nose job scotland

Rhinoplasty/ Nose Job

You may be self-conscious about the appearance of your nose.

A rhinoplasty or “nose job” is an operation that can help improve the shape of the nose.

Plastic surgeons describe a nose job or rhinoplasty as one of the most difficult cosmetic surgery operations. It requires experience and judgement, and there is little scope for error. A good understanding of patient wishes and expectations, technical possibilities and underlying anatomy is needed.

ARRANGE A CONSULTATION

Overview

Rhinoplasty Edinburgh

TYPE OF ANAESTHETIC

  • General

LENGTH OF SURGERY

  • 2-3 Hours

NIGHTS IN HOSPITAL

  • Day procedure

RECOVERY

  • 1-2 weeks off work, 6 weeks before strenuous exercise

Procedure types

CLOSED

The closed approach leaves no visible scars and can be used for nasal hump reduction and narrowing of the nose as well as refinement of the nasal tip.

OPEN

An open rhinoplasty is used when intricate work is needed on the tip of the nose, and this leaves a small scar on the undersurface of the nose (you will find examples of the location and kind of scar in our before and after photos).

CHIN ENHANCEMENT

Nose reshaping is often combined with chin enhancement. A weak chin exacerbates the appearance of a prominent nose, particularly on the side profile, and it is essential that patients are aware of this, as nasal surgery alone in this setting leads to unsatisfactory results.

CORRECTION OF SEPTAL DEVIATION

Rhinoplasty can also be combined with a procedure to correct nasal septal deviation (septorhinoplasty).

NON-SURGICAL RHINOPLASTY

Some patients wishing to avoid surgery may be candidates for a non-surgical rhinoplasty using dermal fillers (injections). Candidates include patients with small bumps or unevenness. Reversible fillers can be used to ‘even out’ bumps, build up flat noses, increase tip projection or straighten a nose. While the results of fillers are not permanent, they can show patients what surgery could achieve, or they can be repeated to avoid surgery altogether.

Rhinoplasty with us

We have been performing rhinoplasty surgery in Edinburgh, Scotland, for 30 years. Mr Quaba has performed over 1000 rhinoplasty procedures in his career and is well versed in using the closed and open approaches. He also has extensive experience with revision rhinoplasty (secondary rhinoplasty). On average, he performs over 100 procedures a year. Our photo gallery has an extensive range of typical before and after images.

Our nose forms one of the most defining features of our face and can have a disproportionate influence on how we or others perceive our appearance. Surgery is often requested for refinement (for example, the tip of the nose) or reduction (for example, a hump on the nose). Rarely an operation is required to augment a small nose. Surgery may be carried out using a closed or open approach. When minimal deformity exists, or the patient finds it difficult to express what they don’t like about their nose, correction can often be challenging.

We see rhinoplasty patients from all over the UK, including Glasgow and Aberdeen.

EXPLORE OUR PROCEDURES
Rhinoplasty with us

Commonly asked questions

How long does it take to recover?

We suggest that patients take 7-14 days off work depending on what they have had done (tip work only – few days; in fractures – 2 weeks). For most patients, recovery is uneventful. Small amounts of bleeding are common, and your nose will be stuffy. Most patients are presentable in public after the removal of the splint (7 days).

How long does it take to see my final result?

The final result is usually present at six months. The obvious major changes will be apparent immediately while the more subtle changes do take time to become apparent. Minor degrees of swelling can take months to settle down fully.

Do you perform rhinoplasty on patients from parts of the UK?

We are increasingly performing rhinoplasty on patients from Glasgow and Aberdeen as well as other parts of the UK. Rhinoplasty is a very specialised procedure, and prospective patients are taking time to research where they feel the best place to go is regarding consultation/ surgery.

What is a rhinoplasty?

A rhinoplasty or nose job is a surgical procedure designed to reshape the nose. Common indications include making the nose smaller, reducing the bridge (hump) of the nose, narrowing the nose, changing the nasal tip, reducing the length of the nose or lifting a droopy tip. Rarely surgery is requested to augment a small nose. Surgery is often requested by patients who have previously fractured their noses.

I don’t like my nose, but I’m not sure why?

As mentioned above, it is easier when you are clear about what you don’t like about your nose and when your concerns match the examination findings. We appreciate that it can be difficult to express specific concerns in many cases. We will often take photos during the consultation, upload them, and discuss what may or may not be correctable.

I don’t like my nose, but I’m not sure why?

I have difficulty breathing through my nose

This is a common complaint and is usually correctable if it is caused by a deviated septum. The septum is easy to assess during the consultation, and any problems will be pointed out to you. Correction of a deviated nasal septum along with a cosmetic rhinoplasty is known as a septorhinoplasty.

Is there an optimal age to have a rhinoplasty?

