What are the potential risks and complications of rhinoplasty?
Modern surgical procedures are generally safe, but there is still a potential risk of complications.
Complications and risks associated with nasal surgery include:
- Excessive bleeding from the site of incision
- Infection which may require antibiotics or in some cases, additional surgery
- Formation of a blood clot under the site of the incision which then requires drainage
- Bruising, pain and swelling around the incision and around the eyes
- Itchy, unsightly and annoying scars known as hypertrophic and keloid scars, which form over the incision
- Longer healing time, especially if you are a diabetic or a smoker
- Wound edges may separate
- Nausea and vomiting may occur for a short time following the general anaesthesia
- Once the swelling and bruising subsides, you may experience an altered sensation in your nose
- Ongoing pain from the nasal bone
- Temporary numbness in the upper front teeth
- Dark circles may appear on the skin under the eyes and may last for about six months or longer
- You may have an impaired sense of smell
- Slight swelling of the tip of the nose may last for a few months, especially if the open technique has been used
- If an implant is inserted, it may extrude through the skin or into the nose
- The nose may flatten as a result of weak underlying supporting structures
- Narrowing of the major airways, which may cause breathing difficulties when breathing through the nose
- Revision surgery may be required if the appearance or function of the nose is unsatisfactory
How much does rhinoplasty cost?
Rhinoplasty surgery is covered by most private health insurance. Review your policy carefully to determine what is covered.
Costs associated with a rhinoplasty vary between $14,000-$16,000 depending on a number of factors:
- Anaesthetist's fees
- Private hospital or day surgical facility fees
- Your level of private insurance cover
- Need for other facial plastic surgical procedures, such as eyelid rejuvenation, facelift, neck lift or brow lift.
- Surgical assistant's fee
Frequently Asked Questions about Rhinoplasty
What is a deviated septum?
A deviated septum is a condition concerning the nasal septum or bony septum where air flows through the right and left of the nasal cavity. If your septum is deviated to one side, or is crooked in some way, the airflow does not come in easily, resulting in breathing difficulties. Patients can also have difficulty with breathing when the bony little outcrops in the nose, called turbinates, become enlarged. Rhinoplasty can help to straighten the septum as well as remove the turbinates so that air can easily flow through the nose once more.
What is the difference between a functional and aesthetic rhinoplasty?
Rhinoplasty is a procedure on the nose that can be performed as a functional or aesthetic operation. The functional component is usually carried out if you have difficulty breathing due to a deviated septum or previous fracture. Breathing difficulties can also come from enlarged turbinates, the bony little outcrops found in the nasal cavity. During the rhinoplasty, the doctor will straighten your septum and remove the turbinates if necessary, in order to restore full breathing ability. A rhinoplasty means different things to different people. Some people just want a small hump taken off their nose, some just want the tip done, some want their nose smaller and some people want all of it done. The aesthetic portion of rhinoplasty addresses whatever the patient feels is the problem with their nose.
What is the difference between physical and social recovery after rhinoplasty?
The recovery process is pretty unique for rhinoplasty because it is comprised of both social and physical recovery. Physical recovery begins about 48 - 72 hours after your surgery. More often than not, the nose has to be broken for rhinoplasty to take place. For this reason, a nasal splint will be applied after the surgery which will lessen the movement and pain after the procedure. The pain tends to take on an aching feeling, which can easily be managed with medication and most people wish to return back to work at this stage. However, this is usually where the social recovery aspect comes into play. Going back into society is a little more difficult because once the rhinoplasty has occurred, you will have visible after-effects that may hinder you. The stitches and splint usually remain on the nose for about 10 days but once removed, you will have a swollen nose and black eyes. Over time, this swelling will move down into your cheeks as gravity takes effect. Obviously there is no physical hindrance there, it is just up to you and how you are prepared to go out into public.
How long before I see the final result of my rhinoplasty procedure?
In terms of seeing the final result after a rhinoplasty, it is best to break the recovery of the nose into three parts; the upper third, the middle third and the lower third. The upper two thirds will take about six weeks to get the final result. The tip, which requires more refinement, will take between 6 - 12 moths for the final result to show. In the first 10 days you will have stitches and a splint on your nose. Once that is removed, you will have swelling and black eyes which will gradually fade. The swelling will also slowly move down into your cheeks as gravity tries to get rid of it. Immediately after the operation, both you and Dr Moradi will be aware that there is swelling in the tip of your nose, but no one else will because people simply do not pay that much attention to your face. At three months, you will think that the swelling is gone but the doctor will be able to notice the smaller signs of swelling. Finally after 12 months, the swelling with be entirely gone and your nose will be as it should.
If I have broken my nose, when is the best time to straighten it?
The best time is within 2 weeks before the nasal bones set. However, if it is longer than this you will need a formal rhinoplasty to re-break the bone and straighten it. Which always involves straightening the septum at the same time.
How long before I see the final shape after rhinoplasty?
The upper half of the nose takes around 1-2 months. However the tip can take around 12-18 months before you get the final result.
So it's important to be patient. Please also massage and tape the nose as long as possible post op.
Can I have a combined procedure?
Yes, many patients who have a cosmetic rhinoplasty also suffer from sinus and breathing issues. In those cases, I combine both operations with one of my ENT colleagues who helps open the sinuses and airway. I perform the cosmetic enhancement and he takes care of the breathing which is a perfect outcome for the patient. Form and function addressed in 1 operation.
When do you do a closed vs open rhinoplasty?
Different surgeons have different approaches. If you only need a hump reduction I use a closed approach. Otherwise I use an open approach as it provides the best access and most accuracy in creating shape.
What is a rib graft rhinoplasty?
This technique is used for revision cases where we need extra cartilage for support and contour. We harvest the rib from the patient and sometimes using cadaveric cartilage.
Ideally we use the nasal septum for cartilage but this is inadequate in revision cases as it has already been used up in the initial surgery. I don't like using ear cartilage because of the lack of strength and support it provides.
When do you do a closed or open rhinoplasty?
If you need a hump reduction an closed approach is used by Dr Moradi. Otherwise, he uses an open approach as it provides the best access and most accuracy in creating a better shaped nose.
With a rhinoplasty, you can do the most perfect procedure and it looks excellent post-op. But, it still takes some time for the patient to see the final result.
Dr Pouria Moradi