underlying cartilage. Most alterations are done from inside the nose so as to minimize any scarring. Your surgeon can create the perfect tip for your nose structure.

Some common cases that patients come in for are:

  • Big Tip: This is a rounded appearance at the tip of the nose, possibly due to thick skin.
  • Crooked Tip: One nostril may appear larger than the other or the nose might be slanted to one side causing an asymmetrical look.
  • Flared Nostrils: When the nostrils are larger and spread farther apart creating an upturned of flat-nose appearance.
  • Hooked Tip: This is when the nose juts out and is overly-long, particularly noticeable on the profile of the patient.

Many patients have noses which are flatter with wider nostrils. In these cases, it is not a question of reducing the skeletal support, but adding to it. The bridge line can be raised by adding a manmade substance or the patient's own bone and cartilage taken from the ear, skull or rib. In each case, the extra tissue is carved to the required shape. Nostrils and nostril floor can be reduced in width by removing a wedge of tissue. The oriental may on occasions need surgery of the upper eyelid, and particularly the inner end where there is often web.

Non-Surgical Or Medical Rhinoplasty

The founder of the Cadogan Clinic, world-renowned plastic surgeon Mr Bryan Mayou, introduced the non-surgical rhinoplasty 30 years ago. In this non-surgical procedure, fillers are injected to alter and shape a person's nose.

Today non-surgical rhinoplasty is a medium-term solution as the filler used - hyaluronic acid – commonly lasts a year, and is therefore not permanent. Some patients prefer to start down the non-surgical route first in order to see the likely result of a long term surgical rhinoplasty, before making the commitment. Others opt for a top-up every year.

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Why Do People Have It?

For many people, both male and female, the size and shape of their nose can cause unhappiness and insecurity. A rhinoplasty, or nose job, can help improve the way we feel about our looks, and increase self confidence and overall levels of happiness.

It can also help improve an array of medical issues, such as correct breathing issues or alleviate the symptoms of sleep apnoea. Whether for cosmetic or medical reasons, a nose job is the most effective and immediate corrective procedure in such instances.

Who Is Suitable

Cadogan Clinic considers individuals fit for the procedure, if all of the following are true of them:

  • Physically and psychologically fit and healthy
  • Bothered by the size or shape of their nose, either for cosmetic or medical reasons
  • Have realistic expectations of what can be achieved by surgery
  • Would like to correct damage or an injury that has occurred to their nose
  • Snore loudly, experience sleep apnoea or have breathing difficulties

Testimonials

The Process

The first step for all of our patients is to meet with the surgeon we feel is best placed to perform your procedure for a consultation.

At the consultation, you will be able to discuss with your surgeon what your hope to achieve from the procedure, as well as discuss in detail what may or may not be possible given the existing structure of your nose. Dependent on which consultant you see, a visualisation of what outcome you can expect will be made via Crysalix 4D imaging technology used at the Clinic to help you visualise this.

After that, several key measurements will be made of your nose, and standard clinical photography will be taken.

Finally, a comprehensive discussion regarding risks and complications will take place, alongside a discussion regarding the post-procedure and recovery phase. Your previous medical history will also be recorded (including previous surgery, medications, allergies etc.) and an assessment of your fitness for surgery.

If your surgeon feels you are a good candidate for surgery, you are then invited to consider whether you would like to proceed for surgery or otherwise following a two-week 'cooling-off' period.

Within this period you are welcome to come in and discuss your potential surgery with your surgeon as many times as you like.

You should expect your consultation to last a full hour, and you should factor coming in at least twice – the second time free of charge – to ensure that both you and your consultant are aligned on your expectations.

Some questions your consultant may ask you include:

  • What is the current state of your overall health?
  • What, if any, pre-existing health conditions do you have?
  • Can you provide a full and comprehensive description of your past medical history?
  • Can you provide a full and comprehensive description of your past surgical history?
  • Please can you provide a list of any medications you currently take, including prescription and over the counter drugs?
  • What is your current weekly level of alcohol consumption, smoking and recreational drug use?
  • Do you have any allergies that we should be aware of?
  • What are your overall goals for surgery?

Some questions you may ask your consultant include:

  • Is a surgical rhinoplasty procedure the right procedure for me?
  • If so, which surgical approach do you recommend as the right one for me?
  • If not, should I opt for a non surgical rhinoplasty alternative?
  • Will there be any pain after the surgery?
  • Will there be any scarring after the surgery and if so, where?
  • What is the recovery process? How long will it take for me to recover from my rhinoplasty?
  • Are my expectations realistic?
  • How many procedures of this type have you done before?
  • Have you got any before and after pictures of rhinoplasties that I can look at?
  • What happens if I am not happy with the results?

