patient guide

Rhinoplasty  Consultation.  Tel: 09 529 5783

Taking your first steps towards a Rhinoplasty can be daunting. The following information is designed to help explain the process so you will be better prepared and know what to expect and what questions to ask.

The adult nose shape develops during the early teens so it is no surprise that many people develop a dislike of their nose as teenagers. For many it is not until their twenties or later that they have developed the confidence to address the issue.

Surgery can be considered for some patients in their late teens, especially with the counsel of a parent or partner. Parents who have passed on the family nose to their children may be very supportive of their children in seeking a Rhinoplasty if they have suffered for confidence because of their own nose. Surgery can also help in later life where ageing changes can affect the nose.

Whilst much information can be gained from the Internet and popular magazines a consultation with a surgeon is what will really help to define what changes are appropriate and possible.

A typical consultation takes from 45 to 60 minutes. This is your opportunity to say what it is that you don’t like about your nose and what you want it to look like. Some patients will be very detailed and specific in their analysis, whereas others just know that they don’t like their nose. They are after advice and assessment. It does pay to think about what features of your nose you like or dislike before the consultation. Pictures from a magazine or photos that you find appealing are useful for concepts, although may prove inappropriate for your face type.

You will be asked a number of questions about the function of your nose and what you would like to change about the appearance. Any previous surgery or trauma to the nose will be noted. General questions about your health and medications will be asked to determine your suitability for anaesthesia. Examination will include an assessment of your facial proportions in relation to your nose as well as a detailed assessment of the nose itself, both internal and external.

Computer morphing is an indispensible tool in this process as it allows surgeon and patient to discuss the potential changes and see how the face changes instantaneously. Several options can be trialled and compared.

Profile morphing also allows changes to the chin to be modelled. Chin surgery is appropriate in about 10% of patients presenting for Rhinoplasty. Of course exact replication of morphed images is rarely achieved but in many cases the results can be close. The real use of morphing is in establishing a concept that both patient and surgeon desire.

The patient has to decide if he or she trusts the surgeon’s assessment and abilities, and the surgeon has to decide if the patient's desires can be met, and whether they have realistic expectations of surgery. Having realistic expectations means that there is a clear understanding of the limitations of surgery and minor insignificant imperfections will not assume exaggerated importance post operatively. Some nose shapes cannot be achieved because of the condition of the skin, skeleton or airway, whereas others are simply inappropriate to the face shape. The most common request is to have the bump removed from the bridge of the nose, but many patients have not realised that the tip will also need to be reduced to balance the nose.

At the end of the consultation both the surgeon and the patient should have a clear idea of what is to be achieved. Once this is established the surgeon can explain in detail what surgical steps will be required. The risks, associations and possible complications will be discussed. Printed material is provided and morphed images can be emailed to you for your consideration. A second consultation, and very occasionally a third, is usual to answer any further questions you may have and review the plan. Bringing a partner or support person can be very helpful.

You will receive some printed material and a full set of pre-operative photos will be taken. Once the operative plan is decided a more accurate cost assessment can be provided. There is a fee for the first consultation but subsequent consultations and all postoperative visits will be free of charge. [ the operation ...]