Rhinoplasty - Mike Tyler explains the open vs closed technique
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Hello, my name is Mike Tyler and I'm going to talk to you a little bit about what happens to you, the patient, when you undergo an open Rhinoplasty operation. Now, as you know the aim of the operation is to change the size and shape and various angles of your nose and I have already discussed that in a previous video. So once you have decided whether you are going to have an open Rhinoplasty what will happen is that you will arrive in the hospital on the day of your operation, you will see me or the surgeon that's going to do the surgery and also see the anesthetist. We'll run through the nature and the aims of the operation with you, we'll get you to sign a consent form and you will probably have your photograph taken. You'll then go down to theater. During the course of the operation, obviously we will do all those elements of the operation that we have discussed with you beforehand. As far as you're concerned, when you wake up, your nose should be fairly numb so that it is not a great deal of pain when you first wake up because we put lots of local anesthetic in. You may well find that you nostrils feel a little bit blocked, either because they're swollen or because we've put packs in. We rarely put the packs in but occasionally we do. You'll have a hard plastic cover, splint that covers your nose that extends onto your forehead and that will be the most obvious sign that you've had a nose operation to anyone that looks at you. The other thing that will be happening is that you may well start to get a little bit of bruising along your eyelids here because during the course of the operation, any bleeding that happens in the nose often spreads to underneath your eyelids. You will be sitting up, you'll have a little pack just along the bottom of the nose just to catch any drips of blood that may come after the operation. You'll go back to the ward and you'll spend the night with us in hospital. The surgeon will come round and see you the following morning just to check that everything is fine and you'll then be allowed to go home. At this point you will have the splint on your head, you will have some black eyes, your nose will feel a little bit blocked, you may get a dull ache around the nose for which usually paracetamol or a little bit of ibuprofen, or combination of both is enough. When you get home we are going to ask you just to take it easy for the first week, we don't want you doing anything that would start your nose re-bleeding again. Most patients who have had a nose bleed before, and as you're aware if you have had a nose bleed if you put your head down to do any work, the nose bleed can start again, so anything that you think would start a nose bleed we would want you to avoid. Putting your head down, sitting in a hot bath, having a hot curry or doing any form of strenuous exercise really. We would also ask you to try and sit up with a few extra pillows so that the bruising and swelling is reduced. Then one week after the operation you would come along and see me, we'd take the splint off, we'd take a couple of little stitches here and have them removed, and the remainder of them are actually inside the nose. At this point you should be able to see the broad effect of what the operation has done, although the nose remains really quite swollen. It's very common for people to notice that the swelling actually increases after we take the splint off because that's been acting a bit like a compressive bandage, like a tubigrip on a swollen ankle, for the week and when we remove it can often get a little bigger. It will often take about six weeks before the main amount of swelling settles and then it will actually continue, the swelling will continue to get better over the ensuing months after the operation. The thing that you will notice about your nose is it feels very wooden and very numb. It is numb, that feeling will start to come back. The wooden hard aspect to it will start to soften as the swelling goes. The othe
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