What to expect before and after rhinoplasty

Before Rhinoplasty

A thorough consultation with your chosen surgeon will be essential before undergoing rhinoplasty. You will have the chance to discuss your personal concerns and if you are a suitable candidate for the procedure. 

If any imaging is used as a tool to plan your surgery, Mr Greensmith believes that this imaging should only be performed by an experienced rhinoplasty surgeon who knows how the nuances of your nose may translate into an achievable goal that can be simulated on a computer. It is not ideal for a nurse educator to perform imaging on a patient in order to plan surgery without the knowledge of nasal anatomy and the full range of rhinoplasty technical experience of a surgeon.

An initial rhinoplasty consultation with Mr Greensmith involves at least 45 minutes of face-to-face time with Mr Greensmith. You should seek a referral from a family doctor as your procedure costs may be partly claimable through your health insurance fund and /or Medicare.

You are encouraged to arrive 15 min to 30 min ahead of time for this to allow adequate time for your registration paperwork as well as 2d and 3D photographs which will be used in the consultation. On arrival our reception staff will help you with the registration paperwork and then arrange a professional series of 2d and 3D Vectra photographs in our private on-site photo studio. Your photos will be stored in your file and on our secure server to protect your privacy. You will be required to specify in writing how you may allow your photos to used used beyond the medical record (e.g. to educate other doctors, patients in seminars or on the internet/social media) but it is your prerogative to decline any further use of your images.

After taking photographs, you will see Mr Greensmith for at least 45 minutes. During this time he will ask you about your medical history, reasons for seeking a rhinoplasty procedure and your goals for your rhinoplasty. Next, he will closely examine both the outside and inside of your nose. The internal nasal examination is important to assess potential causes of breathing concerns. This usually involves a full nasoendoscopy with a Pentax Vivideo nasoendoscope. 

Mr Greensmith will then undertake a detailed imaging simulation of your potential rhinoplasty result using his experience in rhinoplasty in combination with both his findings when examining your nose and your goals. He will frankly and honestly point out if there are major limitations to your goals which may require you to re-set your goals. It is important to remember that the 3D Vectra system should only be used as a guide for you and Mr Greensmith to clearly communicate what you would both like to aim for and does not represent an absolute guarantee of what can be achieved.

If you reach an agreement on these goals, Mr Greensmith will provide you with copies of your imaging to take home and consider further.

Throughout the consultation at no time should you feel rushed and you will have plenty of time to ask questions. Mr Greensmith will then run through the basic details of how the surgery and hospital stays work, as well as important details about recovery.

When you are ready to book your next consultation or your surgery, you can book through his Personal Assistant Ms Lee Dowling on 9508 0508 or leed@melbplastsurg.com.

Even if you decide to book surgery, you should also consider whether you would like a second consultation before your surgery to answer further questions. Do not hesitate to ask Mr Greensmith’s staff by telephone, email or by booking an additional consultation with Mr Greensmith.

After Surgery and the Recovery Period

Rhinoplasty may be performed either as day surgery or as a one overnight stay procedure. If you are eligible for day surgery in the opinion of Mr Greensmith you must remember that this is only possible if you have a responsible adult to take you home from hospital and to be at home with you that first night. By law, hospitals will not let you travel home on public transport or in a taxi. In most cases you can then drive yourself to you next appointment with Mr Greensmith.

After surgery, you may experience pain or general discomfort if you have some packs in place. Packs are not usually used by Mr Greensmith, however you will swell internally and your nose will feel blocked for the first one to five nights after surgery. Mr Greensmith does not recommend sleeping tablets during this period.

The First Visit After Surgery

Your first visit after your surgery will usually be about seven to 10 days after your surgery (12-14 days in the case of more complex rib graft rhinoplasty). At this visit, the special plastic splint on your nasal bridge is removed along with any covering tapes. 

Your skin may feel and look a bit oily after being cover for so long but this will subside. Your nose may appear swollen for quite some time before your final results are visible, so we generally say that your results are about 80-90% visible after your procedure. It can take six to 18 months for the final results to appear. You may also feel quite congested for the following weeks or months. Initial minor asymmetries of nostrils, the tip or bridge are almost always due to asymmetrical swelling at this point and will settle over six to 12 months. 

At this stage, if you are starting to experience some consistent airflow through your nostrils, you will be instructed to start your nose moisturising sprays used twice daily in each nostril for six to 12 weeks after surgery to aid the recovery of the internal lining of your nose. You will also be instructed about any further taping required and the use of any anti-inflammatory gel to the nasal bridge. Mr Greensmith may provide you with exercises to help the healing process for the following six weeks. 

No experienced rhinoplasty surgeon should consider revision surgery in the first six to 12 months after surgery, as most apparent concerns can settle without surgery.

Longer-Term Follow Up

Mr Greensmith aims to follow up with all his patients after rhinoplasty at six weeks, six months and 18-24 months after rhinoplasty. Visits beyond the six week period are not covered in initial costs and you may need to referral from a family doctor for subsequent visits so that we can rebate your visits to Medicare. Further post-operative photographs are taken at some of these visits.

What if a revision is required?

In the unlikely event a minor revision is needed in the years after a rhinoplasty (revision rates range from 2-5% and noses keep changing as we get older/heal) then Mr Greensmith will do everything within reason to help reduce potential additional costs. 

In most cases, costs for minor revisions are minimal or negligible if the patient has private health insurance cover. Mr Greensmith will not agree to revise a rhinoplasty if the asymmetry is so small that correction by surgery would not be realistic or feasible. In some cases, cosmetic injectables may be used to address minor asymmetries. In cases where swelling has been slow to settle and an area such as the tip is too full, then a small amount of dilute anti-inflammatory steroid may be injected.