If you choose to proceed with surgery, the next time you come into the Clinic after your final consultation will be the day of your procedure.

Before admission the following behavioural changes are recommended / required:

  • In the 6 weeks before your procedure we recommend smoking is discontinued as patients who smoke have a higher risk of healing more slowly and complications
  • In the week before your procedure you must cease taking Aspirin or any medication that contains Aspirin
  • In the 6 hours prior to surgery you must not consume food or any drink, other than small sips of clear fluid (e.g. still water, black coffee, black tea) which are allowed up to 2 hours before admission

On the day of your rhinoplasty procedure we ask that you arrive for your admission an hour before the agreed start time of surgery. At this point a nurse will come and record blood pressure and other relevant vitals, you will meet with your anaesthetist and your surgeon who will make the final mark-ups.

Rhinoplasty itself is straightforward and takes place under general anaesthetic over the course of between one and three hours. A Rhinoplasty can be 'open' or 'closed', dependent on where the incision is placed. Your surgeon will choose an incision site that minimises this scale and visibility of this site.

Following the procedure, you will recover in our ambulatory recovery rooms for between two to three hours. Once our specialist nursing team are happy that your initial recovery is complete and you are safe to return home, you will be allowed to leave the Clinic accompanied by a friend or member of your family.

Once home you will have access to our dedicated oncall nursing team 24 hours a day, 7 days a week. This team of specialists are dedicated to your comfort and pain control, and are there to field any questions you may have in the immediate post operative phase.

A Rhinoplasty is one of the least painful procedures, although it is completely normal to feel that your nose is blocked up due to the swelling that you will experience following the procedure. This should subside after 7 – 10 days, after which you should expect some residual bruising. We advise total rest for several days after treatment, and recommend at least 2 weeks off work to allow adequately for this process. We also recommend avoiding UV light for 2 -4 weeks to aid the scarring process.

We ask that you come in and see our nursing team 1 week after surgery to ensure your incision sites have been properly reviewed. At this juncture we also recommend you meet with one of our on site aestheticians to discuss ongoing treatment to support the healing and scarring process.

You should see your results clearly at the 6 week mark, although on occasion it can take a little longer. We ask that you come in to see your surgeon after 6 weeks for a post procedure for a final check up.

What are the risks

Complications are unlikely. That said, as with all surgery, some complications are possible, please read our FAQ's for more information.

Your surgeon will discuss each of these risks comprehensively at your consultation.

Why come to The Cadogan Clinic for your Rhinoplasty?

What Can I Expect From My Surgery?

Our Surgical Patient Advisor, Ellie, answers our patients most frequently asked questions.

What can I expect from my surgery?

Frequently Asked Questions

Rhinoplasty, or a nose job, is nose surgery designed to address aesthetic and functional issues relating to the variety of different nose shapes.

Nose shapes vary between individuals. Different nose shapes addressed by nose surgery include:

- Large noses, nose tips or nostrils
- Long noses, nose tips or nostrils
- Asymmetrical noses, nose tips or nostrils
- Bridged noses or bumpy noses
- Deviated septums

The nose is the central feature of the face and can define the overall balance of the appearance. Nose surgery is able to address a variety of concerns via the technique’s nose contouring and nose reduction properties.

There are five types of nose operation that we offer at the Cadogan Clinic.

Closed Rhinoplasty - the most common type of nose operation. There are no external scars, as all incisions are done inside the nose. The soft tissues are lifted slightly upward, allowing access to the bone and cartilage. Closed rhinoplasty involves reduced nasal tissue irritation, less detectable scarring, shorter operating times and faster recovery.

Open Rhinoplasty - a more invasive nose operation widely used for patients who need more extensive nose contouring or nose reduction Your surgeon will make incisions in the columella, which is the skin between your nostrils beneath your nose. Following the incisions, the skin is lifted up allowing access inside the nasal cavity for your surgeon to perform reshaping. After the surgery is complete, the columella is sutured and the nose will be secured in place with tape and a splint to keep the nose in place. The splint will keep the nose in place during the healing process and normally will be removed after one week. Open rhinoplasty is excellent for patients with issues such as genetic or structural deformities, trauma to the nose requiring grafting and unsatisfactory results from a previous nose job.

