Nasal deformities are caused by a number of things. Nasal deformities can be congenital
in nature which is, where you would inherit certain features from your parents, for instance.
They can also be developmental in nature where one or another of the elements within the
nose, in other words, the bone or the cartilage can grow too much or can grow too little and
as a result produce either an external or an internal abnormality resulting in a cosmetic
or even a functional problem. Of course, trauma can also cause this as well. So, a significant
injury to either a previously normal nose or a previously abnormal nose can result in
significant disruption and obviously external visible cosmetic deformity or perhaps even
internal malfunction.
External nasal deformities are plainly visible and the individual themselves will be quite
aware that there's an element of the nasal passage that the nasal dorsum that doesn't
look good. Friends and relatives may have mentioned this to you and quite often people
have developed a little bit of a complex about the way it looks anyway. So, the external
appearance is obviously very important and that doesn't require any great expertise to
understand. Internally, a little bit different. For instance, there is disruption of the internal
structures, you could have nasal obstruction which could be intermittent or indeed it could
be one side or both sides or an alternating side problem. You can also have problems in
terms of recurrent infections and problems like that. So, these are the sort of things
that will alert one to having some sort of a nasal deformity.
Well, I think it's worthwhile seeing your doctor when the problem you have with your
nose begins impacting on your quality of life. So, for instance, if the external appearance
of your nose is such that it concerns you and you don't want to have photographs taken
of you, or in more extreme cases perhaps you don't want to go out because you're lacking
in self-confidence, those are the sort of external appearance problems where you would
consult with your doctor. Initially your GP preferably, and then probably a specialist
after that. The other things more internally, more functional in other words, so when your
nose is blocked and you can't breathe properly, obviously that's problematic in the daytime
as well, but at night time these things present particular problems for people trying to sleep;
meaning that you have to breathe through your mouth, because you can't breathe through your
nose, your mouth gets dry, you wake up multiple times, you feel very tired. These are the
sort of situations where you might want to discuss this with your GP and ask them for
some treatment, but obviously if the treatments not working, then you really need to see a
specialist.
I think when you go to see a specialist about your nasal problem you would expect to be
greeted and treated with respect as all patients would, but the doctor will ask you the nature
of your problem. So, it's worthwhile having in your mind an idea of the type of symptoms
that have been troubling you, that are causing problems, and also the treatment that you've
had from your GP. All of these things are important for the specialist to know but try
and stick to the actual problem that you have without radiating to more peripheral health
issues. It helps focus on the actual problem that is the issue for you, yourself. The doctor
will examine your nose usually by looking at the external structure of your nose, your
face, the quality of your skin and then we'll look up inside your nose. Now, sometimes it's
necessary to look inside the nose with the fibre-optic telescope. It's not a painful
thing. It's a bit ticklish. It feels a little weird. But after that, the doctor will have
a much better idea of exactly what the nature of your problem is. The doctor will then explain
to you what they think needs to be done and might take some photographs in the actual
room itself, or they may ask a professional photographer to take photographs for you.
Unfortunately, snaps on your phone are not really going to do it because the photos are
actually used on a professional basis for planning surgery. Scans might be required
like an x-ray and these are useful, and then you'll probably come back and see the doctor
again, refer the discussion about what treatment plan is going to be formulated, and those
are the sort of things that you will be seeing and discussing with your doctor.
Nasal deformities form a complex variety of issues and problems and no nose is same as
the another. Every single one is unique and so each nose has to be assessed completely
separately and individually and an individual treatment plan will be formed for your particular
issue. Now, externally, these sorts of things are visible to you and your family but there
may be internal problems that you may not be very aware of. Your consultant will explain
this to you and perhaps show you a diagram as to what needs to be done and explain the
techniques that will be involved. Essentially, we are talking about rhinoplasty surgery to
correct most of these deformities and there are different types of rhinoplasty operations.
Typically, there is an internal operation and an external operation. These are used
for different things. The external operation is a little more extensive but it's more useful
in the sense that it can deal with multiple problems all at the same time, whereas an
internal rhinoplasty is a little bit more focused on one particular issue. The big difference
between them as far as the patient is concerned really is that there is a little incision
just in the middle part, the columella we call it of the nose here. That gives the surgeon
a great deal more exposure to deal with these multiple problems as I've mentioned. The surgery
itself is carried out under general anaesthetic, that is where we put you to sleep. Typically,
these operations take two, two and a half hours so it is a fair operation and therefore
you will need some time off work. Certainly, you'll be looking at a week to ten days off
work and you may well have a plaster or some sort of a splint on your nose to protect the
nose afterwards as the bones and cartilages may be mobile so they need to be protected.
There will be some swelling probably both externally and internally. So, the external
swelling: you might have some bruising or black eyes just here. Internally it may mean
that your nose is blocked for a week or two after the surgery as you might expect if you
had a cold or flu, but gradually the swelling settles over a week or ten days and the bruising
disappears. The plaster will be taken off a week after, the sutures here, if they're
present, will be taken off a week after and gradually the whole thing will settle down.
So typically, most patients would expect to take about ten days off and then back to normal
activities. Contact sports really should be avoided for probably about a month after the
surgery because the nose is healing and could be bumped or damaged in so doing. So, it's
one of these things. We have to be a little bit careful but usually a little bit of care
and diligence results in an excellent result. Cleaning the nose inside is important and
your consultant will explain his or her particular preference for this and that will hopefully
result in a good, much more patent breathing passage for you.