Rhinoplasty

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Conditions that rhinoplasty can correct

Rhinoplasty can be performed on any type of nose and can achieve cosmetic results by altering or modifying your nose’s size, shape, angle, tip, nostrils and bridge. Potential outcomes of rhinoplasty are changes to aesthetic appearance, correction to trauma and functional improvement.

Here is a consolidated list of the issues rhinoplasty can address:

• modify drooped, protruded, or enlarged nasal tip
• correct nostril shape by modifying flared or pinched nostrils
• modify the width of wide or narrow noses
• straighten an off-centred or crooked nose
• adjust size to make nose and nasal openings smaller or larger
• restore the height of flattened areas
• correct nasal bumps or humps
• correct birth defects
• repair nasal damage by injury, breaks, disease or infection
• enhance symmetry and rectify asymmetry
• balance nose proportion for facial harmony
• can also open up nasal passages to improve breathing
• improve the nasal airway for better breathing

Alternative nose surgery

Rhinoplasty can address functional issues relating to breathing through scenarios of structural change, such as widening nostrils. However, rhinoplasty is primarily performed for cosmetic purposes, and septoplasty is a more suitable procedure for improving breathing function. Rhinoplasty and septoplasty can be performed in combination, known as septorhinoplasty, for patients seeking appearance and breathing function enhancement.

It is important to note that every patient’s rhinoplasty will have different outcomes as surgical adjustments vary for differing noses. Goals and expectations will be discussed diligently in your initial consultation at Me Clinic, where our highly experienced specialist Plastic Surgeons will evaluate your needs and requests to conduct the optimal rhinoplasty procedure for your circumstances.

How common is rhinoplasty?

Rhinoplasty, often referred to as a “nose job,” is one of the most frequently performed cosmetic surgeries worldwide. The popularity of rhinoplasty is driven by its ability to significantly enhance facial harmony and self-esteem by altering the nose’s size, shape, or proportions. It is not only sought after for aesthetic improvements but also for functional corrections, such as rectifying breathing issues caused by nasal structure anomalies.

The procedure’s prevalence is evidenced by the high number of surgeries performed annually. In the United States alone, rhinoplasty ranks among the top five cosmetic surgical procedures, with over 200,000 procedures carried out each year. This trend is mirrored globally, as individuals from various cultural backgrounds seek rhinoplasty for both cosmetic and functional reasons.

The demand for rhinoplasty reflects a broad acceptance of cosmetic surgery in general, as people increasingly view such procedures as a viable option for enhancing their appearance and improving their quality of life. The decision to undergo rhinoplasty is often motivated by the desire for a nose that better complements one’s facial features or to address issues that have been sources of self-consciousness or functional discomfort.

Anatomy of the nose

Rhinoplasty, or a “nose job,” intricately modifies various parts of the nose to enhance both function and appearance. Key areas addressed include:

• Root: Located where the nose meets the forehead, modifications here influence the angle and profile of the nose.
• Bridge: The bony section between the eyes, often reshaped to remove humps or straighten the nose.
• Sidewall: The sides of the nose, where adjustments can correct width or asymmetries.
• Tip: The lower end of the nose, often refined to adjust its definition, size, and angle.
• Nostrils and Alar: The nostrils, shaped by alar cartilage, can be resized or reshaped to enhance facial symmetry. Procedures like alar base reduction are common for refining a broad nasal base.
• Columella: The tissue separating the nostrils, pivotal in adjusting the nasal tip’s angle and projection.

Beyond external modifications, rhinoplasty may also enhance nasal function by addressing:

• Nasal Passages: Improvements here, such as straightening a deviated septum (septoplasty) or reducing turbinates (turbinectomy), aid airflow and breathing.
• Nasal Septum: The internal divider of the nasal passages, often corrected to improve both airflow and external appearance.
• Nasal Valves: These crucial airway points may be reinforced or widened to optimise breathing.