Septo-Rhinoplasty – a septo-rhinoplasty is commonly done to improve the way you breathe through your nose. This is often done for patients who suffer from a deviated septum. The septum is the cartilage and bone inside your nose that divides the nostrils. Your surgeon will make an incision in the mucosa (the lining inside your nose), and lift it off the bone and cartilage in order to remove any parts that are bent, putting them into a straight position allowing for clear breathing. This procedure will improve the way you breathe, and the appearance of your nose can be adjusted as well.

Rhino-tip Surgery - Rhino-tip surgery is done to change the shape of the nose by modifying the structure of the underlying cartilage. Most alterations are done from inside the nose so as to minimize any scarring. Your surgeon can create the perfect tip for your nose structure. Typical conditions include a big or crooked nose tip, flared nostrils or a hooked tip

Non-Surgical Rhinoplasty - another very common form of rhinoplasty. It is non-surgical and non-invasive and involves an injectable filler being used to correct very minor imperfections. This is a popular choice for clients who need minimal changes to the shape of their nose. Keep in mind that over time the filler will begin to dissolve and you may need further treatments.

There is the pain of one or several very small needle pricks and that is about it. It is, after all, simply just another filler injection, using the same filler type and needle. There is no need for anaesthesia and there is no pain afterwards.

It is of interest to point out that a surgical Rhinoplasty is also virtually pain-free after surgery.

Do not be put off by pain. If you are uncertain about whether you will like the outcome, then the medical or non-surgical procedure could be a good choice for you.

It is important, nevertheless, that your surgeon is experienced and knows the anatomy, as there are risks particularly of skin loss or embolism with the apparently simpler non-surgical procedure.

Non-surgical Rhinoplasty is a temporary procedure. You will need to schedule maintenance appointments to maintain your new look. The benefit of this is that you can make adjustments over time. Perhaps your desired look changes or it takes several sessions to dial in on exactly what you want to see.

To see if a non-surgical rhinoplasty is best for you, book a consultation with our team at the Cadogan Clinic so we can help determine your goals and recommend the best treatment.

Rhinoplasty is carried out with the patient only just asleep under total intravenous anaesthesia (TIVA), and depending on your requirements, the surgeon may do any of the following:

Nose reduction - make the nose smaller by removing some cartilage and bone. This often involves rasping down the bridge of the nose and fracturing the nasal bones, where they join the face. The skin of the nostrils does not shrink to the same extent as the rest of the nose and there may be a necessity for reducing the base of the nostrils or the floor of the nose, by removing a wedge of tissue.

Nose reshapingchanging the shape of the nose by rearranging or adding to the cartilaginous and bony skeleton.

Nose proportionschanging the angle between the nose and top lip.

At your initial rhinoplasty consultation, your surgeon will go through any pre-operative advice with you which will include eating well, quitting smoking, avoiding alcohol and avoiding aspirin and blood-thinning medication.

You will not be allowed food for 6 hours and water for 2 hours prior to your operation. You may choose to take Arnica tablets to reduce any bruising following your nose surgery. If you have any other questions or concerns then you will be able to address them during your consultation.

Contrary to popular expectation, Rhinoplasty involves virtually no pain following surgery. Whilst there may be some level of discomfort immediately following your procedure (and likely some symptoms such as a blocked nose etc.), pain levels will be modest.

Once you arrive at the clinic for your nose reshaping surgery, you will be taken downstairs by our friendly nurses to be prepped for surgery and meet the anaesthetist. You will also have another chat with the surgeon, as this is the final point when the surgeon needs to know exactly what you require. Once you have had your operation, you will recuperate in our recovery room and when you have eaten a few hours later and you are ready, your surgeon will discharge you with some post-operative advice. A friend or relative is able to collect you and take you home. Before leaving the clinic our nursing staff will ensure you have everything you need including a post-operative appointment time and they are likely to give you some spare gauze to keep under the nostrils to catch any drips.

Rhinoplasty is one of our most popular treatments at Cadogan Clinic, and any risks associated with nose reshaping are the same as with any other surgical procedure that involves a general anaesthetic. Any specific risks will be discussed by your surgeon who will explain the nose surgery process in detail and answer your specific concerns.

Some possible risks can include:

+ Anesthesia risks, as with any surgery there are risks with using anesthesia.
+ Infection
+ Poor wound healing or scarring
+ Change in skin sensation; possible numbness or pain
+ Nasal septal perforation (a hole in the nasal septum). However keep in mind that this is very rare. Additional surgical treatment may be necessary to repair the septum but it may be impossible to correct this complication
+ Difficulty breathing
+ Unsatisfactory nasal appearance
+ Skin discoloration and swelling
+ Possibility of revisional surgery

The best way to avoid risks with surgery is to follow the proper aftercare instructions given to you by your surgeon. Many of these risks are rare.


