How it works
Everything begins with an examination and a consultation. A specialist in Plastic and Aesthetic Surgery looks at the shape of your nose, the height of the bridge, the shape of the tip, and above all the thickness of your nasal skin, because thin or thick skin has a real effect on the choice of material and technique. From there, the surgeon discusses how much height makes sense, which type of implant to use, and where your own tissue should be added, while being clear about what surgery can and cannot do in your case. You will also have the routine pre-operative tests and a review by the anesthetist.
There are a few things to sort out before the day of surgery. You will be asked to stop certain medicines that can encourage bleeding, such as those containing aspirin, for a period before your operation. The surgery is usually done under local anesthesia with sedation, or under general anesthesia, depending on how much is involved and whether anything else is done at the same time.
During surgery, the surgeon takes a small amount of temporal fascia through a hidden incision within the hairline of your temple, so any scar there is usually covered by hair. This fascia is wrapped around the implant, which has been shaped to fit your bridge, creating a soft cushion between the material and your nasal skin. The incision on the nose may be a closed one inside the nostril, or an open incision across the columella, depending on the plan and how much work the tip needs. Through this, the surgeon places the fascia-wrapped implant along the bridge and usually adds some of your own cartilage as well — for example from the ear or the septum — to build and cover the tip, where the skin is thinnest and the implant is most likely to show.
Throughout, the surgeon works carefully to place the implant in the correct layer, to balance the bridge along the midline of your face, and to cover the tip with your own tissue so the chance of the implant showing later is reduced. Once the shaping is done, the surgeon checks the balance, controls any bleeding, and closes the incisions, usually with an external splint over the bridge for the first few days. The whole operation generally takes somewhere between one and three hours, or longer if the tip work is more involved or another procedure is done at the same time. Whether you stay overnight or go home the same day depends on the type of anesthesia and how you are doing.