Rhinoplasty in Melbourne

Surgeons are like any trade. They should all have essential qualifications (MBBS and FRACS). Then their ability to achieve good consistent results depends on how much extra specialist training and experience they have had and the quality of that training. Just like tradespeople, not all surgeons are of equal ability.

Here are some questions to consider when choosing a surgeon:

• How many rhinoplasties has the surgeon done? Less than 200? More than 1000? Do they have examples of their work? Rhinoplasty has techniques a surgeon must master, but the quality of their aesthetic eye is an art, not a science. Make sure you like the noses they create.
• What reputable professional societies do they belong to?
• Are they involved in the teaching of rhinoplasty? Do they stay academically up to date (Conferences etc.)?
• Do they do revision work? Do they do structural (functional) work? Do they do cosmetic work?
• Do they offer image morphing?
• What sort of follow up is offered after surgery? One visit in the first month is substandard.

You need to have a good rapport with your surgeon. Do you connect well? Does he understand your wishes and communicate well? Do they seem meticulous in their approach? Do you think they would be approachable if you had concerns post-op?

Not all excellent surgeons necessarily do the hardest/most complex cases, and many can achieve excellent results for those types of noses they know they can do well (or refer to someone who can). It is important both you and your surgeon feel confident you can achieve the desired outcome.

Rhinoplasty is changing the appearance of the nose. Functional rhinoplasty implies this is done to improve nasal function (breathing). Cosmetic rhinoplasty means we are performing the surgery as we dislike the appearance. Many of my cases are both.

If your surgery has a functional component, your hospital fee and a portion of your surgery and anaesthetic fee may be covered by your private health fund. Many surgeons perform just functional or just cosmetic rhinoplasty. The minority perform both.

If you have problems breathing that requires a rhinoplasty, then yes. However, not purely for nasal appearance.

Be aware not all public hospitals offer rhinoplasty surgery and that your wait for surgery will likely be several years. As in the private sector, rhinoplasty surgeons in public hospitals have varying degrees of experience. You cannot choose your surgeon in the public healthcare system.

It does not matter. What matters is that your surgeon has a solid background and training in rhinoplasty. The techniques are the same. Advanced training in either specialty introduces rhinoplasty techniques, and those interested often pursue further training once qualified as a specialist. Internationally well-regarded rhinoplasty surgeons come pretty equally from both specialties.

If you have significant aesthetic (cosmetic) and/or functional (blocked nose) concerns about your nose, then it is worth chatting to your surgeon.

From there, they can discuss the potential complexities your case poses. If you are in good health and have not had surgery before, you are probably a good candidate. If you have had significant trauma or previous nasal surgery, a rhinoplasty specialist may be more advisable.

Rhinoplasty surgery can be quite lengthy as it is technically very challenging, but the recovery is generally straightforward. Two to three weeks of rest are needed, but it is usually not very sore, and the demands on you are minimal. The healthier you are, the more suitable you are for a more prolonged anaesthetic, but any age may be suitable for a rhinoplasty.

The exception to this is children and teenagers. Generally, we wait until your nose has finished growing (16-18 years of age) before offering rhinoplasty. There are rare exceptions to this.

Apart from improving nasal breathing, many aesthetic features of the nose can be altered. These include, but may not be limited to:

• A bump on the bridge
• A large nose
• A boxy or bulbous tip
• Crooked nose
• Asymmetrical nostrils
• Wide nose
• Upturned or droopy nose
• Collapsing nose
• Lumps, grooves or irregularity

Absolutely. This may not have always been the case in years past, as some techniques achieve small elegant noses by methods that weaken the framework. These techniques are still practised by some but compromise the airway, and the cosmetic outcome is often not long-lasting.

The goal should be good rhinoplasty technique and a lovely natural-looking nose that breathes well and has good long-term structure.

Yes. Revision surgery is often more complex as the soft tissues are more scarred, and your framework may well have been disrupted enough that substantial grafting is required.

In revision work, grafts from rib cartilage are not uncommon, and techniques to help your skin envelope drape better are often employed. This can be some of the most technically challenging surgery performed (in any specialty) and, depending on the case’s complexity, may be referred to a rhinoplasty specialist who regularly does revision work.

Choose your surgeon carefully if you require a revision, as every time your nose is operated on, your chances of achieving the results you want are more challenging or may become impossible.

Yes. Some surgeons offer this. You can find more information on what we offer here.

For closed rhinoplasty, all the cuts/scars are inside the nose. For open rhinoplasty, a small cut is made externally across the skin bridge between the nostrils (and the others are internal). This cut is discrete, and in almost everyone (including those who often scar poorly elsewhere on their body), it heals very nicely and can be difficult to notice.

I perform mostly open rhinoplasty as I prefer the exposure it offers to achieve a dependable cosmetic and functional outcome. Many techniques used in open rhinoplasty are not possible with closed rhinoplasty.

Around the world, there are extremely skilled practitioners of closed rhinoplasty who can achieve beautiful results. Still, these surgeons are uncommon, and even in their hands, complex cases (especially revisions) are often better suited to the open approach where structure can be more readily rebuilt and secured. This view may not be shared amongst surgeons who only perform closed approach rhinoplasty but is widely accepted amongst the international rhinoplasty community.

No. Please refer to my Rhinoplasty Post-Operative notes for precise details. If you need rib cartilage taken, then your chest wall will be quite painful for a week. In some cases, we use irradiated cadaveric rib cartilage, which avoids this.