Rhinoplasty

Introduction

A rhinoplasty is an operation that alters the shape of the nose. This can be done for cosmetic reasons but is also often needed to correct a blocked nose.

Note that Rhinoplasty for cosmetic purposes IS NOT eligible for Medicare rebates and is not covered by many private health insurances.

Indications

The main indication for rhinoplasty performed by Dr Morrissey is difficulty breathing through the nose. The common indications include:

  • Nasal obstruction or blockage.
  • Correction of traumatic deformity.
  • Correction of congenital deformity.

Risks

Rhinoplasty is a complex procedure and as a consequence carries a number of risks. To start with, it carries the same general risks as all operations including:

  • Pain.
  • Bleeding.
  • Infection.
  • Scarring.
  • Failure to resolve symptoms.

Specific risks of Rhinoplasty include;

  • Unhappiness with cosmetic outcome / Nasal deformity.
  • Significant bleeding.
  • Numbness of the nose / Dental sensitivity.
  • Excessive firmness of the nose.
  • Septal perforation.

Dr Morrissey can discuss these risks and other matters specific to you and your condition should you wish to make an appointment.

Treatment Alternatives

Nasal obstruction can be managed in some instances with nasal sprays and other non-surgical options. There may also be surgical options other than rhinoplasty suitable for some people. Dr Morrissey can discuss these with you and help determine whether they will meet your needs.

Preoperative Instructions

Rhinoplasty is performed under a general anaesthetic. You will need to fast prior to surgery and should follow the provided instructions. If you have any queries or concerns please contact your anaesthetist, admitting hospital or Dr Morrissey

Procedure

Rhinoplasty is performed under a general anaesthetic. Initially Dr Morrissey will obtain graft material for the reconstruction if it is needed. Often, he will use rib cartilage or ear cartilage to rebuild the nose. Incisions are made at discrete locations on the nose and just inside the nostril. The skin of the nose is then lifted off the underlying cartilage and bone. At this point the problems with the nose will be identified and corrected. Cartilage from the nose, ear or rib will be used to reconstruct the nasal airway and external shape of the nose. In some cases, the bones of the nose will need to be fractured the straighten the nose.

Once Dr Morrissey is happy with the nose and the airway, he will replace and reconstitute the nasal structures with a view to giving a natural appearance to the nose at completion. Splints may be used inside the nose and externally to maintain position.

Postoperative Instructions

General

During the first 2 weeks after surgery you may feel quite tired and run down. Your nose will feel very congested as if you have a cold or flu. To maximise recovery;

  • Avoid bending, lifting, or vigorous activity for 2 weeks.
  • No work, exercise or sport for 14 days - you may do some gentle walking.
  • Avoid hot showers and baths as they can promote nose bleeding.
  • You may gently blow your nose in the first 2 weeks. Sneeze through an open mouth.

Posture

Try to keep your head up as much as possible. Keep your head elevated when resting, and sleep with 2 pillows if possible. Avoid stooping over.

Bleeding

It is normal to have nasal ooze for the first 24 hours, which will reduce by half each day. Minor bleeding is expected for 3-4 days.

Major bleeding is rare but can occur and is typically quite profuse. If this happens present to the nearest hospital emergency department or call an Ambulance.

Fever

It is common to have a mild fever for the first 24 hours after the operation.  Please call Dr Morrissey’s rooms or see your GP if there is a persistent fever greater than 38.5°C.

Diet

There are no dietary restrictions and you may eat as soon as food is tolerated. A cool diet in the first few days helps minimise bleeding.

Pain

The maximum discomfort will occur the first couple of days to a week after surgery. You may experience some headaches. Take the pain medication as prescribed.

Appearance

Bruising and swelling is to be expected around the eyes and face, which may be more apparent in the mornings. It will fade over 2-3 weeks.

When to call the Doctor

  • If you have any extreme swelling or bruising that is not settling.
  • If you have persistent pain not relieved by the medication.
  • Elevated temperature over 38.5°C.
  • Bleeding that has not subsided after 20 minutes of applying gentle pressure to side of nose while sitting in an upright position with head bent forward (Oozing can be expected).

Medications

  • Saline nasal spray:  please use 4 times daily into your nose. If there are splints present, try to aim into the centre of the rolled splints and then apply an additional spray on the outside of the splint. Continue until reviewed by Dr Morrissey.
  • Paracetemol (Panadol): Please take regularly as per manufacturer’s instructions to minimize pain after surgery/
  • Extra Pain Medication (Tramadol / Oxycodone): These should be taken as prescribed if you need them.
  • Steroids: In some cases, steroids may be used after surgery. Please take as prescribed.
  • Antibiotics: please take as directed.
  • Tranexamic Acid: used to reduce bleeding and ooze from the nose in some cases. Please take as directed.

Avoid Aspirin and Nurofen as they increase the risk of bleeding.

Follow Up appointment

At the time you book your surgery a post-operative appointment will usually be organised. Please contact Dr Morrissey if you are unsure as to the appointment details.

Any nasal splints and dressings (if used in your surgery) will be removed at this visit.

How to contact Dr Morrissey

For non-emergency issues please call (07) 4646 4275 for further instructions.

Dr Morrissey shares ‘on-call’ arrangements with other ENT surgeons and one is usually available to answer questions. After hours the “on call” ENT surgeon can be contacted via the Toowoomba Base Hospital on (07) 4616 6000.

Should your concerns not be addressed via a phone call, please present to your nearest Emergency Department.

In the event of an Emergency call 000 or attend the nearest Emergency Department.

Related Information

Blocked Nose