Each component of the nose serves a specific function and aesthetic role. Rhinoplasty aims to harmonise these elements to create a balanced appearance while maintaining or enhancing nasal functionality. Understanding this detailed anatomy helps patients and surgeons plan surgeries that meet aesthetic desires and functional needs effectively.

What happens during a rhinoplasty procedure?

Rhinoplasty is a surgical procedure that alters the shape of the nose for either aesthetic enhancement or functional improvement. This surgery is typically a day procedure and patients are typically under general anesthesia, ensuring comfort and immobility. A rhinoplasty takes 1-3 hours depending on the complexity of the surgery and the extent of correction needed.

The procedure involves reshaping the bone and cartilage under the skin of the nose. Surgeons can access these structures either from within the nose, known as a closed technique, or by making an incision in the columella, the strip between the nostrils, known as an open technique. Incisions are closed with stitches that either dissolve on their own or are removed shortly after surgery.

Bone and cartilage are either removed or grafted in to improve the nasal shape and proportions. If the septum needs to be straightened or repaired, this can also be done alongside the cosmetic changes.

Directly after rhinoplasty surgery, patients are typically taken to a recovery room where they are closely monitored as they wake up from anesthesia. This immediate post-operative monitoring is often short but crucial to ensure the patient’s vital signs are stable and there are no immediate complications.

Most rhinoplasty procedures are outpatient, meaning the patient can go home the same day. However, whether you will need to stay overnight will depend on the complexity of the surgery, your overall health, and your surgeon’s recommendations. If you are discharged the same day, you will need someone to drive you home and stay with you for at least the first 24 hours.

Dressings and a splint are applied to protect the nose and help maintain its new shape. Internal splints or packing may also be placed inside the nostrils, especially if the nasal septum was involved in the procedure. These are usually removed after a week or as advised by your surgeon.

Before discharge, you’ll be given detailed care instructions, medication prescriptions for pain and, possibly, antibiotics to prevent infection. Surgeons often prescribe pain medication to manage discomfort following the procedure. Follow-up appointments are essential to check on your healing progress and to remove any stitches or splints if necessary.

Options in nose surgery

Nasal surgery encompasses various procedures, including rhinoplasty, which can be categorised into different types based on the specific needs and goals of the patient.

Rhinoplasty, tailored to the individual’s needs and the unique contours of their facial structure, can serve a multitude of purposes, from structural reconstruction for enhanced breathing to aesthetic refinement. At Me Clinic, our Specialist Plastic Surgeons engage with patients to determine the most suitable surgical approach.

We have distinguished the different types and natures of rhinoplasty procedures for better understanding:

• Cosmetic rhinoplasty: This surgery is performed to change the nose’s shape for aesthetic purposes, addressing issues like bumps on the nasal bridge, wide nostrils, or an undesirable nose shape.
• Functional rhinoplasty: This procedure is a combination of rhinoplasty and septoplasty surgery, known as septo-rhinoplasty. The goal of this surgery is to eliminate the functional problems of the nose while also altering the aesthetic appearance.
• Revision rhinoplasty: Also known as secondary rhinoplasty, this procedure corrects or improves the results of a previous rhinoplasty.
• Reconstructive rhinoplasty: This type of surgery rebuilds the nose’s structure and function after traumatic injury, cancer surgery, or congenital disability.
• Tip rhinoplasty: Focuses solely on altering the shape, size, or angle of the nasal tip without affecting the nasal bridge.
• Nostril rhinoplasty: This is a nostril reduction option known as an alarplasty, which solely focuses on changing the shape and size of the nostril.

Rhinoplasty techniques

Closed rhinoplasty

Closed rhinoplasty involves incisions strictly within the nasal cavity, ensuring no visible scars post-surgery. This technique benefits those looking for minimal scarring. However, the internal approach limits direct access to nasal cartilage and structures, which may pose challenges in detailed reshaping efforts. It’s typically reserved for cases requiring more focused changes to the nasal septum or bridge.

