Rhinoplasty

Face: Rhinoplasty

Why would I consider Rhinoplasty?

Rhinoplasty is an operation on the nose to change the appearance. This procedure can have purely cosmetic intentions, or it can relate to previous trauma or reconstruction.
If there has been no previous trauma or deformity of the nose related to birth then the procedure is considered cosmetic. If there has been previous trauma, or the concern about the nose is related to a birth problem, then the surgery is considered reconstructive and may attract appropriate rebate fees.

Who Benefits?

You would consider this procedure if you wished your nose to more closely resemble your feelings about it, or if you have some previous trauma or deformity to your nose that you wish remedied.

A surgeon who is in tune with your needs should not tell you what is wrong with your nose, rather they should ask you what you do not like about it. Questions should be open ended so that the surgeon may understand exactly what your concerns are regarding the appearance of your nose.

There are generally two schools of thought on actual examination of the nose and surgical assessment:

  • Artistic – where the surgery is related to the appearance and aesthetics of the nose on your face.
  • Specific Measurements – where your surgeon uses specific measurements, made before the operation and during the operation, to achieve reproducible results.

For most Plastic Surgeons, myself included, the approach lies somewhere in between – where measurements are used as a general guide but ultimately it is the appearance of the nose in harmony with the rest of your face that is most important.

How is it done?

There are two types of rhinoplasty:

  • Closed Rhinoplasty
  • Open Rhinoplasty

Method

  • Closed Rhinoplasty  – There are no external incisions on the nose.
  • Open Rhinoplasty – an incision is made in the central part of the base of the nose (columella). The nasal skin is then elevated to expose the underlying structural architecture of the nose.

In both methods, the underlying nasal architecture is altered according to the extensive preoperative plan. This typically included removing excess bone and cartilage such as in humps or large tips, suturing cartilages closer and adding grafts for example to avoid a ‘done look’.

If there are functional nasal obstruction problems, then additional procedures such as septoplasty and CIT (cautery of inferior turbinates). Septoplasty is an operation in conjunction with rhinoplasty to correct a deviation of the nasal septum to clear a nasal passage.

What can I expect?

If you are undergoing rhinoplasty, you are typically admitted on the day of surgery fasted from the night before or 8 hours prior.

Rhinoplasty is performed under general anaesthesia and typically carried out as either day case surgery or short stay surgery depending on the extent of surgery.
The exact length of time of the operation depends on the complexity of the operation.

A rhinoplasty can vary from between one and four hours operating time depending on this.

An overall general appreciation of the new shape of the nose can be obtained when the splint is removed, however this does not become clear until swelling has reduced. The vast majority of swelling has resolved after three weeks, however there is some persistent swelling for even six to twelve months following the operation. This is the type of swelling that is not generally noticeable to other people.

How long does it take to recover?

Recovery time is in the order of a week or two pending on the extent of surgery.
Immediately following the operation a patient sleeps on two to three pillows to assist with decreasing swelling. Swelling does occur and is maximal approximately one to two weeks after the operation. Most of this will resolve after two to three weeks post operation, however there will be a minor degree of swelling that will be present for several months.

Following the operation the patient is advised to avoid blowing their nose. Prior to discharge, we ensure that the patient is totally comfortable and happy with their pain relief, appearance and general physical state.

Usually manipulation of the nasal bones themselves is required and a splint is necessary to keep the bones in the new position. This splint remains on the nose for approximately seven to ten days and is then removed in the office.

Although the splint is removed at seven to ten days post operation, the nose remains fragile for approximately a further three week period. Activities such as contact sports should be avoided during this period.

What complications can occur?

Although every endeavour is made to avoid complications, sometimes they do occur. Complications can be related to the anaesthetic or the surgery.

Surgical complications can include: bleeding and bruising, swelling and infection.
In addition, temporary altered sensation can occur in the skin of the nose. For someone with a deviated nose, some residual asymmetry is possible. Minor secondary procedures may be required.

Although this list indicates some examples of complications, surgery should not be undertaken until this has been discussed fully with the surgeon.

What other procedures are often performed at the same time?

Rhinoplasty is typically performed on its own. However, it is not uncommon for it to be combined with others cosmetic surgery procedures.

What does it cost and will private insurance help?

Rhinoplasty surgery if it is a functional procedure can be given an item number. Therefore, private insurance rebates will apply and this will assist with the overall costs.

If the reason for rhinoplasty is cosmetic, then private insurance and medicare rebates are not applicable.

Exact costing is highly variable as it depends on your history and circumstances, the hospital used and specifics of the procedure.

If a procedure can be given an item number then rebates will apply. In this scenario, out of pocket costs are typically less than amounts paid for surgery overseas.

A cost guide can be requested from my office on 9126 9218 (+61 8 9126 9218).

Alternatively, we can be emailed at info@cosmetic-surgery.com.au

Where can I get more information?

If you have specific questions, or wish more information on specific procedures, please contact my office for a complimentary appointment with my nurse / patient liaison officer.

General Photographs


Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

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