Rhinoplasty Surgery

Before you undergo any plastic surgery procedure at Karidis Clinic, you will have a consultation and a pre-operative assessment with your plastic surgeon. They will listen carefully to your concerns and what you expect to achieve and discuss which procedure, or combination of procedures, is appropriate.

At this stage, they will also ensure you are fully aware of the potential risks and complications inherent in that specific procedure and explain to you what you can expect immediately after surgery, throughout the recovery process, and when you will likely see the final results.

During the pre-operative assessment, the surgeon may take measurements of the area to be operated on and assess your skin tissue quality and the degree of skin laxity. The position of the incisions will also be decided upon.

A full medical history will be taken to ensure you are fit and well and can undergo surgery at this time.

After the initial consultation, there will be a two-week ‘cooling-off’ period before you can decide to proceed with surgery. You are welcome to return for further consultations with your Karidis Clinic surgeon, free of charge, if you have more questions.

If you make the decision to proceed with surgery, you’ll be given advice on how best to prepare for your operation, and you will have a dedicated Patient Coordinator who can answer any queries you may have.

Any pre-surgery tests can occur at the Hospital of St John & St Elizabeth, a leading London private hospital where Karidis Clinic is based. The hospital has recently built a new wing including a diagnostic department with the latest X-ray, MRI, CT and ultrasound technology.

We advise patients to stop smoking as soon as possible as nicotine acts as a vasoconstrictor, which impedes the flow of oxygen-rich blood to the surgical site. This can slow down healing, increase the chance of infection and even cause tissue to die. Smoking also increases the risks of a general anaesthetic, and smokers are more likely to suffer ill effects from an anaesthetic.

You will also be advised when to discontinue taking aspirin or other blood-thinning medication in advance of your operation. You will be asked to fast six hours before surgery.

All Karidis Clinic procedures are performed at the Hospital of St John & St Elizabeth. When you arrive, you’ll be greeted and taken to your stylish and luxurious private room with its spacious ensuite bathroom.

The nursing team will take your blood pressure and relevant vitals, and you will see your Karidis Clinic surgeon, who will make the final mark-ups. Our anaesthetist will also visit you.

Clinical photography will be taken to assist in your care and to enable clinical assessments to be made. These become part of your confidential medical record. These include photographs of the operation site and any distinguishing features and will be taken pre-op and post-op. 

Your procedure will be performed under a general anaesthetic, and once the surgeon has sutured the incision site, you will be taken to a specialist recovery room.

Once the hospital nursing team has ensured your recovery is complete, you will be taken to your hospital room for your overnight stay. The hospital nursing team will be on hand throughout the night, and you will be fitted with compression stockings and a compression device if required.

The following day, you will be visited by your Karidis Clinic surgeon or nurse and then discharged into the care of a friend or family member by the hospital nursing staff.

The pain and discomfort experienced after surgery are unique to the individual patient and the extent of their procedure. However, it should start to subside in the first week and should be easily managed with over-the-counter painkillers.

If necessary, you’ll be advised to wear a specially designed surgical support garment for approximately six weeks after surgery to support you during the healing process.

Depending on the nature of your job, you can usually expect to be able to return to work and normal activities between one to two weeks.

You’ll be given a comprehensive plan for the recovery process, including dates for your cast or suture removal and your check-ups with your Karidis Clinic surgeon. However, we are always on hand throughout this period, and you have access to our dedicated surgical nurse 24/7 if you have any concerns.

You’ll find out if you’re suitable for nose reshaping during your consultation. Your suitability will be based on a variety of factors (you’ll be asked about your general medical history). The questions are designed to find out about your overall health and any previous nasal surgery or injury.

If the nose reshaping you require is corrective surgery as a result of a previous rhinoplasty, it’s important to wait at least one year before any further surgery is attempted.

We will ask you about your breathing patterns and whether you suffer from any nasal obstruction. Normally such issues can be addressed during the rhinoplasty. Mr Karidis will then discuss with you why you are unhappy with the shape of your nose.

• Rest as much as you can, your body will need the energy
• Ensure your face is clean
• Make sure that you are hydrated
• Plan transport to pick you up after your surgery
• Have any medications ready (talk to your doctor)
• Prepare meals ahead of time for your recovery
• Read through all your surgical instructions and make sure you understand them
• Call us with any questions!

A rhinoplasty operation is usually performed through incisions inside your nostrils. Occasionally there are external scars, particularly when reducing nostril size (alar base reduction) or if complicated tip work is required. If alar base reductions have been performed during your nose reshaping, then the scars will be found tucked into the base of the nostrils within the natural skin fold. These are also generally well hidden by the natural shadow cast by the position of your nose. In complex tip surgery, you may require an external incision (open rhinoplasty) carefully placed in the columella (the lower middle segment of skin situated between your nostrils) but you will be informed appropriately.

Once the skin is lifted off the nasal cartilage and bone, any bump on the bridge is removed through the incisions with a delicate chisel to give a new profile. The nasal bones, depending on the circumstances, are then usually broken and reset in a careful way to allow them to meet in the midline and narrow the bridge line. If any breathing difficulties exist, then the septum (structure separating the two nasal compartments) can be altered accordingly.

Finally, the tip of your nose, consisting of cartilage beneath the skin, is adjusted in size and shape to refine your nose so that it matches the new profile. Sometimes this is done with internal stitches, other times a small segment of your own cartilage is used.

Once you’re back in your room, you’re propped up in bed with a couple of pillows in order to elevate your head. This is necessary to reduce the swelling around your nose. You may have some bruising around the eyes but this is not always the case. You’ll also notice that it will be difficult to breathe through your nose, this is because of the nasal packs. Understandably, most patients report that the packs are the most unpleasant part of the whole operation — this is not because they are painful, but because you are forced to breathe through your mouth until these are removed, the following morning. There’s no need to worry — you’ll automatically be breathing through your mouth!

The following morning the packs are removed and your breathing will be easier, however, there will still be significant congestion/swelling within the nose, so don’t expect to breathe perfectly from your nose. This, of course, will get better, although it will take a number of weeks before it returns to ‘normal’.

Please also note that once the packs are removed you should expect to get some nasal bleeding in a drip-like fashion. A small gauze bolster will be placed under your nose to catch these drips. You’ll find that within the next few days this will steadily become less until it stops.

It’s very important to realise that even once the plaster cast is removed from the bridge of the nose there will almost certainly be a significant degree of swelling still present. Therefore the shape of your nose at this stage is not the final one.
And it’s common for the nasal bridge to look quite narrow and slim immediately after the plaster is removed, but then subsequently swell up again due to the normal healing process. This obvious swelling will rapidly decrease in the following 3-4 weeks and your nose will begin to settle.

It’s important to remember that even after this time, the shape of your nose is still not the final one. This is partly because of scar tissue which will form underneath the skin of the nose, as a result of the surgery, and which will have a subtle effect on the final shape and volume.

These internal scars gradually change their shape (called scar maturation) and resolve in time. The process of scar maturation will take up to one year, sometimes longer, to complete. After this time, the final ultimate shape of your new nose will become apparent.

As a simple guide in assessing the progress of your nose, you should gently squeeze the tip of a normal unoperated nose, and then your own to compare the firmness. The firmer it is, the more time is required for it to settle.

Nose Reshaping surgery requires a surgeon fee, an anaesthetist fee and a hospital fee. The price also includes all of your pre-operative and post-operative care. The cost may vary slightly depending on your unique requirements, but we will give you a detailed quotation following your consultation.

For more information on what our surgical fees cover, please click here.