Open rhinoplasty

Open rhinoplasty employs the same internal incisions as the closed technique but adds a small, discreet incision across the columella—the tissue separating the nostrils. This additional access point may leave a minor scar, often well-concealed and barely noticeable. The open technique is advantageous for comprehensive reshaping, granting surgeons superior visibility and the ability to manipulate the nasal structure with greater precision, especially when detailed work on the nasal tip or complex corrections are needed.

Our surgeons make decisions on the technique based on the extent of modifications required and the specific anatomical areas to be corrected. Often during these procedures, it is necessary to graft cartilage to support and shape the nose’s new structure. Autologous grafts, typically harvested from the nasal septum, are preferred for their compatibility and reduced risk of rejection. If additional cartilage is required, it may be sourced from the ear or rib, or in some cases, donor grafts may be utilised. This strategic use of grafts is crucial for achieving a natural contour and ensuring the stability of the rhinoplasty results.

What should I expect after rhinoplasty surgery?

After your procedure, you may feel drowsy from the anaesthetic. It is important to have someone drive you home and stay overnight. On this evening we recommend you rest.

You are provided with an after hours direct number in the event you may have any questions or concerns you wish to speak to us about.

Initially, swelling and bruising around the eyes and nose are common, which typically peak within the first week and then gradually subside. You may also experience some stuffiness due to swelling inside the nose. Expect some mucus or bleeding from the nose in the first few days also.

In terms of pain, it is generally mild to moderate and can be managed with prescribed pain medication. It is essential to follow your surgeon’s instructions on wound care to prevent infection and ensure proper healing.

Part of your recovery process includes maintaining an elevated head position even while sleeping, particularly in the initial weeks following the procedure, to help reduce swelling. Careful attention will need to be paid to any dressings; your healthcare provider will instruct you on the proper care and when replacements are necessary. If a nasal splint is applied, it usually remains in place for about a week to secure the nose’s new structure.

You will need to take it easy and avoid strenuous activities for a few weeks. Most patients can return to sedentary work within a week or two post-surgery, but this can vary based on the individual’s recovery and the nature of their work.

While light walking may be encouraged to support circulation, any rigorous exercise should be put on hold to prevent unnecessary stress on the surgical site. You will likely receive the green light to gradually resume more intensive workouts after 3-6 weeks, once your surgeon evaluates your recovery progress. As for contact sports or any situation where your nose could be at risk of impact, a cautious approach is advised. Me Clinic recommends a standard waiting period of six months before re-engagement, to protect the surgical enhancements made and allow the delicate tissues ample time to heal fully.

By following these steps, you are more likely to enjoy a smooth recovery and preserve the improvements made by your rhinoplasty in the long term. Remember, each individual’s recovery can vary, and therefore, personalised advice from your Plastic Surgeon should always take precedence.

Your surgeon will schedule follow-up visits to monitor your recovery and advise when you can resume normal activities, such as wearing glasses and performing regular exercise routines. It’s vital to adhere to all follow-up appointments and communicate openly with your surgeon about any concerns during the recovery process.

Preparing for rhinoplasty

Several important steps must be followed in preparation for rhinoplasty to ensure you are ready for surgery and have a smooth recovery. Me Clinic and our Specialist Plastic Surgeons guarantee you are fully prepared and are not burdened with all the responsibility.

In the lead-up to your rhinoplasty, your Plastic Surgeon will work with you to ensure your procedure is customised to your facial structure and aesthetic goals, taking into consideration the existing bone and cartilage in your nose. They will also ensure that the surgery will not compromise your breathing, and if a deviated septum is present, they may recommend septoplasty alongside your rhinoplasty.

Our Plastic Surgeons will be honest, will not over-promise results as different patient circumstances mean there will always be differing results. It is essential to remember outcomes of a rhinoplasty evolves over time, typically finalising around the one-year mark, so patience and avoiding premature judgments about additional surgeries are important.

For smokers, we recommended to quit well before the surgery to reduce the risk of complications and to promote better healing.

