AESTHETIC & FUNCTIONAL CHANGE
Rhinoplasty or ‘nose job’
Rhinoplasty, commonly known as a ‘nose job’, is a surgical procedure to alter the nose's shape, change the nose size or even it's structure. This procedure is carried out under general anaesthesia for either cosmetic or medical reasons, to improve breathing. The upper third of the structure of the nose is bone, and the lower two thirds are cartilage. Rhinoplasty can change bone, cartilage, skin, or all three depending on needs and requirements.
Florian Bast is a facial plastic surgeon, ENT, and leading expert in delivering these surgeries for patients across some of London’s most prestigious hospitals.
Guide to a Rhinoplasty procedure with specialist
Mr Florian Bast.
Possible reasons for a Rhinoplasty include:
CONDITIONS
Fracture of the nasal bone/nasal trauma
Hump or saddle nose
Bent or buckled nose structure
Nose too long or too short
Nose too wide or too narrow
Nostrils asymmetric or too big
The patient wants a tip lift
Patient wants Aesthetic changes
ENHANCING BEAUTY & CONFIDENCE
Rhinoplasty Aesthetic Procedures
Nasal surgery can deliver essential improvements in the functionality of the nose, breathing, and sense of smell. For many, however, a Rhinoplasty is an opportunity to improve the appearance of the nose and boost confidence.
Surgeries related to the nose have different names and include those for the improvement of nasal breathing (Septoplasty), modification of the shape of the nose (Rhinoplasty), or a combination of both procedures (Functional Septorhinoplasty).
How is a Rhinoplasty or ‘nose job’ performed?
There are two main Rhinoplasty techniques; Closed and Open Rhinoplasty. Both are performed under general anaesthesia.
Closed Rhinoplasty
Corrects the structure through an incision inside the nose. Avoiding visible scars.
Open Rhinoplasty
The surgery is performed through an incision in the area between the nostrils (columella), combined with incisions on the inside of the nostrils. The skin of the nose tip is carefully lifted, and the nasal cartilage and bones are surgically corrected. At the end of the surgery, the incisions are closed with fine suture material. The small incisions usually heal very well and in most cases, are barely noticeable after a few months.
Open vs Closed Rhinoplasty, which is best
for you?
Most experts agree that excellent results can be accomplished with both open and closed rhinoplasty.
One advantage of closed rhinoplasty is the absence of visible scars, but open rhinoplasty offers better intraoperative views and access. The choice of procedure is always based on the patient’s needs. Before surgery, morphed photographs will be used during the consultation process to ensure we agree on the best approach to surgery.
What is the recovery process?
Immediate aftercare involves resting with your head elevated to reduce swelling. Normally splints and packings are not needed and significant bruising is very rarely seen.
Rarely, small silicone wedges are sewn into the nose at the end of surgery for stabilisation and removed after 7-10 days. A nose plaster is also removed after 7-10 days. No tamponades are used.
You will start with specialised lymphatic drainage therapy directly after surgery and with a personalised skin care protocol.
The first week is when you may experience the most discomfort and visible swelling, which significantly improves within two weeks. Most people return to work or school after the cast is off, although complete healing and final results can take up to 18 months to fully manifest.
I see my patients 8 days post-surgery for the cast removal and then another 3 times in the first 18 months. However, I am always happy to see patients if they have problems or questions.
What are the risks of a nose job?
As with many surgeries, there are some risks, for example, bruising. This risk can be reduced by the operating technique and by applying regular cooling packs to the area, which also helps alleviate discomfort. Following a thorough consultation, this will be clearly outlined and will depend on the treatment approach chosen and your particular physiology.
How much does a Rhinoplasty cost?
The price of a cosmetic Rhinoplasty including surgeon, hospital and anaesthetist fees starts from £11,655. This price may vary slightly based on your specific needs and wishes.
Interested in discussing Rhinoplasty Surgery with Mr Florian Bast?
ADDRESSING THE FUNCTION OF THE NOSE
Functional Procedures
For some patients, abnormalities occur in the nasal anatomy, which can negatively impact the quality of life. These issues can affect our ability to breathe through the nose, perhaps causing snoring or sleep apnea; they can prevent our ability to smell and speak correctly. In some patients, nasal problems are painful or embarrassing. Many can be addressed through expert medical care
Functional nasal procedures are surgical interventions designed to improve the function of the nose, particularly focusing on breathing and airflow. These procedures can address structural issues, chronic conditions, and other problems that affect nasal function. Here are some common functional nasal procedures:
Septoplasty:
Purpose: Corrects a deviated septum, which can obstruct airflow and cause breathing difficulties.
Procedure: Involves repositioning the nasal septum (the cartilage and bone dividing the two nostrils) to the center of the nose.
Turbinate Reduction:
Purpose: Reduces the size of enlarged turbinates, which can cause nasal obstruction and difficulty breathing.
