Rhinoplasty, from Consultation to Recovery

Researching rhinoplasty usually starts because of a concern you have about the look of your nose, issues with breathing or changes after an injury.

The nose is central to the face and because it also plays an important role in breathing, rhinoplasty requires careful assessment of both appearance and function.

Dr Jeremy Richardson, Specialist Plastic Surgeon in Melbourne, has a special interest in facial cosmetic and reconstructive surgery, consulting at Queens Parade Specialists in Fitzroy North, Melbourne. This guide covers what to expect if you are considering rhinoplasty, from consultation and planning through to recovery.

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What is rhinoplasty?

Rhinoplasty, or nose surgery, changes or repairs the shape and structure of the nose. It can involve the nasal bridge, tip, nostrils, septum or other supporting structures.

There are some common reasons patients speak to Dr Richardson about rhinoplasty, including:

• A bump or irregularity on the nasal bridge
• A drooping, broad or asymmetric nasal tip
• Changes following injury or trauma
• Breathing concerns related to nasal structure
• Previous nasal surgery
• The shape or proportion of the nose in relation to other facial features

Rhinoplasty is highly individual, so Dr Richardson considers your facial features, nasal anatomy and your concerns and goals when discussing a surgical plan.

What happens at a rhinoplasty consultation?

Your first consultation gives Dr Richardson the opportunity to understand what you have noticed, examine the structure of your nose and discuss what surgery is designed to address. This includes discussing:

• What you would like to change
• Any breathing symptoms
• Previous nasal injury or surgery
• Allergies, sinus symptoms or snoring
• Your medical history and medications
• Your expectations around surgery and recovery

Dr Richardson will examine the external nose and the internal nasal structures, looking at the skin, cartilage, bone, nasal tip, septum and airway.

Clinical photographs are also used for surgical planning and discussion. These can support visualisation of the proposed changes but are a guide, and cannot predict or guarantee a specific result.

Can rhinoplasty address appearance and breathing?

Rhinoplasty is not always about appearance, and for some patients, the external shape and internal function of the nose need to be considered together.

A deviated septum, previous trauma or weakness in the nasal structures can contribute to breathing concerns. Septoplasty, which straightens a bent or deviated septum, is commonly discussed with rhinoplasty if nasal obstruction is present.

Dr Richardson’s surgical planning includes the:

• Shape and structure of the nose
• Nasal airway and internal support
• Skin thickness
• Facial proportions
• Strength of the cartilage and supporting structures
• Effects of previous injury or surgery

Dr Richardson will explain what the proposed surgery is intended to address, its limitations and how appearance and breathing are being considered within your surgical plan.

What happens during rhinoplasty surgery?

Rhinoplasty is usually performed under general anaesthetic. The surgical technique can be open or closed, based on your anatomy and the changes being made.

With open rhinoplasty, a small incision is made across the columella, the strip of tissue between the nostrils, to allow direct access to the underlying nasal structures.

With closed rhinoplasty, the incisions are made inside the nostrils, so there is no external columellar incision.

Surgery can involve reshaping cartilage, adjusting nasal bones, refining the tip, straightening the septum or supporting parts of the nose with grafts. The technique used will be explained during consultation and is based on the surgical plan for your nose.

What to expect during the first week after rhinoplasty

Swelling, bruising, congestion and a feeling of pressure around the nose and eyes are common during early recovery. An external nasal splint is used, and internal dressings or splints are used in some procedures.

Dr Richardson will provide specific instructions around sleeping, wound care, medication and follow-up appointments, though early recovery commonly includes advice to:

• Sleep with your head elevated
• Avoid bending, straining and heavy lifting
• Avoid blowing your nose
• Keep the splint dry
• Take medication as prescribed

You will also need someone to take you home following surgery and assist you as advised during the early recovery period.

How long does rhinoplasty recovery take?

Visible swelling and bruising are most noticeable during the first 1 to 2 weeks. An external splint is usually removed at around one week, depending on the procedure and how you’re healing.

Most patients can plan for around 1 to 2 weeks away from desk-based work or study. Physical work, strenuous exercise and activities with a risk of impact to the nose require a longer break.

Recovery doesn’t finish as soon as the bruising has settled either. Nasal swelling reduces gradually and the tip can remain swollen or firm for months. Refinement can continue for 12 months or longer, especially after more complex surgery or where the skin is thicker.

Dr Richardson will review your healing and guide your return to exercise, work and other activities through your post-operative appointments.

What risks are discussed before rhinoplasty?

All surgery carries risk. With Dr Richardson, this discussion covers the general and procedure-specific risks, along with anything identified during assessment that could affect healing or nasal function. More general rhinoplasty risks may include bleeding, infection, scarring, changes in sensation or breathing, asymmetry, delayed healing and further surgery.

He will also talk through what is to be expected during recovery, what changes take longer to settle and when to contact the surgical team with a concern.

Rhinoplasty FAQs

What is the difference between rhinoplasty and septoplasty?
Rhinoplasty addresses the shape or structure of the nose and can involve both appearance and function. Septoplasty specifically involves straightening the septum inside the nose to address obstruction caused by a bent or deviated septum. The procedures can be performed together where appropriate.

Do I need a referral for rhinoplasty?
If the proposed rhinoplasty is cosmetic surgery, current Medical Board requirements also include a referral from a GP or another medical specialist who does not perform cosmetic surgery.

Is open or closed rhinoplasty better?
Open and closed rhinoplasty provide different access to the nasal structures, and the approach used depends on your anatomy and the changes required.

What if I have had rhinoplasty before?
Previous nasal surgery changes the anatomy and needs to be considered when planning further surgery. Dr Richardson will review your previous procedure, current nasal structure, concerns and available supporting tissue during consultation.

Rhinoplasty surgery in Melbourne

Dr Jeremy Richardson, is a Specialist Plastic Surgeon with qualifications including MBBS (Hons), BMedSc (Hons), DipSurgAnat and FRACS (Plast), is ANZBCPS Board Certified and based in Melbourne. He has a special interest in facial cosmetic and reconstructive surgery, including rhinoplasty, or nose surgery.

If you are considering rhinoplasty, consultation with Dr Richardson includes assessment of your nasal anatomy and an open discussion around your concerns, breathing, surgical options and recovery.

To book a consultation, contact Queens Parade Specialists in Fitzroy North, Melbourne.

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This article is for general information and educational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. All surgery carries risk and results may vary. Consult Dr Jeremy Richardson, MED0001204528, MBBS (Hons), BMedSc (Hons), DipSurgAnat, FRACS (Plast), Specialist Plastic Surgeon, for personalised advice and tailored treatment.