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Rhinoplasty and Revision Rhinoplasty

The slightest asymmetry or malformation of the nose can affect a person’s overall appearance and distract from other features. Because of its location, a nose that is crooked or out of proportion with a person’s face is difficult to conceal. Fortunately, nose surgery, also known as rhinoplasty, is available from our experienced plastic surgeon, Dr Craig Layt. This treatment can enhance the aesthetics of your nose and improve balance among facial features, and it can also be performed to repair functional problems such as a deviated septum.

What is a rhinoplasty?

A rhinoplasty is the medical term for nose surgery, which may be either cosmetic or reconstructive. It is a procedure which aims to correct problems associated with the shape and function of the nose. This treatment involves a general anaesthetic and can be performed as an inpatient or on a day-stay basis.

What are the benefits of rhinoplasty surgery?

Rhinoplasty offers numerous benefits for both men and women who would like to address concerns they are having with the form and/or function of the nose. This treatment can:

Rhinoplasty is just one of many facial rejuvenation procedures we offer here at The Layt Clinic. Other options include facelift, brow lift, eyelid surgery, and more. If you are looking for more comprehensive rejuvenation, Dr Layt can talk with you about your goals and help you determine the options that can help you meet your needs.

Who is a candidate for rhinoplasty?

To determine candidacy, patients who are considering nose surgery will have a rhinoplasty consultation at our Southport or Ballina office. Good candidates for rhinoplasty are typically those who would like to enhance or improve the appearance of their nose and/or correct a functional irregularity that may be having an effect on nasal breathing. Candidates should also be in good overall health and should have reasonable expectations for the outcome of this surgery. During the initial consultation, Dr Layt will perform an evaluation and talk with you about your concerns. If you are a good candidate for rhinoplasty and you decide to move forward with this procedure, Dr Layt will create a customised treatment plan designed to achieve your goals.

Nose Surgery Photos

These before-and-after photos depict a patient that has had rhinoplasty surgery performed by Dr Layt. Below the images, you will find a link to more rhinoplasty before-and-after photos. These patients have consented to the photos being shown. These are actual photos and have not been altered or digitally enhanced. Note that every patient is an individual and therefore final surgical results will vary from patient to patient.

bna-sample Before
bna-sample After

VECTRA® 3D Imaging for Rhinoplasty Treatment Planning

Rhinoplasty can have a significant effect on facial aesthetics, so it is important for patients to have a general idea of what the potential results of the procedure may look like before the operation commences. Fortunately, state-of-the-art technology such as the VECTRA® 3D Imaging system enables us to provide that. During your initial consultation with Dr Layt, he can utilize the VECTRA® system to take high-definition images of your face from a variety of angles. The images can be modified on the computer screen to show you several ways in which rhinoplasty can help you meet your goals, ultimately giving you a glimpse of the potential outcome. It is important to note that VECTRA® imaging cannot fully guarantee that the results will look exactly like the image; however, this technology can give you a clearer idea of the potential results, allowing you to see what is possible with rhinoplasty surgery.

Learn more about VECTRA® 3D Imaging.

What does the rhinoplasty procedure involve?

The specifics of rhinoplasty surgery can vary among patients due to the customised nature of this procedure; however, in general this treatment is usually performed as a day surgery or as an in-patient surgery, if necessary. It is also important to note that this is a major surgical procedure, and thus will require general anaesthesia.

The rhinoplasty operation can sometimes be performed using only internal incisions, but usually involves an open approach where a small incision across the columella (the strut between the nostrils) of the nose combines with internal incisions in order to give better access for a more accurate operation. This is particularly useful in more difficult nose surgeries that may require remodeling of the nasal tip. In many cases, the nasal bones, cartilage, and soft tissues are reshaped to improve the external contour and maintain or improve breathing. The incisions are then closed and appropriate dressings applied. A splint is also applied to the outside of the nose. Occasionally, an internal plastic splint is required to help keep the nose straight. For patients who are having their nostrils reduced, this can often be done through tiny incisions at the base of the nostrils with either type of rhinoplasty; however, it does result in a scar at the base of the nostril.