Procedure: Can be done through various methods, including radiofrequency ablation, microdebrider-assisted turbinoplasty, or submucosal resection.
Functional Endoscopic Sinus Surgery (FESS):
Purpose: Treats chronic sinusitis and other sinus issues by improving drainage and airflow.
Procedure: Uses an endoscope to remove obstructions in the sinuses and improve sinus drainage.
Nasal Valve Repair:
Purpose: Addresses issues with the nasal valve, which is the narrowest part of the nasal airway and can be a common site of obstruction.
Procedure: Can include techniques like spreader grafts or alar batten grafts to support and widen the nasal valve area.
Balloon Sinuplasty:
Purpose: Treats chronic Sinusitis by dilating the sinus openings to improve drainage.
Procedure: Involves inserting a balloon catheter into the sinus passage and inflating it to expand the sinus opening.
Rhinoplasty (Functional):
Purpose: Primarily aimed at improving nasal function, although it can also have cosmetic benefits.
Procedure: Involves reshaping the nasal structure to enhance airflow and address any obstructions.
Polypectomy:
Purpose: Removes nasal polyps that can block nasal passages and affect breathing.
Procedure: Typically done using an endoscope to excise the polyps.
Concha Bullosa Resection:
Purpose: Addresses concha bullosa (a pneumatized or air-filled middle turbinate) that can obstruct nasal airflow.
Procedure: Involves surgically reducing the size of the concha bullosa to improve breathing.
Nasal Fracture Reduction:
Purpose: Realigns the nasal bones after a fracture to restore proper nasal function and appearance.
Procedure: Can be done manually (closed reduction) or surgically (open reduction) depending on the severity of the fracture.
These procedures can significantly improve nasal function, relieve symptoms, and enhance the quality of life for individuals with nasal obstructions or other functional nasal issues.
For information on pricing visit our pricing page or contact us.
Interested in discussing a Functional Nasal Surgery with Mr Florian Bast?
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RHINOPLASTY
Treatment of Chronic Rhinosinusitis
Allergy Management
Allergy Testing and Immunotherapy: Identifying and treating allergies through allergy shots or sublingual tablets can reduce inflammation and symptoms.
Lifestyle and Home Remedies
Humidifiers: Using a humidifier helps keep nasal passages moist.
Hydration: Drinking plenty of fluids helps thin mucus.
Avoiding Irritants: Reducing exposure to irritants such as smoke, pollutants, and allergens.
Immunomodulatory Therapy
For patients with underlying immune deficiencies or conditions contributing to CRS, targeted immunotherapy may be considered.
For information on pricing visit our pricing page or contact us.
Chronic Rhinosinusitis is a prolonged inflammation of the sinuses and nasal passages lasting for 12 weeks or longer despite treatment attempts. The symptoms can vary in severity and may include:
Nasal Congestion and Obstruction: Persistent nasal blockage or stuffiness, causing difficulty breathing through the nose.
Nasal Discharge: Thick, discolored (green or yellow) mucus from the nose or drainage down the back of the throat (postnasal drip).
Facial Pain and Pressure: Pain, tenderness, and pressure around the eyes, cheeks, nose, or forehead, often worsening when bending forward.
Reduced or Loss of Sense of Smell and Taste: Diminished ability to smell or taste.
Cough: Persistent cough, often worse at night due to postnasal drip.
Fatigue: General feeling of tiredness and lack of energy.
Ear Pain and Pressure: Sensation of fullness or pressure in the ears.
Sore Throat: Irritation or pain in the throat, often due to postnasal drip.
Bad Breath: Foul-smelling breath due to chronic nasal discharge.
How can Chronic Rhinosinusitis be treated?
Treatment for Chronic Rhinosinusitis (CRS) aims to reduce inflammation, improve sinus drainage, and eliminate the underlying cause. Various treatment options are available, ranging from medications to surgical procedures.
Medications
Medications may also be prescribed to help with inflammation, infection, congestion and allergic reactions.
Nasal and Sinus Procedures
Functional Endoscopic Sinus Surgery (FESS): This minimally invasive surgery uses an endoscope to remove blockages and improve sinus drainage.
Balloon Sinuplasty: In this procedure, a balloon is inflated in the sinus passages to widen them and improve drainage.
Polypectomy: Removal of nasal polyps that may be contributing to blockage and inflammation.
Interested in treatment of Chronic Rhinosinusitis with Mr Florian Bast?
HARLEY STREET, LONDON
A World Leading ENT & Facial Plastic Surgeon
BALLOON DILATION TREATMENT
Endoscopic Dacryocystorhinostomy (DCR)
Endoscopic DCR is a safe and effective treatment for tear duct obstruction, especially when less invasive treatments have failed. Consult an ophthalmologist or ENT specialist to determine the best approach.
For information on pricing visit our pricing page or contact us.
Endoscopic Dacryocystorhinostomy (DCR) is a minimally invasive surgical procedure to treat nasolacrimal duct obstruction, which prevents tears from draining properly from the eyes into the nose.
