Surgical Procedure

Here’s what you need to know about the Nose Clinic’s procedures.

Our anaesthetic of choice:   The Nose Clinic uses a safe and pain-free local anaesthetic or conscious sedation procedure not linked to hospitalisation and the debilitating side-effects of gaseous general anaesthesia. The Clinic’s specialist team pioneered and perfected conscious sedation for rhinoplasty, and it’s now accepted internationally. Conscious sedation, sometimes also referred to as ‘regional nerve blocking’ - administered in combination with a mild sedative – will enhance your comfort (most patients doze during surgery) and hasten healing (it causes less bruising and swelling).

Our surgical procedure:   The Nose Clinic uses an ‘open’ or ‘closed’ approach, depending on your needs, the type of procedure and skin sensitivity. 

The ‘closed’ approach means we execute surgery through the nostrils – intra-nasally.  This is ideal for simple procedures like nasal hump removals. Surgery that lasts between one-and-a-half and two or so hours; depending on circumstances.

The ‘open’ approach is appropriate for more complex procedures where the surgeon needs more freedom to refine the anatomy, for example, the tip of nose.  Starting with a tiny incision at the base of the collumella (the pillar between the nostrils), to conceal scarring, we partially lift the skin of the nose to obtain a clear view of the nasal anatomy. We then pare and shape the concealed bone and cartilage to create the desired improvement. After surgery, we suture the tiny incision. The result is virtually undetectable. The procedure takes three to six hours, and the anaesthetist and specialist theatre sister assist the surgeon throughout.

Whether we adopt the ‘open’ or ‘closed’ approach depends not only on the type of surgery and the patient’s preference, but also on skin type. Some skin may be too thin and sensitive for the open approach. The decision rests with the surgeon in consultation with the patient. 

Our post-operative care: Immediately after surgery, you will be taken to a quiet recovery room, and you will be discharged only when you are ready to go home. Subsequently, the Nose Clinic will assess your progress through regular consultations. Minor bruising and slight discoloration under the eyes will probably disappear within five to 10 days, and your nose may feel uncomfortable until we remove the tiny sutures on the six or seventh day. After this it may feel a little ‘tight’ as a result of the healing process.

Our approach to surgical dressing: During the immediate post-operative phase, we usually brace the nose and nasal bones with external splints and dressing, but we rarely need to use internal nasal splints and packing. If your nose requires packing and splints, we usually remove them within 24 hours.

Our results: The results of rhinoplasty far exceed the minor discomfort involved in the surgery and post-surgery healing. There may be swelling, particularly in the lower third of the nose, but this will be largely invisible and linked to minor local asymmetry in skin thickness. Although it may take up to 12 months to disappear fully, it will be almost unnoticeable. Some patients use makeup to conceal the initial swelling and discoloration around the eyes and nose, which takes about five to 10 days to clear. After this, we offer several post-operative consultations to monitor your progress, usually at three to six months and then again after 12 months. The costs of these consultations are included in the total fee.

The magic moment: Six or seven days after surgery, we remove the external splint and dressing, revealing the first glimpse of the result. This is a truly exciting moment for both the patient and the surgeon.