• Improving genetic nose traits
• Repairing birth defects
• Restoring the nose after injury or trauma
• Improving breathing through the nose
• Balancing facial features and enhancing general appearance
• Improving the quality of life for self-conscious or ridiculed teenagers
• Defying the aging process in older patients
• Correcting or enhancing prior nasal surgery
• Broadening, narrowing or straightening of the nose
• Improving the transition between the nose and upper lip
• An over protruding columella (fleshy section of the nose which separates the nostrils) can be reduced with surgery
• Restoring a deviated septum

Surgery of the Nose – Patient Guide to Rhinoplasty illustrations reprinted with permission of Royal Australasian College or Surgeons, The Australian Society of Otolaryngology – Head and Neck Surgery and Mi-tec Medical Publishing. The complete pamphlet is available from your surgeon.

• Male or female adults
• With younger patients, the surgery can be performed as long as the skeleton of the face is over 90% developed. With younger girls, this is around 13 – 14 while boys will be considered around 15- 16. Generally girls physically mature at a younger age than boys.
• Patients who are also having chin augmentation or a facelift as it can help balance the features

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  • Decreasing the overall size of the nose
  • Removal of bump on bridge
  • Narrowing a wide bridge
  • Refining and narrowing the tip
  • Adding 'projection' to the tip
  • Narrowing the nostrils and shortening the nose
  • Straightening the nose if crooked
  • Restoring height of the bridge following injury or previous surgery

At the initial consultation, Dr Zacharia will ask the you to express concerns about their appearance and to describe their symptoms.

Digital photographs of their face will be taken and Computer Imaging will be used to analyse the nose. This will enable you to view your current appearance and determine realistic outcomes following surgery.

Rhinoplasty translates to rhino = nose and plasty = shape, which is the basic elements of the procedure – to take the nose and to reshape it to the desired look. Below is a list of all the different types of reshaping, which you may want or Dr Zacharia may suggest.




Rhinoplasty, ’defects’ from either birth or trauma can be corrected by in-fracturing or breaking the bones of the nose and re-setting them narrower and straighter. Out fracture is when the bones are broken and moved out to widen the nose.

Nasal surgery generally requires anaesthesia and is performed as an inpatient procedure.

Closed technique:

Small incisions are made inside the nose and specialised instruments are used to separate the skin from the underlying supporting framework of bone and cartilage. The bone and cartilage are then sculptured to the desired shape. The nature and extent of the sculpturing are dependent on your nasal anatomy and the desired contour.

The skin is then redraped over the new framework and dissolvable sutures are used to close the incisions.

Open technique:

Small skin incisions are made across the columella (the skin that separates the nose). This provides more exposure, especially in complex cases and is often used in revision Rhinoplasty. This incision heals very well and is usually inconspicuous some weeks after surgery.


 

• After the procedure is completed, you’re admitted to recovery and monitored for a couple of hours or overnight before being driven home by a companion.
• A splint or cast is applied to maintain the new shape of your nose and to limit the amount of postoperative swelling.
• The cast will be worn for approximately 7 days and will be removed at an appointment with us. After removal, you may feel a slight stiffness in the upper lift as the swelling moves downward. This will subside in a matter of hours.
• You must be very careful not to bump it as it is vulnerable to breakage. The bones will completely mend within 2 months.
• If you had a Rhinoplasty where the nostrils were narrowed (in the case of flared nostrils) you will have your sutures removed. This may sting a bit, especially since it is in a sensitive area.
• If surgery is performed to straighten the nasal septum, an improvement in breathing will be appreciated at about 3 weeks.
• Although most patients still feel numb in the tip area and report only minor discomfort, your nose may be sensitive after the surgery for approximately a month and a half.
• Usually, there is no visible scarring unless it is an open Rhinoplasty. Generally, Dr Zacharia prefers the closed technique. If it is an open Rhinoplasty, the scar would be on the columella (the skin that separates the nostrils) sometimes resembling a straight line or a flattened 'z'.
• You can expect swelling, especially in the tip if you are having tip work performed. The swelling usually begins to subside within the first month but the end result may not be seen until at least 9 months post-operatively. Although this time period tends to lean towards a year and over.
• You may feel discomfort with breathing through your nose when the packing and cast is on and some patients experience a claustrophobic feeling as if they cannot breathe. This feeling widely resembles a head cold or sinus infection.
• Approximately 80% of the swelling and 100% of the discoloration are usually gone by 2 weeks after surgery. 90% of the swelling is gone by two months after surgery and the rest slowly disappears over the next year.
• Usually packing will be required however; you may be eligible for splints placed in the center of the packing on each side so that direct airflow through the nose is possible. Most patients find this a psychological discomfort rather than a physical.

As with any operation, nasal surgery has risks and potential complications. Complications are extremely rare but may include the risk of bleeding, infection, scarring or an anesthetic problem.

• Rupture of small surface vessels of the nose
• Poor wound healing
• Cardiac and pulmonary complications can occur in longer surgical procedures and may be associated with the formation of, or increase in, blood clots in the venous system
• Numbness or change in skin sensation
• Nasal airway alterations may occur after a Rhinoplasty or Septoplasty that may interfere with normal passage of air through the nose
• Nasal septal perforation (a hole in the nasal septum) may develop but is rare; additional surgical treatment may be necessary to repair the nasal septum but in some cases, it may be impossible to correct this complication
• Pain, which may persist
• Unfavorable scarring, particularly in the open technique
• Skin contour irregularities
• Skin discoloration and swelling
• Sutures may spontaneously surface through the skin, become visible or produce irritation that require removal
• Possibility of revision surgery in approximately 5% of patients. The Doctor’s time does not attract a fee in this instance bit the theatre and anaesthetic fee applies
• It is possible to develop tiny red marks and spots on the nose; this can be the result of blood vessels that may have burst under the skin’s surface during the surgery. Although this is extremely infrequent it can happen and the spots may not always go away.
• Lose of smell (usually temporary)
• If you experience redness and itchiness and sometimes perforation - you very well may be allergic to the dissolvable type sutures. Sometimes the symptoms may not show up until about 3 to 4 weeks after surgery, if this happens, antibiotics can be given. The best thing to do in some cases is to remove any of the left over material and replace it with nylon sutures. These sutures are usually removed in 10 days. Another option can be tissue glue.
• Depression can be common after cosmetic facial surgery but usually abates as the skin heals and the features return to the desired look. Dr Zacharia takes this element seriously and will be available to you throughout your recovery to address any concerns you have.