Surgery to reshape the nose is a very common plastic surgery procedure and it can increase or decrease the size of the nose. The shape of the tip, the bridge and also the nostrils can be changed, as can the angle between the nose and the upper lip. Sometimes breathing difficulties can be corrected at the same time.
The nose is the central feature of the face. Many people are self-conscious of a shape they may regard as too big or too small. Or their nose may have a feature they dislike. The characteristics of the nose are inherited from parents and develop during adolescent years. This continues to around the age of 16, when the nose stops growing. It is, therefore, unwise to operate before then.
What can be done?
An operation called reduction rhinoplasty reduces the size of the framework of the nose over which the skin is draped. The skin itself is not touched. The frame of the nose, which is made up of bone in its upper half and gristle (cartilage) in its lower half, is approached from underneath the skin through cuts made inside the nostrils.
To straighten the nose and to bring its bridge closer to the face, its ridge is cut away. To restore a new ridge or bridge-line, the two sides of the nose are brought together by cutting the bones of the nose where they join onto the cheek bones. The elasticity of the overlying skin allows it to shrink down on the smaller frame.
This operation effectively narrows the noses’s width. If it makes the nostrils seem wide, it may be necessary to narrow them as well by cutting out a small piece of skin in the floor of the nostril, which leaves a fine scar on each side. It is also possible to shorten the nose and to slim down a bulky tip by reducing the amount of cartilage that shapes the end of the nose.
If you have some difficulty breathing through your nose, it may be possible to improve this at the same time by adjusting the lie of the plate of the bone which separates one half of your nose from the other. This is referred to as a septoplasty.
Sometimes the size of the nose as a feature of the face is influenced by the proportions of the other features, such as the chin and the cheek bones. To normalise facial appearance it may be advisable to alter these features as well, either at the same time as the rhinoplasty or during a separate operation.
What are the consequences?
There is always some bruising and swelling, particularly around the eyes, which can take up to three weeks to disappear completely. A firm splint over the nose must be worn during part of this time. By the end of three weeks, swelling will have settled sufficiently for you to look normal to others and as if you had not had recent surgery. Indeed, it is likely that that you will be surprised by the absence of other people’s reactions to your new nose. They, of course, have not been as conscious of your nose as you have been. If you have any anxieties about family and friends noticing a change in your appearance, change your hairstyle at the same time and they will think it is that which accounts for you new looks.
It is worth anticipating your own reaction to the first sight of yourself and your new nose. To start with, you will look rather strange in the mirror and not quite ‘you’. Remember that it takes a few days for your mind’s eye to adjust itself to the new ‘you’. It also takes a good three months or more for all the swelling to settle out of the nose. If there are any minor problems of shape soon after the operation, do not worry, they will almost certainly improve with time. Your nose will also feel rather numb and stiff for several months, particularly around the tip.