Rhinoplasty (Nose Surgery)

• Before undergoing nose surgery, patients are advised to study the procedure, including its potential risks and benefits. A specialist should be consulted to address any misunderstandings and discuss the patient’s desired outcome so that all parties share an awareness of the likely results of surgery. 
• There are currently a range of procedures that can assist medical staff before, during, and after nose surgery, such as photo simulation and the use of an endoscope, both of which offer significantly improved results as compared to traditional techniques. 

The nose is a prominent feature in a person’s appearance. A nose that is too small or too large, misshapen, or deformed⁠—whether due to genetics or as a result of an accident—can leave that person with low self-esteem both socially and professionally. Moreover, some nasal structure abnormalities cause breathing difficulties that can, for example, make exercising difficult and lead to severe symptoms when catching a cold. 

Rhinoplasty—or nose surgery or nose job—refers to procedures aimed at restoring a balanced look to a person’s nose and face by making structural adjustments through the use of surgery. Using modern surgical techniques the results are more natural looking and rapid surgery recovery times are possible. 

There are many methods used to perform nose surgery, from silicone implants and alarplasty to open techniques involving the use of ear cartilage, rib cartilage, fatty tissue, skin grafts, or tissue grafts from the patient’s own body. 

Rhinoplasty using silicone implants 

Silicone implants have been popular for many years, as this is a relatively minor form of surgery which saves time and accelerates recovery times. Experienced surgeons are able to use this type of surgery to augment or reshape the nose using silicone implants according to the patient’s desired outcome. In certain cases, open techniques can be used along with silicone implants, while some surgeries may even utilize acellular dermal matrix (a type of surgical mesh) to improve the esthetic result and reduce the likelihood of complications. However, this type of surgery may not be suitable for patients with smaller noses or noses with structural irregularities. 

Open rhinoplasty 

Open techniques are those that involve making structural changes to the nose and its cartilage. This type of surgery is only suited to patients with structural irregularities, such as a large nasal bone, a large nasal bump, or a completely misshapen or deformed nose, whether present since birth or resulting from a previously unsuccessful nose surgery. Open techniques rely on grafts taken from other areas of the body, such as ear or rib cartilage, to adjust the nose’s structure. These are major forms of surgery, so a general anesthetic and hospital stay are necessary due to the increased time needed to make a full recovery. While results of these surgeries depend on the amount of tissue available, the main benefit of open techniques is that the tissue used is the patient’s own, meaning the outcomes are often desirable because patients need not worry about issues surrounding the use of silicone or other foreign material. 

Alarplasty 

Alarplasty can help patients achieve a more proportional look to their nose, improving its esthetic appearance while reducing any misshapenness. Alarplasty can also be performed alongside other forms of rhinoplasty. 

• People with issues affecting their nasal structure or those seeking a more attractive look to their nose 
• Those aged 18 and above 
• People with no issues affecting their breathing (some cases may require ear, nose, and throat screening by an ENT specialist prior to nose surgery) 
• People with no underlying health conditions that would prohibit surgery, such as hemophilia and Ehlers-Danlos syndrome 
• Women who are neither pregnant nor breastfeeding 
• People seeking realistic results 
• People of sound mental health 

All forms of surgery carry with them an inherent risk that can affect anyone going under the knife. Our medical staff will provide consultations and carry out a risk assessment, offering patients answers for any concerns they may have prior to deciding whether or not to undergo surgery. 

Potential side effects associated with nose surgery include: 

• Scarring: Patients with no history of keloid type scarring are usually able to achieve a smooth looking finish to the skin, with incisions hidden in suitable places 
• Results not matching expectations: Experienced surgeons are crucial. They provide the right advice and design surgery in a way that will offer the most natural-looking, long-lasting results for their patients, while also minimizing the risk of side effects. 
• Other potential risks: Bleeding, hematoma, and skin necrosis are most common among smokers or patients with underlying health conditions associated with the vascular system, such as diabetes, high blood pressure, and hyperlipidemia. However, if such conditions are managed effectively, they should not interfere with surgery. 

