Rhinoplasty

“ Rhinoplasty is the most rewarding of all cosmetic surgery procedures as it beautifies the most prominent feature of your face ”.

Rhinoplasty is an operation to reshape your nose to enhance beauty.

Although it is a most satisfying to the patient, it is also believed to be the most complex of all cosmetic surgical procedures. The problem is , ‘ there is no one nose that fits all ‘. Each nose should be tailored to suit to the face on which it lives. Not all Plastic and Cosmetic surgeons want to delve into the territory of rhinoplasty.

Rhinoplasty in brief

SETTING REALISTIC EXPECTATIONS

Celebrity following , selfie culture and a rapid pace of life reflects in what people want to have done. We want to educate people about ‘ what to expect from a nose job ‘

Clients come in with photos of a celebrity of their choice and want a nose like him / her. A celebrity nose may not suit you because you don’t have the same eyes , cheek bones , chin and the jawline.
Your surgeon may show you omputer morphed images of your new nose. Please ask , how likely it this possible in real time to replicated results . We believe, they can be a guide to show you to choose a nose of your choice, but does not guarantee a replica .
Only you know what an ideal nose you are looking for. The surgeon can only guide you if that could be achieved . its tempting to ask someone to choose for you which will leave you unhappy with the finished job.

There is a dictum for rhinoplasty in particular which we believe in at Esmee clinic . There should be only ‘ one best shot at it ‘. Revision nose jobs are very difficult and make people more unhappy due to extensive scar tissue from the previous surgery.Considering your skin texture, ethnicity, facial shape and bony framework , Dr. Mahadik can make a customised surgical plan tailored for your new nose that best matches to your face.There are different procedures to address different areas of the nose. Please familiarise your self by browsing further.

TYPES OF RHINOPLASTIES

Open Rhinoplasties are standard of care , where the incisions expose and deconstruct the entire nose to reconstruct and reshape it in a better way.

They can be broadly classified into

1) HUMP REDUCTION

Prominent , slim and straight noses are attractive. Sometimes the bone on the top and middle of the nose overgrows to give a hump. Even slight changes in sizewill throw facial proportions out of harmony.

Hump reduction is a procedure to shave off that excess bone and readjust the cartilage framework. The procedure will give a nice slanting slope to your nose. In some large noses, reduction of a hump ,make the nasal tip appear larger than before. So a ‘tip-plasty’ has to be incorporated in the procedure for large noses with a hump.

2) AUGMENTATION

A flatter nose can be very detrimental for an otherwise attractive face.

Small flat nose – In small flat noses, the flat area of the nose in between the eyes may be augmented with ‘grafts. The grafts used to achieve projection could be bone , cartilage from your body or silicone implants.

Large flat nose – They often have larger and wider nostrils along with a flat nose. The anatomy makes it difficult to correct the projection alone and you will need to correct the nostril areas as well to balance the new height of the nose. Collumela also needs some structural support to achieve and maintain its new height.

3) TIP PLASTY

Tip plasty is done either as an isolated procedure or as an adjunct to the other Rhinoplasty procedures.

The procedure involves literally deconstructing the entire tip of your nose. The skin is separated carefully from the cartilage framework and the nasal septum in the middle and elevated as a hood.

The rest is sculpting of the arches of the wide/ deformed / splayed / flat cartilages with knige and fine permanent stitches. Cartilage is harvested form expendable site to make structural support struts for columella height or to augment the dorsum of the nose.

The aim is to achieve a narrower slim looking tip that matches your facial profile.

RECOVERY & RISKS

RECOVERY

Surgical time	2-4 hrs
Hospital	General anaesthesia in a Day Surgery
Back to work	2 wks on average
Medicare rebate in cost	Cosmetic nose jobs have no medicare benefits . Small rebates apply for broken noses and breathing problems. We will factor this discount into your quote. However, we choose not to waste our time on phone calls to medicare.
Final outcome	Nasal swellings are the notorious to settle. Although variable ,it may take 9-12 mnts to settle completely.
Cost	AUD 7- 9 K for an average complex nose job.

Go home	you will be sent home after a few hours with someone to drive /escort you back
Pain	strong pain relief tablets should take care of the mild to moderate pain for a week.
Sutures	You will only have 4-5 tiny sutures at the columella that need to come out around day 6 – 7. All other sutures inside the nostrils will dissolve
Stents	Dr Mahadik may put removable stents in your nostrils . They stay for 7-10 days to support the new framework and reduce bleeding.
Difficult breathing	Swelling and stents may block the nostrils partially making it uncomfortable. This settles in a week and people breath through mouths like what happens when you get a congested airway after catching flu.
Swelling	The nose , eyes and the cheeks will be swollen for the first 2 weeks. 80 % of the swelling resolves in 6 months . Rest of it comes down in 9-12 months.
Final outcome	Healing times are very prolonged in nose jobs as it involves the cartilage .You can expect the final outcome in 12 months or more.

RISKS

General risks – Like for any surgery the risks are , infection bleeding , blood clots in the legs and chest infections

Specific risks include –

Scar hypertrophy or keloid
Over or under correction
Skin necrosis

FAQs

# What is the ideal age for Rhinoplasty

Rhinoplasty is recommended after 18 years of age after the nose has finished its growth.

# What scars will I see on my nose

Most incisions are inside the nostril and not visible. There are only 1 or 2 visible scars each about mm. You will always have one on the columella and may have one on the either side of root of the nose Scars become red and raised for upto 3 months . Then they start to fade and become almost inconspicuous after a year .

# When do I go back to work

You need your nose protected with a splint for 2 weeks.. Desk work can be started after 10 days. Your face might still look a bit swollen till a 2-3 week mark.