As always with cosmetic surgery, it is essential that the surgeon, not only understands exactly what you are looking for, and can deliver it, but psychologically it is necessary to be as certain as one can be that this desired result actually satisfies the patient.

 

We usually recommend our rhinoplasty patients to take at least one week off work, as you will be wearing a splint for up to ten days. There is no reason however, why you should not be working from home. There may be some bleeding from the nostrils overnight or for longer if the septum or turbinate's have required treatment. You are likely to have some swelling and bruising below the eyes, if the nasal bones have been fractured. This is completely normal and will subside within the ten days. We also tell patients to avoid strenuous exercise for at least two weeks following the operation.

There are two parts to this answer. How long does it take to resume full normal activities and how long does it take for the nose to reach its final state? There is a huge time difference between the two. There is also individual variation.

Patients are usually surprised that the operation is virtually painless. We use Total IntraVenous Anaesthesia (TIVA) and therefore you wake up quickly from the operation and will not feel sick. You will be ready to go home within an hour or two. Expect some bleeding from the nostrils and you will find a gauze dressing strapped under the nose. This will be changed as necessary by the nurse whilst you are in the hospital and by yourself at home.

The bleeding usually stops by the next morning and be replaced by a clear ooze which tends to coagulate around the nostrils and internal sutures. Just keep this clear on the outside with tap water. The inside is unimportant. The nurse will deal with this when you come back at a week. The internal sutures dissolve on their own, but she will remove any skin sutures at the same time.

There is often bruising around the eyes. It is not painful. It appears quickly after surgery but settles equally quickly. The last remnants under the eyes go by 10 days.

Most patients, where the bones are fractured, will have a plastic or plaster of Paris splint over the nose, which is removed in 7 to 10 days. This is the moment of revelation. However, the nose is not how it will finally end up. It will be swollen and without definition. The tip, in particular, may at this stage appear unchanged. The actual final shape will take 6 to 12 months to settle. You will get some idea when this is, when the skin feels normal and all stiffness has gone. You need to be patient.

You are not ill after surgery, just a little bruised with a splint. You should not exercise for a couple of weeks, but you can do most other things if you don’t mind people seeing you. It is the same splint for a broken nose, and this would be the obvious white lie to explain it.

There are two parts to this answer. How long does it take to resume full normal activities and how long does it take for the nose to reach its final state? There is a huge time difference between the two. There is also individual variation.

Patients are usually surprised that the operation is virtually painless. We use Total IntraVenous Anaesthesia (TIVA) and therefore you wake up quickly from the operation and will not feel sick. You will be ready to go home within an hour or two. Expect some bleeding from the nostrils and you will find a gauze dressing strapped under the nose. This will be changed as necessary by the nurse whilst you are in the hospital and by yourself at home.

The bleeding usually stops by the next morning and be replaced by a clear ooze which tends to coagulate around the nostrils and internal sutures. Just keep this clear on the outside with tap water. The inside is unimportant. The nurse will deal with this when you come back at a week. The internal sutures dissolve on their own, but she will remove any skin sutures at the same time.

There is often bruising around the eyes. It is not painful. It appears quickly after surgery but settles equally quickly. The last remnants under the eyes go by 10 days.

Most patients, where the bones are fractured, will have a plastic or plaster of Paris splint over the nose, which is removed in 7 to 10 days. This is the moment of revelation. However, the nose is not how it will finally end up. It will be swollen and without definition. The tip, in particular, may at this stage appear unchanged. The actual final shape will take 6 to 12 months to settle. You will get some idea when this is, when the skin feels normal and all stiffness has gone. You need to be patient.

You are not ill after surgery, just a little bruised with a splint. You should not exercise for a couple of weeks, but you can do most other things if you don’t mind people seeing you. It is the same splint for a broken nose, and this would be the obvious white lie to explain it.

You can view before and after nose job images in our Before and After Nose Job Gallery on this page.

At your consultation, your consultant will also share more extensive examples of rhinoplasty before and after results they have achieved.

We feel strongly that you can best understand what might be possible for you and your nose by reviewing the results of previous nose contouring and nose reduction operations.

It is very rare to be able to get your nose job on the NHS as it is considered a cosmetic surgery. It may occasionally be possible to get your rhinoplasty on the NHS if it is ascertained that the surgery is for medical reasons, but this is very rare.

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