Indications for Endoscopic DCR
Endoscopic DCR is indicated for patients with:
Nasolacrimal Duct Obstruction (NLDO): Blocked tear drainage causing excessive tearing.
Recurrent Dacryocystitis: Repeated infections of the tear sac.
Chronic Epiphora: Persistent overflow of tears.
Congenital Dacryostenosis: Tear duct obstruction present at birth.
Failed Previous DCR Surgery: Unsuccessful previous external DCR surgery.
What happens during Endoscopic DCR?
The procedure is generally performed under general anaesthesia. An endoscope is inserted through the nostril to visualise the nasal cavity. A new opening is then created between the lacrimal sac and the nasal cavity to bypass the blocked duct. To ensure the new passage remains open, a temporary stent may be placed. Post-operative care includes the prescription of antibiotics and nasal decongestants, along with follow-up visits to monitor healing.
Advantages of having a Endoscopic Dacryocystorhinostomy
Minimally Invasive: No external incision, reducing scarring.
Faster Recovery: Quicker recovery compared to external approaches.
Reduced Complications: Lower risk of infection and complications.
Direct Visualization: Improved precision due to direct endoscopic view.
Interested in discussing Endoscopic Dacryocystorhinostomy (DCR) with
Mr Florian Bast?
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Our Articles
OTHER RHINOPLASTY PROCEDURES
Understanding Septoplasty, Turbinate Reduction, and Septal Perforation Closure
Septal Perforation Closure: Repairing the Nasal Septum
Septal perforation closure is needed when there is a hole in the nasal septum, which can result from previous nasal surgeries, trauma, infections, substance abuse (e.g. cocaine), or certain medical conditions. Symptoms of a septal perforation may include crusting, nosebleeds, a whistling sound when breathing, and difficulty breathing.
Several techniques can be employed to close a septal perforation, such as local flap surgery (using adjacent nasal tissue to cover the hole) and grafting (using tissue from another part of the body or synthetic material to close the perforation). Risks associated with septal perforation closure include failure to close the perforation, recurrence of the perforation, infection, and bleeding.
Proper aftercare is crucial for successful healing. Patients should avoid nasal trauma and picking at crusts, use saline rinses to keep the nasal passages clean, and follow the surgeon’s advice regarding nasal hygiene and activity limitations.
For information on pricing visit our pricing page or contact us.
When it comes to nasal surgeries, three common procedures often come into play: Septoplasty, Turbinate Reduction, and Septal Perforation Closure. Each of these surgeries addresses specific nasal issues that can significantly impact breathing and overall quality of life.
Septoplasty: Straightening the Septum
Septoplasty is performed to correct a deviated septum—a condition where the nasal septum, the bone and cartilage dividing the nasal cavity, is off-center or crooked. This deviation can cause difficulty breathing through the nose, frequent sinus infections, nosebleeds, and sleep apnea.
During Septoplasty, the surgeon makes an incision inside the nasal cavity to access the septum. They then trim, reposition, and sometimes replace parts of the bone and cartilage to straighten the septum. As with any surgery, septoplasty carries risks such as bleeding, infection, adverse reaction to anaesthesia, persistent symptoms despite surgery, and rarely, a change in the shape of the nose.
Post-surgery, patients should avoid strenuous activities to prevent bleeding, keep the head elevated to reduce swelling, follow the surgeon’s instructions regarding nasal care, and attend follow-up appointments to ensure proper healing.
Turbinate Reduction: Enhancing Airflow
Turbinate reduction is intended for individuals with enlarged turbinates—bony structures inside the nose covered with soft tissue. Enlarged turbinates can cause chronic nasal congestion, difficulty breathing through the nose, and sleep disturbances.
There are various methods for turbinate reduction, including submucosal resection (removing part of the bone while preserving the mucosal lining), radiofrequency reduction (using energy to shrink the tissue), and laser reduction (using a laser to remove tissue). Potential risks of turbinate reduction include bleeding, crusting inside the nose, dryness or a feeling of nasal obstruction, and infection.
After turbinate reduction, patients should avoid blowing the nose forcefully, use saline sprays to keep the nasal passages moist, refrain from smoking or exposure to smoke, and follow all post-operative care instructions provided by the surgeon.
Interested in discussing Rhinoplasty procedures with Mr Florian Bast?
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SURGICAL CARE
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Interested in incorporating Skinade MD into your pre and post-procedure care?
Mr Florian Bast offers ENT and facial plastic surgery at a variety of hospitals in London, England. These include: Rhinology at Cromwell Hospital, London; Rhinology at Cadogan Clinic, London; Balloon sinus dilation at The Lister Hospital, London; Endoscopic balloon dilation at Weymouth Street Hospital, London; Rhinology at Guys Hospital and St Thomas’ Hospital, London; ENT services at 25 & 9 Harley Street, London; Rhinology at Sydney Street Diagnostics Centre, London.