Cosmetic surgery - rhinoplasty

Rhinoplasty is surgery to repair or reshape the nose. This may be performed for cosmetic reasons or to correct a deformity due to injury or birth defect. Almost all of these operations are performed through the nostrils, which means there are no visible cuts (or subsequent scars) to the face.

Conditions of the nose
Some of the conditions that can be corrected by rhinoplasty include:

• Broken nose
• Birth defects of the nose
• Nasal obstruction
• Self-consciousness about the size or shape of the nose.

• Choose an appropriately qualified surgeon. Ask them about their training and experience in performing the procedure.
• Inform yourself fully of the possible risks, side effects and complications of the procedure.
• Think carefully about your expectations. Rhinoplasty may improve your appearance and self-confidence, but it won’t necessarily deliver your ‘ideal’ body image or change your life.
• Don’t be swayed by advertisements that promise amazing results – if they sound too good to be true, they probably are.
• Think about the impact on your financial situation, as cosmetic surgery does not usually qualify for rebates from Medicare or private health insurance companies.
• You should have a ‘cooling off’ period after attending your first consultation. This will give you time to think about your decisions.

• Physical examination – to make sure the treatment is appropriate.
• Medical history – including any prescription drugs, over-the-counter drugs, herbs or vitamin or mineral supplements you may be taking. Some preparations can interact with surgical medications and need to be avoided.
• Treatment required – if your operation is for cosmetic reasons, you have to know exactly what shaped nose you would like. Make sure your surgeon understands why you want the operation so they can decide the best method of reconstructing your nose to your satisfaction. If you need surgery to repair a broken nose, it is best to seek medical attention straight away. Otherwise, the swelling of the tissues can delay surgery for around five days. If this is the case, your doctor may give you a course of antibiotics to take in the meantime, to reduce the risk of infection.
• Anaesthetic choice – rhinoplasty can be performed using general or local anaesthetic, depending on the extent of the surgery required, your health, and the preference of your surgeon.

• Anaesthesia – you will be given a general or local anaesthetic.
• Post trauma – to repair a broken nose, slender instruments are usually inserted into each nostril to gently push the bones back into their proper alignment. A bad break may require a small cut (incision), so that the surgeon can see to arrange the bone fragments correctly.
• Cosmetic surgery – rhinoplasty for cosmetic reasons can include ‘open’ or ‘closed’ techniques.
• ‘Open’ technique – this involves accessing the nasal bones via incisions inside the nostrils and through the columella (the skin that separates the nostrils).
• ‘Closed’ technique – this involves accessing the nasal bones via incisions inside the nostrils. Once the incisions are made, the skin is lifted away from the underlying bones and cartilages.
• Surgical procedures – this depends on the reshaping required; for example, the nasal bones may be chiselled, or broken and realigned, or else cartilage may be trimmed back.
• Stitches – incisions are closed with dissolving stitches.

• The inside of your nose is packed with special gauze.
• Your nose bridge is covered with a splint, commonly made of plaster of Paris. The splint helps to minimise swelling and keep your nose in its new profile while healing takes place.
• Sometimes, a small tape may be placed over the nose to keep the dressings in place.
• Nurses record your vital signs, including temperature, pulse, breathing pattern and blood pressure.
• Nurses inspect your dressings for signs of bleeding and replace the outside dressing if necessary.
• You have to breathe through your mouth until the packing gauze is removed.
• You will probably notice a lot of swelling and bruising, mainly around your eyes. The swelling should go down in a few days, and the bruising may go away in the first week or two.
• You may have to wait four or five hours before you are able to eat and drink. However, once these few hours are over, you should be able to eat anything you like.
• You can get up out of bed and move around a few hours after the operation.
• If you need pain relief, ask the nursing staff to give you what your surgeon has ordered.

• Pain
• Swelling
• Bruising
• The sensation of a ‘stuffy’ nose for a few weeks
• Numbness of the nose for a few months
• Delays in healing
• Sudden nose bleeds
• Infection.

• Make an appointment for a later check-up with your surgeon after about one week.
• If you have any medications to take home from hospital, be sure to ask what they are for, and how often and for how long you have to take them.
• If you are prescribed antibiotics, make sure you take the whole course.
• Hold your head upright as much as you can.
• Your bandages and packing gauze may be left in place for up to a week or so, and then your surgeon will remove the dressing and take out the nasal packs.
• Follow all instructions on how to best keep your nose clean.
• Avoid blowing your nose.
• Contact your surgeon if you have any sudden nose bleeds.
• You may need to be off work for around two weeks.
• Avoid contact sports (or any activities that could cause your nose to be knocked) for about six weeks.
• Broken nasal bones may hurt or ache for up to eight weeks. See your surgeon for advice on appropriate pain relief. Remember that aspirin can increase the risk of nose bleeds.

• Your doctor
• Plastic surgeon
• Australian Society of Plastic Surgeons Tel. 1300 367 446

• Rhinoplasty is surgery to repair or reshape the nose.
• Rhinoplasty may be performed for cosmetic reasons or to correct a deformity due to injury or birth defect.
• A cosmetically altered nose may take up to six months to adjust to its final profile.

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