Me Clinic has 35 years of experience in Plastic surgery and Cosmetic surgery, with our Plastic Surgeon’s performing thousands of surgeries. You are in safe hands at Me Clinic and we will provide all information prior to your surgery and during the consultation.

Your pre-surgery meeting will include a detailed medical history review, a physical examination, and possibly some imaging to plan the procedure and set realistic expectations. It is vital to openly discuss your motivation for the surgery and what you hope to achieve. This will aid the surgeon in creating a tailored approach for your rhinoplasty.

Rhinoplasty questions to ask your surgeon

A Specialist Plastic at Me Clinic offer thorough and high quality consultations that should cover what is needed from you and what to expect from rhinoplasty.

Important questions that will be answered or alternatively you should ask to ensure you are prepared for surgery are:

• Am I an ideal candidate for rhinoplasty?
• What limitations do we face with my nasal structure for reshaping goals?
• Could you explain how my airway function might improve post-surgery?
• What post-operative regimen should I follow for recovery?
• What are the specific risks associated with my health and age?
• How do you assess the success of rhinoplasty surgeries?
• Based on my nose’s anatomy, what surgical approach would you recommend?
• Could you provide before and afters of previous patients?
• How long should I expect the full recovery and final results to take?
• What will the total cost of the procedure be, including all associated fees?

Other important considerations include:

• Avoid taking aspirin, ibuprofen, and certain herbal supplements as they can increase bleeding.
• Arrange for transportation and post-operative care as you’ll need assistance, especially in the first 24 hours after surgery.
• Prepare your recovery space at home with necessities like pillows, ice packs, a thermometer, and a telephone within easy reach.
• Follow all preoperative and postoperative instructions provided by your surgeon to ensure the best possible outcome.

Rhinoplasty recovery timeline

It is important to note that individual recovery from rhinoplasty surgery can vary based on a range of factors including the extent of the surgery, the patient’s general health, and adherence to post-operative care instructions.

Me Clinic’s experienced Plastic Surgeons will thoroughly discuss the recovery process, what to expect and answer all your questions to ensure you are fully prepared for Rhinoplasty. The following timeline serves as a general guide and should be adapted to align with the advice of your Plastic Surgeon.

Immediately post-op: first few hours

• Experience mild to moderate pain; pain relief can be requested from the nursing staff.
• Possible swelling and bruising, particularly around the eyes; these should begin to subside within the first week.
• Stuffy or blocked nose feeling due to internal dressings.
• Splints and dressings in place to support healing; these help maintain the new shape of your nose.
• Restricted from eating or drinking for a few hours post-surgery.

Day 1 to week 1: initial healing phase

• Splints, either internal, external, or both, remain in place to stabilise the nose structure.
• Prescribed pain medication may be necessary to manage discomfort.
• Ice packs may be recommended to alleviate swelling and bruising.
• Advised to rest with head elevated to reduce swelling.
• Avoid strenuous activities and blowing your nose.

End of week 1: follow-up and splint removal

• First post-op visit for assessment, usually involving the removal of any splints and sutures.
• Noticeable reduction in bruising and swelling; however, some persistent swelling is normal.
• Gradual resumption of normal activities; continue to avoid strenuous exercise.

Weeks 2 to 4: continued recovery and activity resumption

• Return to work and social activities, being mindful of the nose’s sensitivity.
• Light exercise can be reintroduced; however, avoid contact sports or high-impact activities.
• Follow specific surgeon’s instructions regarding nasal care, such as using saline sprays.

1 month and beyond: long-term healing

• Most of the visible swelling and bruising should have subsided.
• Swelling will continue to reduce, but the nose may take up to a year for final settling.
• Gradual return to all normal activities, including exercise.
• Protection from the sun and careful handling of the nose are important to prevent complications.

6 months to 1 Year: final results emerge

• The majority of swelling should now be resolved, with the true shape of the nose becoming evident.
• Final outcomes of surgery should be apparent, though subtle changes may continue as the nose fully heals.

