Rhinoplasty, or a nose job to you and me, is not a decision most people take lightly. And rightly so, it's a full-on operation that doesn't just require you going under general anesthetic but will change the way you look forever.
If your nose is something you want to change and you've been thinking about rhinoplasty for a while, it's well worth doing your research and finding out exactly what the process entails from consultation to recuperation. So we headed to Knightsbridge to speak with Mr. Kambiz Golchin, an ENT and facial plastic surgeon at Rita Rakus in London, to find out just that. From the time you'll need to book off work to the clever way you can see what your new nose will look like before going under the knife.
The Rhinoplasty Consultation
"Normally by the time someone comes in, they will have been thinking about a nose job or rhinoplasty for a long time, typically years," Golchin tells me.
"We have a chat about what bothers them and what they would like to achieve. Then I examine the nose and look at realistically what can be achieved. I'll walk them through the different options, in terms of what approach is best, if they are a good candidate for rhinoplasty and if they can expect a good result, which is what they are really there for in the first place. I then give them the information pack and send them off to think about it.
"Once they have had time to think, they come back for a second chat. I find that's a really useful way of making sure that they’ve had time to really consider the pros and cons and all the info given to them. A bit like a cooling-off period; if you sign for a mortgage, you get that window to change your mind. It's the same idea, really.
"On the second consultation if we both agree that it’s a good thing, and we have to both agree, then we make plans for a surgery date. The consultation is a longer process than just coming in and next week they’re booked in—it doesn’t work that way at my practice."
So, What "Issues" Can Rhinoplasty Fix?
"Quite a lot. For most people, it tends to be simple things, like a bump or hump on the bridge of the nose. Some don’t like the tip if it’s a bit too wide or droopy. Or, it can be the result of a sporting injury, so the nose was broken at one point and it’s a bit twisted or crooked. It could be a combination of all of those. There can also be breathing issues if there has been an injury, so there can be a medical and functional aspect to it, as well as an aesthetic aspect," says Golchin.
While a nose job can potentially help with snoring or sleep apnea, Golchin says there is no guarantee since these issues are "often from the soft palate, not the nose."
Are There Different Types of Nose Jobs?
"There is the non-surgical option, that's kind of a trendy topic at the moment. And a lot of people are promoting and doing it. Except for a lot of people, it’s not the right thing to do, and I think it’s a bit over-marketed really," Golchin tells me. "It doesn’t last, it’s a temporary treatment, but also sometimes it’s the wrong approach. For example, if somebody has a hump, you can use filler to fill above and below it, which gets rid of the hump and makes it level, but in effect, you’re making the nose bigger, which isn’t necessarily a good thing."
Golchin who also works with Botox and fillers isn't against the temporary nose job, "I do do them, but for specific patients for specific clinical needs. I don't think offering it as an alternative is the right approach."
Finding a Reputable Surgeon
"Word of mouth is usually the best way and patient testimonial is also a good way of making sure you're going to the right person. Another good thing, if you’re not sure, is to have more than one consultation, go see two or three people. If you think about it, it’s a big commitment and investment, so it’s important to find the right person that you gel with; it's key to make sure they are on the right wavelength as you."
Deciding on Your New Nose
"We do see, from time to time, people bringing in pictures of celebrity noses and lips and so on, that they would like. It's obviously a difficult subject because you may not have the right type of nose to achieve that and it may not suit your face to have, say, Kim Kardashian West's nose. It has got to be a balance and in harmony with the person's other features," advises Golchin.
He uses 3D imaging software as a tool and a guide. "It helps to ensure we're all on the same wave-length as to what final result could be achieved."
The Surgery and After Care
"The length of the surgery depends on what needs to be done. It can take anywhere from an hour to four or five. Often it will be done as a day case, so you can be in and out on the same day. Or you may need to stay overnight, if it's been quite long or done late in the afternoon, to make sure you have enough time to recuperate.
"From a practical point of view, you will need a couple of weeks off work, but it can take up to 18 months for the nose to finally settle and for you to see the finished result," Golchin explains.
"There will be some special cleansing that you will need to do for the first 10 days, as you will have plaster over your nose. Once that period is over it's more about leaving everything to settle down and for the swelling to go down. Contact sport is out, as it takes about three months for the nose to become solid again."
As for follow-up appointments, this will vary depending on the patient and surgeon, but typically Golchin has a follow-up appointment with the patient two weeks after surgery and then six weeks after.
It's worth knowing that a nose job has the potential to cause breathing issues. "Where there is excessive or aggressive reduction, especially at the tip, this can cause scarring, which would basically cause a restriction in the breathing. Often it doesn’t show itself until years later."