Rhinoplasty
About rhinoplasty
The nose forms the central feature of the human face and is the focal point along with a person’s eyes for attention when interacting with others. It is no wonder then, that many people look to alter or improve this aspect of their appearance. Rhinoplasty is the name given to surgery for the nose and is a delicate procedure that requires a considered approach, artistry and, naturally, the appropriate training to perform.
Procedure details
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The nose forms the central feature of the human face and is the focal point along with a person’s eyes for attention when interacting with others. It is no wonder then, that many people look to alter or improve this aspect of their appearance. Rhinoplasty is the name given to surgery for the nose and is a delicate procedure that requires a considered approach, artistry and, naturally, the appropriate training to perform.
Dr Mathew Lee is a fully qualified plastic surgeon with specialised training in rhinoplasty including an international fellowship dedicated to the art of nose surgery. He performs both functional and cosmetic rhinoplasty procedures.
Functional rhinoplasty addresses any breathing issues related to the structure of the nose. This may be a crooked septum, crooked nose, weak or abnormally shaped cartilages and may or may not be related to previous surgery or trauma.
Cosmetic rhinoplasty looks at changing the aesthetic appearance of the nose whether it is a dorsal hump, wide base, boxy tip or pointy tip. More often than not, the functional and cosmetic aspects of a rhinoplasty are intimately related and come into consideration with all nose procedures.
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The total cost for a rhinoplasty ranges from $15,000 to $25,000 depending on the complexity of the case and the role health insurance may play. This is inclusive of the surgeon’s fee, any required hospital stay, theatre fee, anaesthetist’s fee and follow-up visits.
The estimated cost can be provided following your consultation with Dr Mathew Lee.
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Your pre-operative planning is conducted over two visits to our Mornington office and involves the expertise of Dr Mathew Lee and the team of experienced plastic surgery nurses.
Pre-operative planning looks at your reasons for wanting rhinoplasty and will ultimately establish the goals for your surgery. Functional and aesthetic issues will be discussed, and a detailed analysis of your nose will be done. Where trauma has led to a change in the shape and function of the nose, photos of what it used to look like are useful. In some cases, bringing in photos of the type of nose you are looking to achieve cosmetically can help; however, you must remember that every face is different and what may suit one person in terms of nasal features, may not be appropriate for others.
Your general health and ability to tolerate general anaesthesia will be discussed. Previous nasal surgery will be taken into account, and in cases where nasal septal work has been done elsewhere, a discussion on rib cartilage for a more reconstructive type of procedure may be required.
Detailed information of what to expect, bring and prepare for your surgery will be discussed.
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During your consultation for rhinoplasty, you will have the opportunity to see a 3D simulation of what your nose may look like following surgery.
Surgical changes to your nose, can significantly affect your appearance. The nose is, after all, the central and often defining feature of a face.
The use of 3D imaging and manipulation is one of the best ways to ensure that you understand the aims of rhinoplasty from an aesthetic perspective.
Dr Lee finds it an invaluable tool when talking to patients about adjustments and results that may be difficult to visualise for a patient. Patients really benefit from the visual perspective and surgical sequence demonstration that imaging manipulation can provide and as such, Dr Lee personally takes patients through this.
Improvements to profile, size, shape, and length can all be demonstrated and refined to help me reach an understanding of what my patients are aiming for. A visual consensus on the ultimate goal through a 3D image of a face provides reassurance for both the surgeon and the patient. Patients are given the photos to take home and share with family.
Whilst the actual surgical outcome will not be identical to the computer image, it does provide a realistic simulation that can help with expectations and patient decisions.
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Rhinoplasty is performed under a general anaesthetic in an accredited hospital facility.
The operation can take from 3 to 6 hours depending on the complexity of the presenting problem.
There is no fixed time limit to the procedure and, provided it is safe, surgery only stops once the desired result is achieved.
The only external scar from the procedure is on the columella which is the small bridge of skin between the nostrils. This scar heals well and is, generally, very difficult if not impossible to see. The other incisions are internal and are concealed within the nose, so no scar is visible except in the case where rib graft is required.
