Bulbous Nose

Correction of Bulbous Nose

Bulbous nose refers to a round and heavy nasal tip, which looks like the shape of a ball. A bulbous nose lacks the subtle highlights and shadows that define the elegant features and shape of the nasal tip. The nose looks bulky, undefined, and unrefined. There are two main reasons for a bulbous nose: the weak cartilage framework in the nasal tip, and the bulk and thickness of the overlying skin and soft tissues envelope (SSTE).

Bulbous nose is a fairly common condition in Asian rhinoplasty. Asian patients with a bulbous nose usually have weak and small lower lateral cartilages, and thick and bulky soft tissue and skin over the nasal tip. Correction of a bulbous nose can be done through tip-pasty technique with trimming of the soft tissues (SSTE) and reinforcing the weak cartilage framework using cartilage grafts.

A bulbous nose is sometimes associated with the low nasal bridge, wide nostrils, and thick alar wall. In such cases, correction of the bulbous nose can be combined with nose augmentation and alarplasty to achieve more balanced overall results.

Preparation

1. 1. 1. Inform the doctor of any pre-existing medical conditions and drug allergy. All medical conditions must be treated and stabilized before surgery.

      2. Stop smoking at least one week before surgery. Smoking is harmful to wound healing and increases the risks of other post-operation complications.

      3. Stop the following medications and supplements from one week before surgery until one week after surgery.

         1. All supplements containing vitamin E, ginseng, ginkgo, garlic, fish oil, and other ingredients that increase bleeding during the procedure. Other supplements, traditional medicine, and herbs, in which ingredients are unknown, have to stop as well.

         2. Medicine that increases bleeding during the procedure such as aspirin, NSAIDs, and warfarin. However, you may need to consult your physician who prescribed the medication before you stop them.

      4. On the day of surgery, wear simple and comfortable clothing. Do not wear any makeup. Do not wear any jewelry and metal objects on the face and body.

      5. Don’t wear glasses on the day of surgery.

Surgery

Duration: 1-3 hours

Anaesthesia: Local anaesthesia

Hospitalization: Not required.

Recovery*: Back to work in 3-7 days, light exercise after 2 weeks, heavy exercise after 3-4 weeks. * The actual speed of recovery may vary from person to person.

Surgery Technique*:

An open rhinoplasty approach is employed. Soft tissue trimming is performed to reduce the bulk in the nasal tip. The weak cartilage framework is strengthened and buttressed with cartilage grafts.

Post-operative Care**

1. What to expect: Swelling usually peaks on the second to third day after surgery and will gradually subside after that. Post-operative pain is usually minimal.

2. General care:

   1. Apply the cold pack in the first 3 days. Elevate the head during sleep to reduce swelling.

   2. Avoid smoking for at least one month. Smoking increases the risk of wound complications.

   3. Good rest and adequate sleep are helpful for a speedy recovery.

   4. Avoid applying pressure on the nose. Sleep on the back and do not sleep on one side to avoid pressure on the nose.

   5. Do not pick the nostrils with a finger. Instead, use a cotton tip to clean the nose.

   6. Be relaxed and calm. Contact the clinic if there are any queries.

3. Medicine: Finish the oral antibiotics as prescribed. Take the painkiller as when necessary.

4. Wound care: Clean the wound with a clean cotton tip soaked with sterile water/saline. Apply antibiotic ointment. No wound dressings are required. Remove the adhesive strips applied on the nose after 3 days.

5. Physical activity: Avoid heavy physical activity and exercise for at least one month.

6. Follow-up: Come back one week after surgery for suture removal and review.

7. Emergency: If there is heavy bleeding, a rapid increase in swelling or severe pain, contact the clinic/doctor for advice immediately.

** The instructions in this list are only for general guidance. If you have any specific queries or concerns during the post-operative recovery, please contact the clinic for further advice.