As a result of cleft operations carried out in childhood, some people find it hard to breathe down one or both sides of their nose or may become aware of differences in the way their nose looks. This does not bother some people, but other people feel that they would like it changed. Nose surgery can be considered if you feel that you would like to change the way your nose looks and/or works.

Your surgeon might call the procedure a 'Rhinoplasty' and it is usually done by making a small incision in the skin underneath the nose tip. Sometimes the surgery can also involve making changes to the septum, a strip of bone and cartilage, which runs down the middle of the nose. In this case, the operation is called a 'Septo-Rhinoplasty'. Any changes made to the face through surgery can be altered by growth, so we would not usually consider this treatment until you have finished growing, at about 18 years or older.

Preparing for surgery 

If you are considering nose surgery you can book a clinic appointment to see the cleft team. We will also make sure you have the opportunity to talk about nose surgery when you attend routine cleft appointments.  At the appointment a surgeon, one of our psychologists and a speech and language therapist will see you. The team will listen to which aspects of your nose you would like to change and discuss the potential risks and benefits of surgery with you. Your nose is an important feature in the middle of your face and you should carefully consider the impact of making a significant change to your appearance. One of our psychologists will support you with this and can see you separately to talk things through. These discussions are confidential and may help with any worries or concerns you may have.

The surgeon will look closely at the outside and inside of your nose and the rest of your face and will need to know if you have had any accidents involving your nose or if you are using any treatments for nasal problems (such as hay fever). If you are considering any other surgeries you should discuss this with the team as some, such as jaw surgery, should be done before this procedure.

Surgery 

Unlike most of the operations you have had at the Children's Hospital, rhinoplasty is usually carried out in the Bristol Royal Infirmary; therefore the wards and surroundings may be unfamiliar to you. Sometimes people can go home on the day of surgery and sometimes an overnight stay is necessary. Your surgeon will tell you how to care for your nose whilst it heals; some activities (for example, swimming and contact sports) should be avoided after surgery. If this is an issue you should discuss this with your surgeon at your cleft appointment. Your follow-up outpatient appointments will be held at the same location as your usual cleft appointments.