Often osteotomies (controlled fracturing of the bone) are required to reposition the nasal bones to straighten the nose and preserve the contour of the bridge. Significant hump reduction almost always requires osteotomies.
Local anaesthetic with adrenalin is used during surgery to help control bleeding and pre-emptively manage pain. When you wake up, your nose may feel congested, but there will be minimal pain. External dressings will include steri strips to the dorsum of the nose along with a custom thermoplastic splint to help control swelling. Inside the nose, silicone tubes (Doyle splints) are used to stabilise the septum and control internal swelling. These have replaced nasal packing and avoid the unpleasant task of removing gauze packs from your nose. Doyle splints are removed after 1 week.
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Canvas Plastic Surgery will ensure you are provided with tailored support for your specific post-operative care.
Rhinoplasty can be done as a day procedure, but some patients stay overnight for comfort and pain relief.
You need to allow about 2 weeks for recovery in terms of work and social commitments as this is the time required for bruising around the eyes and face to settle. The amount of bruising and swelling does vary from patient to patient.
The amount of bruising and swelling often depends on whether the bone needs to be fractured, however; regardless, it should settle over this 2-week period.
Post-procedure timeline
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Dr Mathew Lee will review you in hospital before you go home if you have stayed overnight. You should apply ice to your forehead for the first 24-48 hours to help reduce bruising a swelling.
Once home, you will need to rest and undertake only light activities. Avoid bending and lifting anything over 1kg. Dressings need to be kept dry. Avoid very hot showers that may stimulate bleeding and swelling.
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During the first week, you will require regular pain relief. This takes the form of regular paracetamol, a slow and immediate release stronger pain killer and often an anti-inflammatory. In some cases, a short course of steroid will be prescribed to help manage swelling. Day 3 is normally the worst; however, things improve after this. At 1 week, you will be reviewed in our rooms to change dressings, remove internal Doyle splints and sutures, and to assess your progress. Expect some swelling and congestion once the internal splints are removed. Post-operative care will be discussed. The thermoplastic splint will remain on for 1 more week.
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During the second week, internal swelling often progresses as the Doyle splints have been removed. As such, breathing may temporarily decline. This is normal and will improve with time. Your thermoplastic splint and all taping is removed at the end of 2 weeks.
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Further follow up is at 6 weeks, 3 months, 6 months and 12 months to monitor your progress and take clinical imaging. Clinical imaging or photos are used to monitor your progress during your recovery. In most circumstances, all normal activities may resume 6 weeks after surgery in a graduated fashion.
Before and afters
Other considerations
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There are many potential complications from surgery and thankfully, the majority of these are extremely rare.
Bleeding, infections, wound healing problems and scars are potential complications of any procedure.
General anaesthesia itself also carries a small risk. Breathing can be affected if the internal dimensions of the airway are changed. Shape asymmetries, bony edges and visible cartilages under the skin can occur. The aesthetic outcome can also vary due to factors outside of the surgeon’s control. Excess swelling and scar tissue can detract from the desired aesthetic outcome. Small revisions may be needed in up to 5% of cases to adjust any remaining cosmetic or breathing concerns.
Complications will be discussed during your consultation with specific relevance to the rhinoplasty you will be having. Information will also be provided for you to take home and read that includes relevant complications.
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There is a lot of media attention relating to overseas surgery and surgery with ‘cosmetic surgeons.
In the age of online forums, social media and misinformation, it can be difficult to separate fact from fiction.
The simplest response to this is that you get what you pay for. Cheap surgery is offered by taking shortcuts which equates to increased risk for patients. Some people are willing to take this risk and may get away with it. Unfortunately, when things go wrong, the complications can be devastating and potentially life-threatening.
In making a decision to have rhinoplasty, it is important to ensure that you see a qualified specialist plastic surgeon with experience in rhinoplasty to discuss your options and suitability.
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We welcome you to speak with us to obtain specific information about our processes.