We prefer to wait until patients are at least 18 years old and have completed the growth of their facial skeleton. It is crucial to consider an individual’s emotional and social maturity and to make sure that they fully understand the implications of rhinoplasty surgery.

Is there an upper age limit for rhinoplasty?

No, as long as you are in good physical and mental health, age is not a factor. Rhinoplasty in the 40s and 50s is relatively common. However, it should be noted that the recovery period and swelling may last longer in older age groups.

Am I a good candidate for rhinoplasty?

If you do not like the way your nose looks and are willing to undergo a surgical procedure, and if you are in good physical and mental health, then it is worth having a consultation to discuss your concerns. During your consultation, we will talk with you in detail and examine you. If we feel we can fulfil your expectations, then we will let you know what can be achieved and what that involves.

How many rhinoplasties do you perform?

Currently, we perform over 100 rhinoplasties a year within our practice.

Do you operate on ‘ethnic’ noses?

Most patients who have rhinoplasty surgery with us in Edinburgh are of Caucasian background, but we also have many patients of Middle Eastern and Asian background.

What is your approach toward rhinoplasty?

We take a conservative approach to rhinoplasty, avoiding the ‘done’ look and aiming to give a natural ‘unoperated’ appearance. We will be realistic and aim to give you the best idea of what can be achieved.

Will I see examples of your work?

Yes. Some patients have kindly agreed to allow us to use their images on the website (rhinoplasty photos). Many more patients are happy for their images to be viewed during the consultation. You will see a range of results.

Is there any visible scarring?

If an open rhinoplasty is performed, then there is a small scar visible on the undersurface of the nose (across the columella). Scar quality varies from patient to patient, and scars can take up to 18 months to settle. With closed rhinoplasty, there are NO visible scars at all as surgery is performed via incisions on the inside of the nose.

How should I prepare for my first visit?

You should have some idea about what you would like changed about your nose. It may be useful to write down any questions you may have. We will need to know your past medical history, including any previous nasal surgery. Some patients do bring photos of the kind of noses they like. Photos can be useful in helping to assess your needs and expectations.

How long do I need to stay in the hospital?

We carry out all our rhinoplasty procedures as day cases. Overnight stay may be available at extra cost if required.

What kind of anaesthesia is used for rhinoplasty?

A general anaesthetic is used in our practice.

How long does a rhinoplasty take?

Depending on the complexity, it takes 1-2 hours.

Is a rhinoplasty painful?

Not usually. Typically there is not much in the way of pain postoperatively. Most of our anaesthetists use total intravenous anaesthesia (TIVA), and generally there is little in the way of postoperative nausea.

Do you use nasal packing?

Yes. This is a commonly asked question, and the concern is about pain when the packs are removed. We use soft packing which is removed the morning after surgery and causes little in the way of discomfort when removed at this stage.

Will I have a splint on my nose after surgery?

We use a low-profile splint whenever structural work has been carried out. If you only need work on the tip of the nose, you might not need a splint. We remove the splint after seven days.

Patients with bony work carried out during rhinoplasty must wear a splint for seven days after their surgery.

What to expect

You will be up and about the day after your surgery, but it will take a couple of weeks before you are entirely up to speed. Your mood may fluctuate after surgery – this is normal. A small amount of bleeding is typical during the first few days

DISCOMFORT/PAIN

This can occur during or after the operation and rarely (less than 1 in 100) may require a return to theatre. Heavy bleeding may require a blood transfusion. Bleeding can also occur in the first few weeks after surgery if there is an infection affecting the lining of the nose.

Rarely blood can collect between the lining of the nose and your septum and can become infected (septal haematoma/abscess risk: less than 2 in 100).

BRUISING/SWELLING

After surgery, particularly during the first 24 hours, your face will feel puffy.

Temporary swelling and bruising around your eyes and nose will increase at first and peak after 2 or 3 days. Most swelling and bruising should disappear within two weeks. Some subtle swelling will remain for several months.

Black eyes and swollen nose and eyelids for 1-2 weeks, especially if you have had work on the bones of your nose.

APPEARANCE

Your nose will look better in 2-3 weeks and usually continues to improve for many months. The tip of your nose will drop to its permanent position in 3-6 months. Final results may not be apparent for up to 18 months.

View before and after gallery
What to expect

What are the risks?

Surgery is carried out under general anaesthesia as a day case. The procedure lasts around 2 to 3 hours. The risks of general anaesthesia include clots to the legs (deep vein thrombosis) and, very rarely, clots in the lungs (pulmonary embolus). We take several precautions to minimise these risks. The other risks of general anaesthesia include chest infection. The risk of a life-threatening complication under general anaesthesia is approximately 1 in 100,000. The risks relating to rhinoplasty surgery itself include:

Bleeding

This can occur during or after the operation and rarely (less than 1 in 100) may require a return to theatre. Heavy bleeding may require a blood transfusion. Bleeding can also occur in the first few weeks after surgery if there is an infection affecting the lining of the nose.

