The following information sheet is intended to assist patients undergoing rhinoplasty surgery with Dr Nicholas Lotz.
Rhinoplasty is a common surgical procedure designed to restore the shape of your nose after an injury, or as a purely cosmetic procedure if you wish to change the way it has developed.
Irregularities which are seen on the outside of the nose, such as a bent or twisted nose, will often also result in the airway being impeded, and fixing the shape of the nose can improve your airway at the same time.
Many patients are self-conscious of the appearance of their nose, particularly when they see themselves in photographs. Changing the appearance of the nose to bring it more into harmony with the rest of your face can improve your self esteem and may give you more self confidence.
Common reasons for rhinoplasty include:
Rhinoplasty surgery is performed by both Plastic Surgeons and ENT Surgeons. It is important to make sure that your surgeon is qualified as this can be difficult surgery. Dr Lotz has performed a large number of rhinoplasties, and he also performs combined surgery with ENT colleagues if they are performing surgery to correct a patients’ airway but are not happy with altering the shape of the nose themselves.
Dr Lotz has a specific interest in surgery to improve the appearance of the nose. During your consultation he will spend time with you to help understand which parts of your nose you would like changed and to give you an idea of what may be achieved from the surgery.
Previous injury to the nose
If the surgery is to be performed due to a previous injury to the nose, or if you have problems breathing, then a Medicare item number may apply, which means that some of the surgical and anaesthetic fees plus the hospital stay may be covered by Medicare and your Health Fund. Dr Lotz will be able to provide you with an exact quotation for surgery following your consultation.
During your initial consultation, Dr Lotz will spend time with you discussing your general health, current concerns about your nose, and what you would like to achieve from the rhinoplasty surgery.
All patients have slightly different requirements, and will require surgery to be tailored to their needs. Dr Lotz will explain in detail what is required in your case, and the relevant risks and expected recovery will be discussed. You will be shown photographs of other patients who have undergone similar rhinoplasty surgery, so you have an idea what to expect with respect to results.
You will be sent an information pack further explaining the procedure, along with a detailed, personalised quotation which explains all the relevant costs pertaining to the procedure as well and any heath fund or Medicare rebates applicable.
It is important that you stop any blood thinning medications at least 10 days prior to surgery in order to reduce the risk of bleeding.
You should also cease smoking a month before and a month after your surgery to reduce the risk of skin healing problems.
You will have a second consultation a week or two prior to your surgery to answer any final questions you may have, and photographs will be taken to aid planning your rhinoplasty surgery.
Dr Lotz will visit you in the hospital the morning after the surgery before you are discharged. Rhinoplasty is not usually too painful, but you will be given pain medications and antibiotics to go home with, as well as a detailed instruction sheet.
You will be seen in the consultation rooms a week following the surgery. At this time, the small plaster on the nose will be removed after a week, as will any stitches. Note that the stitches inside the nostrils are all self-dissolving and will not need to be removed. You will then have some skin coloured tape applied to the nose for another week to help control any swelling. You will be able to shower normally now that the plaster has been removed.
Rest and Recovery
There will be some bruising and swelling after the surgery for a week or two, and you may have black eyes. Sleeping with your head elevated on a couple of pillows for the first few nights following the surgery will help this to go as quickly as possible. It may take several months for the swelling to completely settle, and it is also common to have some numbness of the tip of the nose which can last for several months.
After the surgery you should rest at home for the first week, avoiding strenuous activity and lifting.
Sport will need to be restricted for a few weeks after the surgery, and any contact sport needs to be avoided for 2 months to avoid nasal injury.
Most patients will be back at work 2 weeks after the surgery.
Although rhinoplasty is a safe operation, like any surgery there are risks. Dr Lotz will explain all of these in detail to you during your consultation. Risks can be reduced by quitting smoking before surgery, following a healthy diet, and stopping any medications which may result in increased bleeding risk. Complications which can occur following rhinoplasty include:
21 year old patient. Traumatic saddle nasal deformity. Rhinoseptoplasty performed using cadaver rib allografting. Result at 3 months shows correction of dorsal collapse and improved tip projection.
Although there is no age limit for rhinoplasty, the late-teens, when the nose is near full development, is the earliest recommended age. Most people’s noses stop growing by about the age of 16 or 17. Surgery before this time risks the nose distorting as it grows.
Rhinoplasty surgery is performed in a private, accredited hospital under general anaesthetic with a qualified anaesthetist. The time required depends on the extent of the surgery required. The usual surgery time is 2-3 hours. Most patients stay one night, but some may prefer to go home the same day.
In open rhinoplasty surgery, a small scar is placed on the underside of the nose. This will fade in time to be almost invisible.
The cost of rhinoplasty surgery is determined by the expected complexity and duration of your operation and will be estimated following your first consultation.
In patients with traumatic deformities, or who have breathing difficulty, there may be a Medicare item number. You will be sent a detailed quotation following your consultation outlining surgeon, anaesthetic and hospital costs, as well as any applicable rebates.
A rhinoplasty procedure may attract an item number from Medicare which allows you to claim a rebate.
If you have the appropriate level of health insurance cover, they may pay for your theatre and accommodation fees. Possible Medicare item numbers are 45638 / 41671.
Strenuous activities can prolong swelling so it is recommended to avoid these for at least 3 weeks after surgery. Contact sports should be avoided for 6 weeks as this time is needed for the bones to heal. You will be able to drive once the swelling subsides and doesn’t interfere with your ability to see. Flying is allowed 2 weeks after surgery.
You will be seen by Dr Lotz within 7 days of your surgery. Regular appointments are made to remove sutures and to check on your healing following surgery.
After rhinoplasty, it is important to be patient as it is important to remember that it can take many months, and sometimes more than a year, for all swelling to disappear and the final shape to be revealed.
A new surgery should not be performed until you have fully recovered from the original procedure. The amount of time required will differ from patient to patient, and anyone interested in revision rhinoplasty should be evaluated individually.
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