Written by Dr Cameroon McIntosh, SORSSA President
1. The What
A rhinoplasty (nose job) is a complicated operation to improve the shape and function of your nose -one that should be performed by a specialist surgeon who is highly trained and often carries out the procedure.
There are two parts to a rhinoplasty operation: one being that of cosmetic, which is all about bringing harmony to your nose and face – while the other deals with the functional aspects by improving the flow of air through your nose.
A detailed history and examination is essential, as very often a number of specialised additional tests need to be performed such as air-flow/pressure and CT scans of the nose, septum and sinuses. What is visible on the outside as unsightly, is probably caused by an internal problem such as a deviated septum.
2. The What Not
A ‘liquid’nose job is not a rhinoplasty. It is a temporary, less safe and less efficient way of trying to improve a patient’s cosmetic outcome by injecting fillers into a very high risk anatomical area of the face. Be very careful if you decide to undergo this intervention.
3. The Why
There are two main groups of patients who undergo a nose job. Those with nasal obstruction, and those who want to look better. By far, the majority of patients have both complaints.
Let’s start with those whose noses are blocked. Some patients are loud snorers – try this quick test: Close your mouth and try and snore. Now pinch your nose closed and with your mouth open, then try snore. Easy to see that your blocked nose may be the cause for you or your partners morning grumpiness!
There are various reasons a nose may be blocked, such as a deviated septum, collapsing nasal valves, enlarged turbinates or nasal polyps to name a few.
The other main group of patients are those whose noses look ugly to them. A rhinoplasty can have a massive impact on patients’ self-confidence.
4. The Why Not
It’s very important to have clear goals as to why you want the surgery. If you think of vague things such as; “It’s just not nice” or “I want to get married,” then this may not be the operation for you. Try and be as specific as possible, where you can narrow it down to three defined outcomes.
5. The How
There are two main approaches to surgery. One of those is the so called ‘open approach’, whereby a small cut is made under the nose (columella -) and the other is the so called ‘closed’ approach, where all incisions are made inside the nostrils.
There is endless debate on the best approach, yet the bottom line is to make sure your surgeon is not only very well versed in their approach, but also chooses the correct technique to address your unique problems.
6. The Who
Is your surgeon a member of SORSSA?
In September 2017, the Society of Rhinoplasty Surgeons of South Africa (SORSSA) was founded by a group of passionate specialist surgeons in Port Elizabeth. We had a number of motivations behind us for forming this non-profit organisation.
One of them was to provide a forum for the exchange of information and ideas relating to the art and science of rhinoplasty – while promoting and updating all the education and research pertaining to this procedure. Our aim was to inform the membership, the medical profession, and the general public.
Another was to put Africa on the map, where we would be able to cooperate with other international organisations for the advancement of knowledge in the field of rhinoplasty.
Lastly, we set ourselves the goal on an annual scientific meeting comprised of peer-reviewed presentations by nasal surgeons in South Africa and other countries.
Looking at it now, it’s truly remarkable how we’ve managed to reach all the above-mentioned goals we set ourselves in such a short period of time.
And our numbers are only growing…
- How to become a member:
To be eligible for active membership, you have to be a qualified ENT, plastic surgeon, or facial plastic surgeon, with at least two years post qualification experience. What this boils down to is that if you have a SORSSA member operating on your nose, they would have at least two degrees (Medicine and ENT/Plastic Surgery), or have more than 15 years of experience in the medical field behind them. Visit www.rhinoplastysociety.co.za for more info.
7. The When
There’s no rule of thumb, however, the majority of cosmetic rhinoplasty patients are in their 20’s and 30’s, whereas the majority of functional rhinoplasty patients are in their 40’s right up to their 70’s (when the effects of age start taking their toll on nasal function).
When it comes to pediatric cases, these are very specialised and only a handful of surgeons in South Africa have experience with these.
8. The Cost
The total cost of an operation is split between the hospital fees, the anesthetist and the surgeon. The three most important factors influencing your quote will be the level of difficulty of the operation, if you have medical aid and the type of medical insurance you have. Some medical aids are far more supportive of functional rhinoplasty than others.
Generally, your surgeon will submit a detailed motivation to your medical aid as to why you would need the surgery to improve your nasal function. Your surgery can vary from being completely covered by your medical aid, or partial coverage of the procedure.
Conversely, in cases where rhinoplasty is requested for solely cosmetic reasons, medical aids do not pay for the surgery. The good news is that there are financial institutions who may give loans to suitable candidates.
9. Safety
Any operation has risks, which are usually related to general anesthesia. However, surgical rhinoplasty is normally carried out as a day procedure and thus has limited complications.
A skilled, expert surgeon should experience less difficulties, and be able to treat any issues that may arise.
10. The downtime
Depending on the extent of your surgery, you will need to take time off work to recuperate anywhere between one and two weeks as all the swelling settles. Sutures normally stay in for five to seven days.
Conclusion
I hope this article has you found you in a far more informed and empowered position to make the right decision about your rhinoplasty.
Written by Dr Cameron McIntosh
MBChB (Stel), MMed (UFS), FCORL (SA), IBCFPRS (Washington DC)
- International board-certified facial plastic surgeon
- Dual-certified otorhinolaryngologist
- Founding president of SORSSA (Society of Rhinoplasty Surgeons of South Africa) www.rhinoplastysociety.co.za
- Rhinoplasty specialist in private practice in Port Elizabeth www.drcameronmcintosh.com
A2 Disclaimer: This article is published for information purposes only, nor should it be regarded as a replacement for sound medical advice.
This article was written by Dr Cameron McIntosh and edited by the A2 team EXCLUSIVELY for the A2 Aesthetic & Anti-Ageing Magazine Mar/Jun 2020 Edition (Issue 33).
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