Nasal deformities – A guide to rhinoplasty

Nasal deformities are caused by a number of things. Nasal deformities can be congenital in nature which is, where you would inherit certain features from your parents, for instance. They can also be developmental in nature where one or another of the elements within the nose, in other words, the bone or the cartilage can grow too much or can grow too little and as a result produce either an external or an internal abnormality resulting in a cosmetic or even a functional problem.

Of course, trauma can also cause this as well. So, a significant injury to either a previously normal nose or a previously abnormal nose can result in significant disruption and obviously external visible cosmetic deformity or perhaps even internal malfunction. External nasal deformities are plainly visible and the individual themselves will be quite aware that there’s an element of the nasal passage that the nasal dorsum that doesn’t look good.

Friends and relatives may have mentioned this to you and quite often people have developed a little bit of a complex about the way it looks anyway. So, the external appearance is obviously very important and that doesn’t require any great expertise to understand. Internally, a little bit different. For instance, there is disruption of the internal structures, you could have nasal obstruction which could be intermittent or indeed it could be one side or both sides or an alternating side problem. You can also have problems in terms of recurrent infections and problems like that. So, these are the sort of things that will alert one to having some sort of a nasal deformity.

Nasal deformities
Nasal deformities

Well, I think it’s worthwhile seeing your doctor when the problem you have with your nose begins impacting on your quality of life. So, for instance, if the external appearance of your nose is such that it concerns you and you don’t want to have photographs taken of you, or in more extreme cases perhaps you don’t want to go out because you’re lacking in self-confidence, those are the sort of external appearance problems where you would consult with your doctor. Initially your GP preferably, and then probably a specialist after that.

The other things more internally, more functional in other words, so when your nose is blocked and you can’t breathe properly, obviously that’s problematic in the daytime as well, but at night time these things present particular problems for people trying to sleep; meaning that you have to breathe through your mouth, because you can’t breathe through your nose, your mouth gets dry, you wake up multiple times, you feel very tired.

These are the sort of situations where you might want to discuss this with your GP and ask them for some treatment, but obviously if the treatments not working, then you really need to see a specialist. I think when you go to see a specialist about your nasal problem you would expect to be greeted and treated with respect as all patients would, but the doctor will ask you the nature of your problem. So, it’s worthwhile having in your mind an idea of the type of symptoms that have been troubling you, that are causing problems, and also the treatment that you’ve had from your GP.

All of these things are important for the specialist to know but try and stick to the actual problem that you have without radiating to more peripheral health issues. It helps focus on the actual problem that is the issue for you, yourself. The doctor will examine your nose usually by looking at the external structure of your nose, your face, the quality of your skin and then we’ll look up inside your nose. Now, sometimes it’s necessary to look inside the nose with the fibre-optic telescope.

It’s not a painful thing. It’s a bit ticklish. It feels a little weird. But after that, the doctor will have a much better idea of exactly what the nature of your problem is. The doctor will then explain to you what they think needs to be done and might take some photographs in the actual room itself, or they may ask a professional photographer to take photographs for you. Unfortunately, snaps on your phone are not really going to do it because the photos are actually used on a professional basis for planning surgery.

Scans might be required like an x-ray and these are useful, and then you’ll probably come back and see the doctor again, refer the discussion about what treatment plan is going to be formulated, and those are the sort of things that you will be seeing and discussing with your doctor. Nasal deformities form a complex variety of issues and problems and no nose is same as the another. Every single one is unique and so each nose has to be assessed completely separately and individually and an individual treatment plan will be formed for your particular issue. Now, externally, these sorts of things are visible to you and your family but there may be internal problems that you may not be very aware of.

Your consultant will explain this to you and perhaps show you a diagram as to what needs to be done and explain the techniques that will be involved. Essentially, we are talking about rhinoplasty surgery to correct most of these deformities and there are different types of rhinoplasty operations. Typically, there is an internal operation and an external operation.

These are used for different things. The external operation is a little more extensive but it’s more useful in the sense that it can deal with multiple problems all at the same time, whereas an internal rhinoplasty is a little bit more focused on one particular issue. The big difference between them as far as the patient is concerned really is that there is a little incision just in the middle part, the columella we call it of the nose here. That gives the surgeon a great deal more exposure to deal with these multiple problems as I’ve mentioned.

The surgery itself is carried out under general anaesthetic, that is where we put you to sleep. Typically, these operations take two, two and a half hours so it is a fair operation and therefore you will need some time off work. Certainly, you’ll be looking at a week to ten days off work and you may well have a plaster or some sort of a splint on your nose to protect the nose afterwards as the bones and cartilages may be mobile so they need to be protected.

There will be some swelling probably both externally and internally. So, the external swelling: you might have some bruising or black eyes just here. Internally it may mean that your nose is blocked for a week or two after the surgery as you might expect if you had a cold or flu, but gradually the swelling settles over a week or ten days and the bruising disappears. The plaster will be taken off a week after, the sutures here, if they’re present, will be taken off a week after and gradually the whole thing will settle down. So typically, most patients would expect to take about ten days off and then back to normal activities.

Contact sports really should be avoided for probably about a month after the surgery because the nose is healing and could be bumped or damaged in so doing. So, it’s one of these things. We have to be a little bit careful but usually a little bit of care and diligence results in an excellent result. Cleaning the nose inside is important and your consultant will explain his or her particular preference for this and that will hopefully result in a good, much more patent breathing passage for you.

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