Rhinoplasty

Want to get Rhinoplasty done in Sydney?

In this video, Professor Thomas Havas talks about his international experience with performing Rhinoplasty procedures (nose job), the different techniques used, the difference between cosmetic and functional Rhinoplasty and the important information you need to know before undertaking a Rhinoplasty procedure.

Over the last 20 years, Prof. Havas has performed several thousand rhinoplasties.

To find out whether you are the right candidate for Rhinoplasty, please call 02 9387 7360 or use the booking form to book an appointment.


What is a Rhinoplasty?

A rhinoplasty is an operation performed to alter the appearance or functioning of the nose. In laymen’s terms, it is sometimes referred to as a ‘nose job’.

Rhinoplasty is the most commonly performed cosmetic surgical procedure. It tends to be performed either by Ear Nose and Throat Surgeons (particularly those with post-Fellowship training in nasal physiology and/or Rhinoplasty) or by Plastic Surgeons. By and large, rhinoplasties are divided into purely cosmetic operations and functional operation; that is to say cosmetic rhinoplasty or functional rhinoplasty.


Cosmetic Rhinoplasty or Functional Rhinoplasty

Cosmetic Rhinoplasty or Functional RhinoplastyCosmetic rhinoplasties are done essentially to alter the shape of the nose. The nose can be reduced, it can widened, it can narrowed, it can be made bigger, it can be made smaller and all of this can be achieved by reshaping or altering the position of the nasal bones and/or the cartilages that make up the supra structure of the nose.

The nose is the central feature of the face: it is where the face finds its axis, it is the anchor of emotional facial movement such as smiling or crying, and any lack of harmony between the nose and the face is immediately noticed and considered to be a cosmetic problem.

Both cosmetic and functional rhinoplasties can be done in one of two ways. Closed structure rhinoplasty involves getting access to the structure of the nose via an incision made inside your nostril using either telescopes (endoscopically) or direct visions. One of the most common questions asked by patients contemplating a rhinoplasty is, will there be a scar Doctor? The answer to this is complex and the best surgical approach is tailored for each individual case. If subtle refinement is required in terms of altering the size of the nose, subtle contour changes to the shape of the nose or subtly changing the alignment or straightness of the nose, this can often be achieved by a closed structure rhinoplasty. This means that there will be no cuts associated with the operation.


What is Open structure rhinoplasty?

Open structure rhinoplasty involves making a small cut in the columella and lifting the skin of the nose off the supra structure. This allows access to the cartilaginous and boney structure under direct vision. Although this procedure is associated with a very fine scare in the foot of the nose (which is usually imperceptible after 3 months), it is the approach to rhinoplasty, which is associated with a scar. The advantages of open structure rhinoplasty is that for more complex cases, for twisted noses, for large boney and cartilaginous humps, where tissue needs to be imported after excessive previous surgery, procedures can be undertaken under direct vision, struts, stents or augmentation material can be sutured in place and the tip of the nose can be reinforced either by stitching cartilaginous tissue that is there or by importing tissue from a distant site.

Open Structure RhinoplastyMore and more, we are performing revision rhinoplasty on people who have had operations years or decades ago, in which too much tissue was injudiciously removed. In cases like this, particularly where there are associated airway problems, we have to harvest cartilage from a donor site. This is often the earlobe, or sometimes the rib. If tissue is imported, placement under direct vision using an open structure rhinoplasty is nearly always necessary.

Functional rhinoplasty is an operation not only to change the physical appearance of your nose, but heavy emphasis is placed on restoring normal nasal airflow or normal function. Functional rhinoplasty is the operation that is often performed in revision cases, cases of nasal trauma, cases of congenital lack of development of the nose, or cases where there is significant collapse of the airway, limiting nasal airflow during exercise.


Nose Job Procedure

Regardless of the type of rhinoplasty, a rhinoplasty is performed under a general anaesthetic in a hospital setting. The operation takes between one and a half and two hours of operating time. When you wake up from the procedure, you will have a synthetic plaster on your nose to hold the re-sculptured components of your nose in place. More often than not, there will be no fixed packing in your nose and no stents or splints. Occasionally, if you ooze a little bit more than average some absorbable packing material will be left in your nose. This does not need to be removed, and dissolves of its own accord in between 3 and 5 days.

The operation can be as a day only procedure. Usually, the limiting factor in whether you can go home that day and/or need to stay in overnight depends on how you pull up after the anaesthetic. The anaesthetic is usually a relatively light general anaesthetic. It does not involve endotracheal incubation and is usually performed using a laryngeal mask to maintain the airway.

In the majority of cases, the control of blood pressure is maintained by the use of special inhalation or gases, which not only keep you asleep but control the depth of your anaesthesia and your blood pressure. Occasionally, for complicated cases or in patients with high blood pressure, additionally drugs have to be given to lower the blood pressure and in these cases the operation is performed under controlled hypotension.


‘Should I get a nose job?’

Nose Job Bondi Junction If the physical appearance of your nose causes you any concern and particularly if it is associated with any functional problem such as blocked nose or difficulty in breathing, you should certainly consider getting advice about, and probably to, having a functional rhinoplasty. In days bygone, there was a certain stigma attached to rhinoplasty essentially because it is the most common cosmetic operation. People were seen to be frivolous or vain if they contemplated an operation like this, but for the last decade or so, appropriate corrective surgery both cosmetically and functionally, is now accepted as being not only mainstream but desirable and contributing significantly to improved quality of life.


Nose Job Recovery Time

As indicated above, the operation can be done either as a day stay or at most, it requires one night’s hospital stay.

When you leave hospital, you will have a plaster on your nose. Most people, particularly those working in hospitality or customer confrontation situations, elect not to go back to work while the plaster is on the nose.

As a rule of thumb, a 2-hour anaesthetic takes approximately 3 days to recover from. It takes your 3 days to metabolise and excrete the anaesthetic agents. Thereafter, although you may experience a little bit of fatigue and a little bit of nasal blockage, you will feel well, you will be able to breathe through your nose and even if you do not go to work you will be up, around, dressed, walking about, working on your computer, and interacting with your family and friends. The plaster is usually removed in a week to 10 days. By that stage, 70 to 80 percent of the swelling associated with the operation has settled, and most people return to work after 1 week. After 1 week, physical activity can be recommenced but vigorous physical activity, particularly in the head down posture, should not be undertaken for the first 2 weeks.


For further information, please call 02 9387 7360 and make an appointment with one of our friendly team members.