Overview

Rhinoplasty is a surgical procedure designed to modify the internal or external structure of the nose.

It can be performed for functional reasons (to improve airflow or correct a deviated septum) or reconstructive purposes (after trauma or developmental irregularities).

Every patient’s anatomy and goals are unique, so the approach to rhinoplasty is individually planned after comprehensive medical assessment.

What to Consider Before Rhinoplasty

Undergoing rhinoplasty is a significant decision that requires careful planning and consultation.

Before surgery, your specialist will assess:

• Facial proportions and nasal anatomy – including cartilage strength and skin thickness.
• Medical history – including previous nasal surgery, bleeding disorders, or respiratory conditions.
• Motivations and goals – to determine whether they are realistic and medically achievable.
• Overall health – ensuring fitness for anaesthesia and recovery.

These evaluations ensure that the procedure is appropriate and safely tailored to each individual.

Consultation Process

The consultation phase is an essential part of surgical planning. During this stage, your surgeon will:

1. Take a detailed medical history – including any allergies, medications, or prior nasal trauma.
2. Conduct a physical and nasal examination – which may include nasal endoscopy or imaging to assess airflow and structure.
3. Take clinical photographs – to document baseline anatomy and assist with surgical planning.
4. Discuss achievable outcomes – outlining what rhinoplasty can and cannot change.

Digital imaging may be used as a communication tool to illustrate potential proportions, but these are not predictions or guarantees of outcome.

Preparation for Surgery

Before proceeding, patients are required to:

• Obtain a GP referral, as per the Medical Board of Australia Guidelines for Cosmetic Surgery (2023).
• Attend at least two consultations, with one being in person with the operating surgeon.
• Observe a minimum seven-day cooling-off period before confirming surgery.

These steps ensure informed consent and adequate time for decision-making.

Structured and Reduction Rhinoplasty

There are several rhinoplasty techniques depending on individual needs.

Structured rhinoplasty involves reinforcing or rebuilding nasal support using the patient’s own cartilage.

Reduction rhinoplasty focuses on reducing the size or projection of the nose while maintaining strength and function.

A combination approach, sometimes called structured reduction rhinoplasty, can restore nasal harmony in patients with:

• Nasal prominence following injury or ageing.
• Weak or drooping nasal tip cartilage.
• Disproportion between the nose and surrounding facial features.

This surgery is complex and must preserve both the structural integrity and function of the nose.

The Surgical Process

Rhinoplasty is performed under general anaesthesia in an accredited hospital or day-surgery facility.

Two main approaches are used:

• Closed rhinoplasty: Incisions are made inside the nostrils, leaving no visible external scar.
• Open rhinoplasty: A small incision is made across the columella (the strip of tissue between the nostrils) for greater visibility and precision.

Depending on the patient’s needs, the surgeon may reshape bone, cartilage, or soft tissue.

The nasal skin naturally adjusts to the underlying structure without external trimming.

Recovery and Healing

Recovery varies by individual and surgical complexity.

• Initial swelling and bruising generally improve within two weeks.
• Nasal refinement and internal healing continue for 12–18 months.
• Avoid strenuous activity and protect the nose from pressure or impact during early healing.

Your surgeon will provide detailed post-operative instructions and schedule follow-up visits to monitor recovery.

Risks and Possible Complications

As with all surgical procedures, rhinoplasty carries potential risks, including:

• Bleeding or infection.
• Scarring or prolonged swelling.
• Asymmetry or contour irregularities.
• Changes in nasal sensation or breathing.
• Septal perforation (a small hole in the nasal septum).
• Adverse reactions to anaesthesia.

Your surgeon will explain these risks and answer questions before you decide to proceed.

Setting Realistic Expectations

Rhinoplasty outcomes depend on many factors, such as skin thickness, cartilage strength, and healing response.

While structural and functional improvements can often be achieved, results vary among individuals.

Open communication with your surgeon about your goals and medical history helps ensure appropriate planning and expectations.

About Dr Shahidi

Dr Shahram Shahidi

BSC(MED)(HON I) MB BS(SYD) FRACS FAAFPS

MED0001167352

Specialist Otolaryngologist (Ear, Nose and Throat) – Head and Neck Surgeon

Fellow, Australasian Academy of Facial Plastic Surgery

Dr Shahidi is an Australian-trained, FRACS-qualified ENT surgeon with over 20 years of experience in nasal, sinus, and facial surgery.

He provides comprehensive nasal assessment and patient-specific surgical planning focused on functional outcomes and anatomical balance.

Disclaimer:

All surgical and invasive procedures carry risks. Individual results vary.

Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.