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The questions people arrive holding, answered at length and from published sources. These are dated by publication and they are allowed to age. The standing guidance lives in the guides, which is dated by review instead.
It can, in three different ways. Swelling can hold the upper lip down for a while after surgery, a small muscle can pull the tip of the nose down each time you smile, and changes made to the tip alter how the lip looks at rest. Only the first wears off on its own. The other two are changes to the face, and they belong in the consultation before surgery.
"Greek nose" is used for two different profiles. One is a straight bridge with no hump. The other is the line of classical sculpture, where the forehead runs on into the nose with almost no dip at the top. Neither is a diagnosis, and changing a nose towards either one is a different operation with a different limit.
Rotation describes where the tip sits, and an upturned nose is a rotated one. Rotating a tip upwards means shortening and repositioning structures the nose already has. So the strength of that cartilage, the skin over it and the length of the nose decide how far rotation can go before tip support and the airway pay for it.
The two words name two operations on two different parts of the nose, and they are not alternatives in the way the comparison suggests: they are often done together, in one anaesthetic, on the same list. What separates them for the person deciding is not the technique. It is that one of them has been tested against not operating at all and the other has not, that one is funded on written criteria and the other usually is not, and that the word printed on the consent form decides whether you have agreed to your appearance changing.
Not for appearance alone. The NHS website puts cosmetic surgery outside routine provision and says nose reshaping may be provided if it is needed to help you breathe. The criteria that decide a particular case are written lower down, and they do not agree with each other. This page quotes four of those documents by name, with the version and date of each that carries one: two integrated care board policies from England, the one national referral protocol in Scotland, and an NHS England policy written for members of the Armed Forces and their families. Wales and Northern Ireland run their own arrangements and were not read for this page.
A septoplasty is done for the airway, not the face, and ENT UK's leaflet says the operation is not meant to change the way your nose looks. It then lists a slight change of shape among the complications and says it can be common, with no number behind it. In a randomised trial, 17 of 171 people in the surgery arm reported a change in appearance at six months. The largest series we opened says its authors saw external deformities in less than 1 per cent, with no count published. Three kinds of statement, kept apart here.
Septoplasty alone normally leaves no cast and, per ENT UK, no black eyes are expected, and it is still not a small recovery, because the nose is blocked afterwards by swelling and by whatever is placed inside it. This post gives the timings a British professional body and one NHS trust give their own patients, explains packing and internal splints, and puts the things that went wrong next to the number of people they happened to.
Before and after photographs are the first thing most people look at and the last thing most people are taught to read. A pair can be honest, careful and still not tell you what you think it is telling you, because a nose photographed at the end of an operation is not the nose the patient will have, and two photographs taken under different lighting from different distances are not a comparison at all. Here is what to check.
The phrase covers four situations that have almost nothing in common. One is a medical complication and needs a doctor this week. One is a result that is not what somebody hoped for, and is a conversation rather than an emergency. One is a nose that simply has not finished settling, where the honest answer is to wait. And one is a decision taken on information that was wrong before anybody operated. Telling them apart is most of the work.
Most people expect a nose operation to be agony and it usually is not, which is a genuine finding rather than reassurance. In the small published series where pain was actually measured, patients reported moderate pain for around two days and used very few painkillers. The same series recorded scores near the top of the scale for somebody, so an average is worth reading carefully, and the discomfort most people describe afterwards is not pain at all.
Istanbul has become one of a handful of cities people fly to for a nose. This page sets out the part of that which is measured, the part which is an argument, and what the regulation in force actually requires of the place you would be operated in. The three things worth settling before you book are at the end.
The usual answer is fifteen or sixteen for girls and a year later for boys. It comes from an estimate of when the nose stops growing, not from a law and not from a measurement anyone takes on an individual patient. Three published sources give three different figures, and the gaps between them are worth reading before you treat any of them as a threshold.
Almost every account of rhinoplasty recovery ends at one year. The measurement behind it studied 40 patients, and its one year figure is a value read off a fitted curve rather than something recorded at twelve months. Its clock starts at the one to two week visit, not at the nose someone had before.
There is good randomised evidence that surgery relieves a blocked nose, and it is far more specific than it is usually reported to be. The trial recruited adults whose septum a specialist could see was deviated, and it tested one operation against sprays. Whether it describes any particular blocked nose depends on what is blocking it.
People ask whether surgery abroad is safe and expect the answer to be a number. We went looking for that number. What exists is a small American dataset, a few counts of patients who turned up at British hospitals afterwards, and national statistics that record arrivals and revenue rather than outcomes.
Revision rhinoplasty corrects the result of a previous nose operation, whether the problem is the appearance, the breathing or both. It is harder than a first procedure, usually needs cartilage taken from elsewhere, and is normally planned only once at least twelve months have passed.
Why there are not more of these
We publish here when we have something to say that a source will carry. A blog that posts weekly on a medical topic is repeating other people's pages, and a quiet month is the better version of that.