Before the surgery:
I have just explained that the nose is essentially made of a osseous and cartilaginous frame, covered with skin and mucous membrane, and that it is possible, by incisions dissimulated inside the nostrils, to separate the skin and the mucous membrane from the osteo-cartilaginous frame , so as to be able to modify it.
The skin and the mucous membrane then regain their place, and the more the skin is thin, more quickly it adapts to the new frame. In certain cases of long or broad nostrils, it is possible to reduce them at their base, which leaves an almost invisible scar in the natural fold of the base of the nostril.
I examined the interior of your the nose, and announced that I would correct the nasal partition if it was out of place as this is essential to obtain a straight nose, without respiratory difficulties.
I explained that the objective is to attain a harmonious nose which does not seem to have been operated upon. That’s why it is necessary for this future nose to be adapted to your face, and one should not impose a standard or copied nose, but preserve your nose and correct its defects.
We are going to see each other again anyway after you have had the photographs taken that I prescribed, I will then show you my operational project, so that we agree on our target to reach, on the importance of the reduction in the bump, the shortening and the modification of the point. But you have to be conscious of the theoretical limits of this “design” wether it is on photograph, graphical image, video or plaster moulding…
The surgery:
I explained that the anaesthesia will usually be mixed, local with a drowsiness during the injections and that you will spend the night following the operation in the clinic.
You will have on your nose a plaster held by sticking plaster, and the nostrils blocked by swabs which maintain the mucous membrane in proper position. Generally, I remove these swabs the following day. You will then clean your nose with cotton buds.
The majority of patients do not suffer, but fin dit difficult to breathe through the nose for a few weeks. The eyes sometimes swell during the first few days, but return to normal very quickly.
The incisions inside the nose are stitched with catgut, which is reabsorbed naturally by the body. There will thus be no stitches to remove.
A weeping from the nose often occurs during the first days. It will have to be wiped off with a cotton bud or a compress. During this cleaning, drops of blood may appear. Do not be alarmed, except if the bleeding is abundant and persistent.
After the surgery:
I told you that the plaster would be removed six to ten days after the operation.
Do not dash to your mirror, except if you belong to the group of the patients who have very few marks. Often, there is a little swelling at the root and on the sides of the nose and bruises on the lower eyelids are frequent.
All of this quickly returns to normal and three weeks after the operation everything has usually disappeared. Already after the removal of the plaster, slightly tinted glasses will allow you to pass completely unnoticed because the nose itself appears normal. These glasses shouldn’t rest on the bridge of the nose, it will be necessary to wear glasses lateral supports, or to attach the glasses to the forehead with sticking paster.
I also warned you that if you do not see traces of the operation any more after three weeks, the point of the nose will remain a little sensitive and a little stiff. It will actually take six months to a year for everything to become normal again; during this time the nose will continue to regain its original suppleness. You will come back to see me then so that I can evaluate the final result.
I advise you to avoid exposure to the sun during the first months, because your nose will swell muchmore than usual. You can protect yourself with a hat and filter creams.
After a month, your nose will be as solid as it used to be. If you receive a shock, a fracture can occur, that will be treated like any fracture of the nose, by putting the displaced bones back into proper position.
After a month you will be able to start playing again, except diving, which must be avoided for two months. Your sense of smell should not be durably modified by the operation but it can be initially weakened because of the swelling of the mucous membranes.
Dr Thierry BONVALLOT