Throughout recovery

• Attend all follow-up appointments to monitor progress.
• Follow personalised advice from your Plastic Surgeon regarding medication, dressings, and activity levels.
• Any concerns or unusual symptoms should be promptly discussed with your Plastic Surgeon.

Rhinoplasty results

After rhinoplasty, the final shape and results of your nose typically occur at the 12-month mark, with the most noticeable transformation appearing at six months. Your rhinoplasty outcome is considered permanent, but to ensure the results last as long as possible, it is critical to observe your surgeon’s guidelines on post-operative care diligently and attend scheduled check-ups regularly. Integrating a balanced diet and consistent exercise regimen while steering clear of smoking will contribute significantly to the sustained results of your rhinoplasty.

How much does rhinoplasty cost?

The surgical fee for rhinoplasty starts at $12,000. As every patient we see has different requirements, it is difficult to provide standardised pricing as each procedure is tailored for each individual patient’s situation. During your consultation your Surgeon will discuss with you the best options for you. You are then provided with a quote so you know exactly what is involved in your procedure and what it will cost.

Our philosophy is simple. We want you to be fully informed, and we want you to understand all your options and have one accurate price quoted once. The consultation fee is $350, and a referral from your doctor is required which can qualify for a Medicare rebate.

Rhinoplasty medicare rebate

Eligibility for a Medicare rebate for rhinoplasty depends on whether the surgery addresses medical, rather than cosmetic, concerns. Procedures aimed purely at enhancing appearance are not covered by Medicare. In contrast, rhinoplasty that is necessary for functional improvements such as remedying breathing issues or rectifying defects from injuries or birth conditions, may receive a rebate.

Post-2018 revisions to the Medicare Benefits Schedule (MBS) have refined the eligibility criteria, particularly affecting secondary rhinoplasty to alleviate breathing issues that arose from prior surgeries.

Patients should engage with a Specialist Plastic Surgeon to assess rebate eligibility, corroborate with Medicare, and inquire with their private health insurance provider. Knowledge of MBS item numbers relevant to rhinoplasty is vital for this process, as these codes are integral to the rebate application.

Some of the MBS item numbers pertinent to Rhinoplasty include:

• 41671 for septoplasty,
• 41672 for reconstructing the nasal septum,
• 45635 for partial rhinoplasty addressing the bony structure, and
• 45641 for rhinoplasty correcting airway blockages.

The coverage for these procedures may vary, and specific documentation like photographs, tests, and a GP referral will be required. Patients are advised to thoroughly understand the MBS codes applicable to their surgery and to be cognisant of how concurrent procedures might impact their Medicare coverage.

In summary, Medicare may subsidise Rhinoplasty procedures that are performed for health-related reasons, but cosmetic modifications are excluded from a Medicare rebate. Patients should also note that even with eligibility for coverage, there will likely be out-of-pocket expenses, and comprehensive documentation will be necessary to facilitate the rebate process.

Ideal candidates for rhinoplasty

Generally, a suitable candidate for rhinoplasty is someone who:

• is disatisfied with the shape, size or proportion of their nose
• suffers from breathing difficulties caused by structural issues of the nose
• is usually above the age of 18 or has a fully developed nose and facial structure
• has sustained a nasal injury such as a broken nose
• has realistic expectations of the procedure and results
• is psychologically prepared for the surgery and its recovery process
• is in good health and a non-smoker (or willing to give up smoking before surgery)

The best rhinoplasty is tailored to your nose and features. Me Clinic’s highly experienced Plastic Surgeon will examine your nose during your initial consultation and discuss how rhinoplasty can improve it to meet your goals and expectations.

Our plastic surgeons who specialise in rhinoplasty surgery:

How do I find out more about rhinoplasty surgery?

Don’t hesitate to get in touch with the Me Clinic or call (03) 9569 3511. We have over 35 years of Plastic & Cosmetic Surgery experience to share with you. We ensure you will be fully informed and understand your options before any procedure.