Rhinoplasty

A rhinoplasty or ‘nose job’ is a procedure that involves reshaping the size, and shape of the nose to improve the appearance of the nose. It is performed in both men and women.

A rhinoplasty can:

  • Change the size, shape and angle of the nose
  • Remove the hump on the top of the nose
  • Restore symmetry of the nose after a previous traumatic accident
  • Refine the nasal tip when it is drooping, elevated or too wide.
  • Improve nasal breathing

Women and men seek rhinoplasty surgery to:

  • Achieve a more defined feminine or masculine nasal shape
  • Achieve a nasal shape in proportion to the rest of their face if it is too large or too small
  • Correct the effects of a previous injury that may have resulted in a crooked or badly shaped nose
  • Achieve a change in their facial profile, shape and image.
  • Feel more confident

The best candidates for upper blepharoplasty are men and women who:

  • Wish for an improvement, but not perfection, in the appearance of their nose
  • Are physically and mentally healthy
  • Have realistic expectations
  • Are at least 16 years of age and have finished growth
  • Do not smoke

Rhinoplasty surgery may not be suitable for men and women who:

  • Have multiple medical problems
  • Are on blood thinning medication
  • Have unrealistic expectations
  • Have had multiple previous operations on the nose.

At MODE, Dr Aggarwal will guide you through the planning of surgery and help decide which procedure is best suited to achieve your goals.

Procedure Snapshot
  • Anaesthetic: GA by accredited anaesthetist
  • Time: 3-4 hours
  • Duration of stay: Day Surgery
  • Hospital: Any of the hospitals where Dr Aggarwal works.
  • Medicare/Health fund rebate: Medicare and Health Funds will provide a rebate only if there has been a previous traumatic injury to the nose necessitating rhinoplasty surgery for medical reasons.
  • Recovery: You go home the same day. You are required to go home with a nasal splint on the outside of the nose, and you may have nasal splints or dressings inside the nose. Most people can resume work within 1-2 weeks but the swelling takes many months to subside.
  • Results: It can take up to 12 months to achieve final results, and these can vary from patient to patient.

Cosmetic Concerns

  • A very small inconspicuous scar is placed between the nostrils, in an area called the columella
  • The remaining scars are placed inside the nostrils and are not visible.
  • Like all external scars the columella scar will be visible immediately after surgery but this heals very well long term. The scar may also be visible during the period of swelling which lasts several months after surgery.
  • Yes this is a frequent complaint for which rhinoplasty surgery is often performed.
  • Deviation of the nose occurs from both deformity of the bony skeleton at the top of the nose (frequently injured during previous trauma) and the cartilage framework.
  • Part of the rhinoplasty procedure involves repositioning the bones through cuts performed in the bones called osteotomies.
  • The cartilage septum between the two halves of the nose is also reshaped and repositioned.
  • This is a frequent reason for patients to request a rhinoplasty.
  • The key to dorsal hump reduction is to achieve a gender appropriate shape to the nose – in men we aim to reduce the hump so that the profile (side view) shows a straight dorsum of the nose, and in women we aim to reduce the hump to show a slight slope that looks aesthetic.
  • A dorsal hump reduction can achieve an excellent cosmetic result.
  • The tip is refined by a combination of cartilage removal, soft tissue removal, and fine suturing of the nasal tip cartilages and cartilage grafts to produce an appealing nasal tip.
  • It is important to remember though that nasal tip swelling lasts several months and it can take some time before appreciating the final result.

 

Procedure Information

The procedure is usually performed under general anaesthesia given by an accredited anaesthetist in a fully accredited and licensed facility (usually one of the North Shore’s premier private hospitals). The procedure takes three to four hours and patients go home the same day.

  • Dr Aggarwal will mark you before your procedure, taking into account the changes you wish to achieve.
  • The scar of a rhinoplasty extends across the columella which is the part of the nose between the two nostrils. The remainder of the scars are placed inside the nostrils on each side.
  • Local anaesthetic is carefully injected just under the skin.
  • The skin of the nose is lifted to reveal the cartilages of the nose, and the lower part of the nasal skeleton.
  • The dorsal hump if present is removed
  • The cartilage of the septum is then adjusted through both partial removal and careful suturing
  • The cartilages around the nostrils (called the lower lateral cartilages) are reshaped, their size adjusted, and carefully resutured to modify and refine the nasal tip
  • Additional cartilage grafts are added to make the nasal shape robust to long term scar healing
  • The nasal bony skeleton is carefully reshaped and remodelled.
  • The nasal skin is closed with absorbable and non-absorbable sutures.
  • Splints are then placed inside the nose on either side of the septum to maintain its position and also allow easy breathing during the initial post-operative period when swelling occurs.
  • Tapes and splint are placed on the outside of the nose to reduce swelling and maintain shape.
  • You will be instructed to go home in the company of a responsible person who can be with you, look after you and alert Dr Aggarwal in case you are not feeling well.
  • It is also a good idea to keep your head elevated when you sleep at least for the first 3-4 nights and up to a week.
  • You will be given a script for antibiotics by Dr Aggarwal which you must continue for 1 week. You will also be given appropriate pain relief medications.
  • While most sedentary activities can be resumed when you go home, you must lay low and not exert yourself. You should refrain from any activity that raises your blood pressure for the first week. Most people are able to return to normal work at 1-2 weeks.
  • Dr Aggarwal will see regularly after your discharge from hospital.