Rarely blood can collect between the lining of the nose and your septum and can become infected (septal haematoma/abscess risk: less than 2 in 100).

Infection

The surgical site can become infected, and this usually settles with antibiotics. Deep infection can also occur, and very rarely this can lead to the collapse of the bridge of the nose and require re-operation.

Swelling and bruising

Swelling and bruising are to be expected, and most of the swelling settles by six months. Residual swelling may be present up to 18 months after surgery, particularly at the tip of the nose.

Breathing difficulty

Sometimes breathing can be worsened, and there is a higher chance of this if you already have problems with breathing or allergic rhinitis. In most patients with pre-existing breathing problems, we aim to improve breathing after surgery rather than worsen it.

Scar

You will have a permanent scar on the undersurface of your nose (columella), and very rarely, this may be red and thickened. The scars from the cuts inside your nose are hidden.

Numbness

It is common to have small areas of numbness, and these usually recover with time.

Reduced sense of smell

Uncommon (less than 1 in 100 risk) and usually recovers with time.

Under or over correction

Removing too much or too little tissue.

Unsatisfactory cosmetic outcome

It is essential to have realistic expectations of what can be achieved. The healing process is difficult to predict, and it can take up to 18 months before everything settles completely. A residual hump can come back, or nasal bones can thicken if you have overactive bone healing. Scar tissue can prevent your skin from shrinking to the right size. There may also be minor irregularities that you can see or feel under the skin.

Perfection is rare in rhinoplasty surgery, and free revisions will only be offered to correct complications or outcomes that fall below what is expected of a typical result. Revision surgery will not be provided to correct minor imperfections.

Rhinoplasty aftercare

If you have had a rhinoplasty with us or are considering it, we have provided detailed instructions and advice on aftercare following the surgery.

EXPLORE RHINOPLASTY AFTERCARE
Rhinoplasty aftercare

Rhinoplasty – Best money I’ve ever spent!

I had septorhinoplasty in Sep 2018 because my nose was awful – squint, bulbous AND projecting. I would never let anyone take my photo and was extremely paranoid and unhappy with it. I’m now 5 months post surgery and I’m SO glad I did it. It was worth every penny. I am so much more confident in my appearance. I don’t run away from cameras anymore and my overall confidence is so much higher! There’s still quite a bit of swelling there but it already looks so much better, so I’m excited to see how it looks in another 6 months or so.

At my first consultation, Mr Quaba was great, I felt like he took my concerns seriously and he took the time to explain what could be done to improve the appearance of my nose.

I think one thing to bear in mind with rhinoplasty is that you see the final results a LONG time after the actual operation. The swelling isn’t obvious after a couple of weeks and most people won’t think you look strange, but it’s definitely there. My nose was enormous for a few days after the cast came off so I would definitely recommend taking 2 weeks off work if you can… unless you don’t mind walking around with a cast on and a massive nose, but I did!

Overall, great results and really pleasant experience with Mr Quaba and all of the staff at Spire hospital. No complaints whatsoever and I’m very happy with my surgery. Very highly recommended if you’re considering rhinoplasty 🙂

LizzieSc

Realself Feb 2019

READ MORE PATIENT TESTIMONIALS
®

Body dysmorphia

Body dysmorphic disorder (BDD) is a mental health condition in which someone can’t help thinking about one or more perceived issues or faults in their appearance. Other people may think that their concerns are minor or they may fail to see them at all.

People with BDD, continuously focus on their appearance and body image, repeatedly checking the mirror, grooming or seeking reassurance, sometimes for many hours each day. The perceived flaw likely causes significant distress and impacts on a person’s ability to function in their daily life.

People affected with BDD often seek out cosmetic procedures to try to “fix” their perceived flaw. Afterwards, they may feel temporary satisfaction or a reduction in their symptoms, but often the anxiety returns, or they may move on to focus on other perceived problems related to their appearance.

Some patients may have features of body dysmorphia. Such patients are not likely to be offered surgery.

If you are considering surgery, it is worth trying the self-assessment tool below known as the Cosmetic Procedure Screening Questionnaire (COPS).

The questionnaire was developed by David Veale, Nell Ellison, Tom Werner, Rupa Dodhia, Marc Serfaty and Alex Clarke (2012) Development of a cosmetic procedure screening questionnaire (COPS) for Body Dysmorphic Disorder. Journal of Plastic Reconstructive and Aesthetic Surgery, 65 (4), 530-532.

TAKE THE COPS QUESTIONNAIRE