Rhinoplasty

For many patients, rhinoplasty or “nose job” was once the perfect cosmetic procedure to aesthetically sculpt, contour and balance the facial profile. Yet over the past decade, more patients are opting for the procedure to correct nasal blockages that hinder breathing, their sense of smell or ability to sleep.
We explain rhinoplasty’s benefits from every angle.

Rhinoplasty is one of the most popular surgical procedures that are often life-changing for many patients. The nose is not only the centrepiece of the face, but it also provides a harmonious balance to our other facial features and is crucial to our ability to breathe, rested sleep and self-esteem.

In the right hands of Dr Lionel Chang, a FRACS-qualified plastic surgeon, rhinoplasty makes it possible to change the shape, size, contour and smooth function of the nose. But before you commit to having the surgery, it is important that you consider the benefits and risks that come with any surgical procedure. This includes opting for a non-surgical procedure [using fillers].

So what makes a patient an excellent candidate for the procedure?

If you have a nose that is either too large, too wide, asymmetrical or too small in comparison with your other facial features, rhinoplasty is an ideal procedure to create a more balanced appearance. The goal of a rhinoplasty is to create a subtle change to your facial features that will blend harmoniously with the rest of your face.

Functional Rhinoplasty  [corrective surgery]

In the same way, rhinoplasty can be performed in a number of ways to optimise the symmetry of the nose, resolve nasal obstructions and drastically improve any other irregularities, trauma or birth defects without altering the nasal contour.

The most common procedures include:

  • Deviated septum, a condition in which the bone and cartilage that divides the nasal cavity in half of the nose is misshaped and impacts the breathing passages
  • Nasal valve collapse, a condition that refers to the narrowing or weakening of the nasal passage as a result of a congenital predisposition [from birth], injury or previous surgery.                                                                   
  • Nasal polyps, soft, noncancerous growths that appear on the lining of your nasal passages or sinuses and are mostly caused by chronic inflammation triggered by allergies, asthma and frequent infections.         
  • Enlarged turbinates, a condition that ranges from mild congestion, upper respiratory infection, allergies to total nasal obstruction.

Additionally, rhinoplasty can improve your sense of smell and sleep apnea — a condition that can lead to depression, fatigue, hormone imbalance and an array of cardiovascular diseases if left untreated.

Once a deviated or blocked septum has been diagnosed by your ENT [ear, nose and throat] specialist, the septum can be repositioned and straightened. Similarly, any nasal obstruction that causes disruption to your sleep [including snoring] can be corrected by opening the airways or correcting any structural issues of the nose.

Like all surgical procedures, it is important that you discuss your concerns, aesthetic goals and the recovery process in depth during your consultation with Dr Chang, who has had over 30 years experience in performing successful rhinoplasty procedures.

 

       


Procedures

Functional rhinoplasty can be carried out either as an open or closed surgery.

The most common procedure for less drastic reshaping is a closed rhinoplasty, which involves incisions and modifications made inside the nasal structure [on the undersurface of the columella; the tissue that divides the nostrils]. The technique also leaves the patient with no visible scarring and faster recovery time.

Open rhinoplasty involves Dr Chang creating a vertical incision on the underside of the nose between the nostrils so that the inner nasal structure [cartilage and bone] becomes visible. This technique is often required for the more extensive alterations to the nasal tip, complex nasal abnormalities and full nasal reconstruction, and involves having the nasal skin draped over the new framework of the nose during the procedure. After the nose is closed with tiny sutures; shaping plaster, a nasal splint and/or nasal packing are used to help stabilise the septum.

The procedure may take anywhere from one to two hours, with the more complex procedures taking longer.

Recovery and results

Though the initial recovery period is quick, the healing process is gradual [from 12 months]  and the final results are not often visible until six months due to the skin having to shrink to the new, underlying framework. Initially, patients will experience significant swelling, numbness and bruising around the nasal region, with some also experiencing minor bleeding and minimal pain [which will be managed with prescribed medication]. The complete reduction of swelling will take up to six months and the resulting scar is also small and unobtrusive but does not completely disappear.

It is also recommended that you should take two to three weeks off to ensure that your nose begins to heal and the swelling is kept to a minimum.

During your consultation, Dr Chang will make his recommendation about the best course of action to take in order to achieve the most attractive and effective results. This includes discussing whether the surgery will be performed under general or local anaesthesia [subject to the procedure, existing health issues and your preference].

Only after the swelling has subsided can the outcome of the procedure be properly assessed. It is also important to remember that every patient’s anatomy is unique and lifestyle habits [such as smoking and drinking] will not only compromise the wound-healing process but can trigger necrosis [destruction of cell tissue] and clotting.

If you have experienced a bad result with another surgeon, a revision rhinoplasty can be performed to correct any errors or complications made in the first surgery and help restore your self-confidence.

Corrective action should take place after 12-24 months from the initial surgery. Often performed as open rhinoplasty, the procedure typically requires cartilage grafting [from the septum, ears or ribs] to augment the appearance of the nose.

During your consultation, you will be required to discuss how many procedures you have had and a thorough evaluation will follow to reveal where the surgery went wrong and what needs to be corrected.


Non-Surgical Rhinoplasty

Quite often patients who are dissatisfied with the appearance of their nose will opt for non-surgical rhinoplasty.

The procedure involves injecting hyaluronic acid injections or collagen-stimulating dermal fillers into the nose in order to temporarily correct deformities and augment and contour the shape of the nose. Anti-wrinkle injectables can also be used to temporarily freeze the muscles and diminish wrinkles around the nasal region and mouth; an effect that leaves the profile of the nose in symmetrical proportion with other facial features.

Though the results are immediate with no downtime required for recovery, patients should continue with the treatments in order to maintain the effect.

If you are dissatisfied with your new look, non-surgical rhinoplasty is also reversible, either through the effects of the fillers dissolving naturally over three-six months or within 24 hours of the initial procedure by injecting hyaluronidase into the nose in order to dissolve the hyaluronic acid-based fillers.

The best way to determine if rhinoplasty is suitable for you is to first schedule a consultation with Dr Chang. In addition to assessing your medical history and quality of the skin, he will also discuss your aesthetic goals, psychological preparedness, the recovery process, any potential risks, pain management and the best results that will likely be achieved.

Contact Jane Luong, Practice Manager for further information or to book a consultation.