Risks & Complications

Every surgery carries risks, and therefore one must consider if risks outweigh the benefits for your own personal situation. If they do then the surgery may be well worth it. Dr Aggarwal will discuss the pros and cons of surgery with you during your consultation.

  • Risks of anaesthetic – there are general risks of going under an anaesthetic such as a mild stress on the heart and lungs, risk of reaction to anaesthetic drugs and risk of blotting in the legs. There is also a risk of aspiration (fluids from the stomach going into the lungs) as well as nausea and vomiting post procedure. These risks are low in patients who are otherwise fit and healthy but anaesthesia can affect different patients in different ways.
  • Bleeding (1-2%) – any bleeding is controlled during surgery however unexpected bleeding can occur in the immediate postoperative period. If this occurs it will necessitate a return to theatre to control the bleeding.
  • Infection (<1%) – this is very rare. However you are given antibiotics during induction (when you are going to sleep), as well as a course of oral antibiotics after your surgery to keep this risk to a minimum.
  • Asymmetry to the nose or nasal tip – while nose reshaping surgery aims to recorrect this it may not be possible to correct it completely. Sometimes nasal asymmetry occurs long term as scarring changes the shape achieved initially. Occasionally suturing techniques and cartilage grafts or cartilage removal can create an asymmetry not present before surgery.
  • Obstruction of nasal airway – Rhinoplasty aims to improve the nasal airway. If this is the primary reason for a rhinoplasty Dr Aggarwal will get you to see one of his ENT colleagues, and sometimes the surgery is performed in conjunction with such a specialist. Nasal splints are used in the immediate post-operative period to allow breathing during the swelling period. However it is possible to create an obstruction not present before surgery due to modification of the cartilage and bony framework of the nose.
  • Pinched tip – this is when tip surgery is performed to refine the tip through cartilage removal and careful suturing. The art of beautiful rhinoplasty surgery is to avoid creating a tip that is too narrow, called a pinched tip that looks artificial. Dr Aggarwal tries to prevent this through judicious cartilage and soft tissue removal and also via cartilage grafts that blunt the tip to avoid sharp angles and bumps, however this can occur even when taking care during surgery, and occasionally longer term as scars change the shape initially achieved.
  • Abnormal bumps or lumps that were not there before or in different positions to pre-operatively – this can be sutures that are felt through the skin or cartilage bumps created by suturing or remodelling during surgery. Occasionally cartilage grafts used to blunt angles can themselves create new bumps. Rhinoplasty is generally a trade-off – while original concerns are addressed, new issues can be created through surgical manoeuvres performed.
  • A frame deformity – this is a special deformity that can occur from surgery when there is disparity between the bony and cartilage framework. It occurs when the cartilage framework is reduced and narrowed excessively, and often comes with obstruction of nasal breathing. Correction requires repeat surgery.
  • Hypertrophic or poor scars – How one’s body behaves to scarring is individual and largely genetic. Some types of skin are more prone to hypertrophic or keloid scarring, and some individuals and families are more prone to this. We will routinely advise you on how to improve the quality of scars over time. You should also discuss any history of abnormal scarring with Dr Aggarwal preoperatively.

