What does a rhinoplasty procedure involve?

A rhinoplasty, often referred to as a nose job, is a surgery performed to reshape the nose. This might involve changing the size of the nostrils, adjusting the bridge or refining the nasal tip. The procedure is typically performed under general anaesthesia in a hospital or specialist clinic.

During the surgery, the surgeon will make incisions to access the bone and cartilage. In a 'closed' rhinoplasty, incisions are made inside the nostrils, whereas an 'open' rhinoplasty involves a small cut across the columella (the tissue between the nostrils). To close these incisions, surgeons commonly use dissolvable stitches, also known as absorbable sutures.

When are dissolvable stitches used in nose surgery?

In most rhinoplasty procedures, dissolvable stitches are the preferred choice for internal incisions. Because the mucosal tissues inside the nose are moist and heal rapidly, fast-absorbing sutures are ideal. These stitches do not require manual removal, which reduces discomfort for people during the early stages of rhinoplasty recovery.

Surgeons may also use dissolvable stitches for the external skin in some instances. However, if external sutures are used and do not flake away within five to seven days, a doctor might choose to have them removed manually to ensure the risk of visible scarring is kept to a minimum. If non-dissolvable stitches are used, they are typically removed within one week after rhinoplasty surgery.

How long do dissolvable stitches last?

Rhinoplasty surgery will generally require dissolvable stitches while the nose is healing. The duration for which dissolvable stitches remain in place varies depending on the type of material used and individual healing factors. Generally, you can expect the following timelines:

• Internal nasal lining: most dissolvable stitches used inside the nose disappear or fall out within 7 to 14 days. The moisture inside the nostrils helps the sutures break down spontaneously.
• External skin sutures: if fast-absorbing sutures were used on the skin, they typically flake away within one to three weeks.
• Deep structural stitches: in some cases, long-lasting dissolvable sutures are used on deeper cartilage grafts to provide support while the tissues bond. These can take four weeks to four months, or even longer, to dissolve completely.

It is entirely normal to find tiny fragments of clear or white thread falling out of your nose during the first two weeks after surgery. This is a sign that the healing process is progressing as expected. While most stitches dissolve within 7 to 10 days, some specific materials used in more intricate nose surgery are designed to stay present for up to three months before they finally disappear.

What should you expect during rhinoplasty recovery?

The first few weeks after nose surgery are usually the most uncomfortable, as this is when swelling, bruising and tenderness are most noticeable. Bruising often appears around the eyes and cheeks, while swelling can affect both the outside and inside of the nose. This can make the nose feel blocked, tight or sensitive while the tissues begin to heal.

During this early stage, your surgeon will likely recommend keeping your head elevated, including while sleeping, to help reduce swelling. You should also avoid putting pressure on the bridge of the nose, including wearing glasses, for several weeks, as this could affect healing and the final shape.

Most people feel ready to return to work or social activities after around two weeks, once much of the visible bruising has improved. However, swelling can take much longer to settle. While you may notice gradual changes in the shape of your nose over the following months, the final results of rhinoplasty may not be fully visible for 12 to 18 months.

Important rhinoplasty aftercare for your stitches

To help your stitches dissolve correctly and reduce the risk of infection, it is important to follow the aftercare instructions provided by your surgeon. These instructions may vary depending on the type of rhinoplasty performed, but they will likely include:

• Keep the area clean: your surgeon may recommend gentle nasal saline rinses to keep the internal tissues moist and support healing.
• Apply ointments: you may be advised to apply an antibiotic ointment to the nostrils and incision area. Some surgeons may also recommend careful cleaning around internal suture lines.
• Avoid force: do not pick at, pull or disturb your stitches. This can disrupt healing tissue, introduce bacteria and affect the final cosmetic result.
• Do not blow your nose: for the first few weeks, avoid blowing your nose, as pressure can tear the sutures. If you need to sneeze, try to do so through your mouth.
• Make lifestyle adjustments: avoid alcohol, strenuous exercise and heavy lifting for the period advised by your surgeon, as these can increase swelling and bleeding risk. You should also protect your nose from knocks or impact while it heals.

Your surgeon should provide you with clear and effective aftercare advice, including how to care for your stitches, what symptoms to monitor and when to seek further medical help.

When should you be concerned about your healing?

While some discomfort is normal, you should contact your surgical team or a doctor if you notice unusual signs, including:

• Increased redness or heat around the nose.
• Persistent bleeding that does not stop with light pressure.
• An unpleasant smell or yellow discharge from the nostrils (signs of infection).
• Extreme pain that is not managed by prescribed medication.
• Sudden numbness that does not improve.

If you notice that the skin around your stitches is becoming increasingly irritated or if the crusting around the wound seems excessive, seek professional medical advice immediately.

When does a complication become negligence?

Every surgery carries a degree of risk, but people have a right to a professional standard of care. It is important to note that not all complications constitute a breach of duty, as surgery involves inherent risks. However, a complication may be considered negligence if it was caused by a failure in the expected standard of care. Examples of avoidable harm in rhinoplasty include:

• Poor surgical technique leading to extreme asymmetry or a collapsed bridge.
• Inadequate aftercare instructions that lead to a preventable infection.
• Failure to obtain informed consent regarding the specific risks of the procedure.
• Performing the surgery in an unsanitary environment.

If you believe your surgeon failed to meet the accepted clinical standards, you may have grounds for a claim. At Cosmetic Surgery Solicitors, we provide a compassionate, professional service to help you secure the compensation you deserve to cover corrective surgery, further treatment and the emotional impact of the experience.