• Samitivej Srinakarin Hospital utilizes a range of techniques to screen, plan, and make adjustments during surgery, including photo simulations, laser leveling, and endoscopic procedures 
• The surgeons in charge of these procedures have over 20 years of combined experience in the field 
• Positive outcomes are achieved as a result of our techniques and medical expertise 
• Those unable to visit the hospital after surgery can be monitored through the use of our Virtual Hospital 

6 months prior to nose surgery 

• Halt any medications containing vitamin A (isotretinoin) as these can impact the healing of wounds 
• Avoid getting nose filler injections 

3 months prior to nose surgery 

• Prepare the body for surgery with a light exercise regime and plenty of rest 
• Undergo your annual health screening and, should you have any underlying health conditions, be sure to consult your doctor to ensure they are under control 
• Avoid undergoing any laser therapy or fine thread lifting treatments on the nose 

4 weeks prior to nose surgery 

• Avoid smoking for at least 4 weeks preceding surgery, and then for at least 4 weeks following surgery 
• Avoid sunbathing 
• Avoid any other surgeries close to the time of surgery. Women who are expecting their period on the date of their surgery should consult the surgeon in charge regarding a plan to postpone the surgery 

10 days prior to nose surgery 
Avoid taking drugs that affect blood clotting capabilities, such as:  

• Anticoagulants, including aspirin, Coumadin, Ticlid, Plavix or Aggrenox (consult your regular physician regarding the safe halting of any medication)  
• Nsaid drugs, including Ibuprofen, Advil, Motrin, Nuprin, Aleve, Relafen, Naprosyn, Diclofenac, Naproxen, Voltaren, Daypro, Feldene, Clinoril, Lodine, Indocin, and Orudis  
• Sedatives, including Zoloft, Lexapro, Prozac, and Pristiq  
• All vitamin supplements that can affect blood clotting capabilities, such as fish oils, omega-3, co-enzyme Q10, evening primrose oil, glucosamine, arnica, ginseng, gingko, and herbs  

In addition to following the aforementioned advice, patients should attend a medical consultation regarding nose surgery to better understand its potential risks and benefits, as well as to address any misconceptions and to ensure all parties share an understanding about the desired results. 

• https://www.isaps.org/member-directory 
• https://www.thprs.org/find-doctor 
• https://checkmd.tmc.or.th 

1. Medical staff will consult the patient regarding desired outcomes prior to surgery 
2. Surgery takes 1-3 hours to complete 
3. A trained anesthesiologist will administer a local or general anesthetic depending on the procedure being used 
4. Patients may undergo ‘day surgery’ or be required to recover in hospital for 1–2 days following surgery 
5. Follow-up consultations to monitor the patient will be held on days 5 and 9 following the procedure. 

Recovery times differ depending on a range of factors, such as the patient’s general health prior to surgery, the type of surgery performed, and the post-surgery care undertaken. 

1. The head should remain raised for the first 7 days following surgery (patients should use 2-3 pillows while sleeping) 
2. Cool and hot compresses should be used to reduce pain and inflammation 
3. Scarring should be cleaned daily, using dampened gauze to wipe away dried blood 
4. Swelling and bruising may last 1-3 weeks following the procedure and the face will appear particularly swollen for the first 3-5 days. Although the swelling usually goes down within 1-2 weeks, it could take 2-3 months for all the swelling to improve 
5. Avoid direct exposure to sunlight for 3-6 months 
6. Patients should not consume pickled foods or alcoholic beverages during recovery 
7. Patients should be able to return to work after about a week 
8. Patients should avoid all forms of exercise for the first 4 weeks 
9. Patients should attend all scheduled follow-up appointments 

Nose surgery is extremely popular and is becoming more and more common due to the impact it can have on a patient’s overall appearance and greater sense of self-confidence. Nonetheless, anyone considering nose surgery should first consider the safety of the procedure by selecting an institution and surgeon with vast experience in the field, who can minimize any potential risks that may occur during surgery and ensure the best results for the patients. 

At the Samitivej Plastic and Esthetic Surgery Institute, our qualified specialists from Board Certificated Plastic and Reconstructive surgeons performs a large selection of operations to help your outside look the way you feel on the inside with an excellence care on all surgical procedures. We specialize in breast surgeries such as breast augmentation, breast lift and breast reduction. Our plastic surgeons are also experienced in Face lift, body contouring procedures; body lifts surgeries after significant weight loss. We also do combination surgeries of breast, tummy and many other areas. 

Samitivej has a team ready to help and provide services for:   

• Treatment Plan Consultation with a doctor via online video-call (second opinion)  
• Treatment Planning if you have medical records or a price estimate from another hospital  
• Cost Planning by our Appraisals Team with price guarantee (only for procedure packages without complications)  
• Check Initial Coverage Eligibility with Thai and international insurance companies (only for insurance companies in contract with the Hospital)