Procedure FAQs

  • We recommend that patients obtain a referral for rhinoplasty surgery.
  • If you do obtain a referral it is possible to claim a Medicare rebate of approximately $73 for the initial consultation
  • Furthermore if you have had trauma to your nausea causing it to become misshapen, you may qualify for the Medicare item number. If you have an appropriate level of health cover, you may qualify for a rebate from Medicare/health funds with a referral.
  • You can see us at our main practice at Gordon, or at our other locations at Hornsby, Hunters Hill or Camperdown.
  • Please scroll to the bottom of the page to find out more information about these locations.
  • Any of the hospitals where Dr Aggarwal works: most commonly at the Sydney Adventist Hospital, or Hunters Hill Private.
  • Cease fish oil, and other supplements such as Ginkgo, Ginseng.
  • Please discuss with Dr Aggarwal if you are on blood thinning medications as to when you should stop and recommence those.
  • Stop smoking well in advance of surgery.
  • You must not do any activity that raises your blood pressure for 72 hours
  • Most people are able to resume most activities at 1-2 weeks.
  • Dr Aggarwal will provide you with the necessary scripts for antibiotics and pain relief.
  • You will be required to wear a nasal protective splint for the first few weeks.
  • You may also have a bolster under your nose for the first 24 to 48 hours to absorb any ooze from surgery.
  • Not usually.
  • Yes
  • However we always encourage patients not to be away overseas shortly after having a procedure, so that we can closely follow your recovery and address any concerns that may arise.
  • You can swim in a pool or beach after 2 to 3 weeks once all wounds have healed.
  • It is best to not drive for the 24-48 hours after rhinoplasty surgery due to possible effects of the anaesthetic. Early swelling and discomfort may also interfere with your ability to do normal things like driving and its best to make sure you are feeling comfortable before driving or operating heavy machinery.
  • Your face will be puffy, and the areas around your nose and eyes will be bruised and swollen after surgery. Most of this subsides in the first 1-2 weeks after surgery.
  • Your return to work or school depends on how much exertion your job or your school activities require. Most normal activities including exercise can usually be resumed within three weeks.
  • Minor swelling of your nose may persist for up to a year but most likely will not be noticeable to others.
  • It will be a few months before you can expose your reshaped nose to direct sunlight, and it may be a number of weeks before you can wear glasses without special support, such as tape, if the bones in your nose were altered
  • No, this surgery is performed under a general anaesthetic in an accredited private hospital.
  • Slight imperfections along the dorsum of the nose (the upsloping part of the nose), a dorsal hump and tip imperfections can sometimes be camouflaged with filler. A filler is composed of hyaluronic acid, which is a normal component of soft tissues in the body and can last 12-18 months. However it has to be injected safely to avoid the blood vessels in this region. This procedure is sometimes nicknamed ‘liquid rhinoplasty’.

Procedure Pricing

  • The total fee for rhinoplasty surgery varies from $13000 to $16000 depending on the expected duration of surgery.
  • This fee is all inclusive, which includes
    • Surgical fees
    • Hospital theatre fees
    • Anaesthetist fees (if applicable)
    • Follow up
  • Please note that some patients may qualify for a Medicare item number and this can reduce the out of pocket costs to $7000-9000.
  • Please note that the above prices do not include
    • Preoperative consultation fees – which are $280 for the initial consult and $140 for additional preoperative consultations

Gallery & Video Your Procedure Request Consultation

Meet Dr Aggarwal

Dr Aggarwal is a well regarded, respected, highly skilled and experienced Specialist Plastic Surgeon. Graduating at the top of his class throughout his training, Dr Aggarwal has completed fellowship training at some of the world’s most prestigious reconstructive and cosmetic plastic surgery institutions. He continues to publish research is prestigious plastic surgery journals, and is actively involved in the training of future plastic surgeons.

What sets Dr Aggarwal apart from others is his personal, affable and warm nature. Not only does he pay attention to detail, to producing natural, beautiful results but he ensures that the patient’s journey is just as special as their outcome. Dr Aggarwal looks after patients at two of Sydney’s most prestigious public hospital campuses (RPA and POWH/RHW), and operates privately on the North Shore.

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If sedation or general anaesthetic is required, it is delivered by an accredited anaesthetist

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Latest News

New Consulting Locations

In addition to our Hornsby and Camperdown locations, in 2018 we bring you:

  • Hunters Hill (Lower North Shore) – conventiently located near one of Dr Aggarwal’s operative locations at Hunters Hill Private Hospital, Hunters Hill offers the convenience of accessing Dr Aggarwal in the lower north shore.
  • Gordon (North Shore) – set to be our primary practice, our flagship rooms will be open for trading in August 2018. Follow our blog to see an update on progress.
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Consulting Locations

Gordon (Flagship)

Suite 13, Level 3, 924 Pacific Highway, Gordon NSW 2072

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Hornsby

85 Burdett St, Hornsby NSW 2077

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Camperdown

Level 2, Clinic D, Chris O’Brien Lifehouse, Camperdown NSW 2050

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Hunters Hill

Level 1, 6 Ryde Road, Hunters Hill NSW 2110

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Phone:

1300 80 9000

info@modeplasticsurgery.com.au

Suite 13, 924 Pacific Highway
Gordon NSW 2072, Australia

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