Depending on each patient’s unique needs, rhinoplasty can be an effective treatment on its own, or it can be paired with other facial procedures—such as non-surgical cosmetic enhancements—to help create a more balanced appearance.

It is important for both you, the patient, and your support network or family, to work together throughout this journey with your surgeon and the clinical team and to attend all post-operative appointments and follow post-operative directions after your rhinoplasty procedure. Remember that any surgical or invasive procedure carries risks. Before proceeding with rhinoplasty, you should seek a second opinion from an appropriately qualified health practitioner.

What can I expect during rhinoplasty recovery?

Immediately after nose surgery you will have a splint on the outside of your nose. Some patients may require a splint on the inside of the nose, as well. These will be removed about one week after rhinoplasty. Nasal packs inside the nose are not often necessary; however, most patients will need a piece of gauze placed under the nose for a temporary period, which will catch any fluid that may come out of the nose. This should be changed as required. The day after the nose surgery you will probably notice some bruising under your eyes. This is normal and should be no cause for alarm. When the splint is removed the final result will not be totally evident yet. There will be some swelling present and this will go down with time.

Most patients are able to return to work and other non-strenuous routines approximately one week following rhinoplasty surgery. It is important to avoid heavy lifting and activities that may compromise the healing process for several weeks. Swelling and bruising should fade significantly in the weeks after the procedure; however, there will likely be some swelling for months. The final results from a rhinoplasty may not be apparent for a year or more.

What are the potential risks of rhinoplasty?

Rhinoplasty is a common and reliable surgical procedure. However, surgery always involves some level of risk. The potential risks will be discussed thoroughly during your pre-operative consultation and Dr Craig Layt will provide a list of instructions to be followed before and after surgery to minimise the risk and encourage rapid healing.

What is revision rhinoplasty?

Rhinoplasty is a very complex and complicated surgical procedure. The nasal structure is refined but the final result depends also on the behaviour of the scar tissue and skin in the postoperative period. Revision rhinoplasty is sometimes performed after a primary rhinoplasty as a secondary procedure to refine results. It is well known that rhinoplasty surgery has one of the highest revision rates in cosmetic surgery due to the complexity of the surgery and the unpredictable nature of how the patient’s tissues will behave. This is often due to the fact that you are operating on a structure where minor irregularities are obvious due to its central position on the face and the relatively thin layer of skin. The surgery involves dealing with bone and cartilage, which behave differently in the post-operative period. Cartilage has memory and a tendency to warp whilst bone heals early and is relatively rigid. The behaviour of these structures in the post-operative phase along with the effects of scar contracture are beyond the surgeon’s control. This can mean an excellent on-table result in theatre, yet may yield some imperfections at a later date.

Additionally, revision rhinoplasty can be an option for patients who have had rhinoplasty from another plastic surgeon and would like to address complications or unsatisfactory aesthetic outcomes that have resulted from that procedure. Dr Layt has performed many primary and revision rhinoplasty procedures and will be happy to discuss the benefits and risks of rhinoplasty surgery, both primary and revision surgery, with each individual patient.

How much does rhinoplasty cost?

The approximate guide for the cost of rhinoplasty at The Layt Clinic usually falls in the $12,000 to $22,600 range, which includes the surgeon’s fee, anaesthetic fee, and surgical theatre fee. This range is based on a very general average. Rhinoplasty treatment plans are uniquely tailored to each patient’s specific needs and goals, which makes the cost of the procedure quite variable among individuals. Factors that will determine the final price of rhinoplasty include: the surgical technique utilized; fees for the surgeon, use of the operating theatre, and anaesthesia; the overall complexity of the operation; and other associated expenses. Once Dr Layt formulates your rhinoplasty treatment plan during the initial consultation, a member of our team will be able to calculate the total cost of your procedure and present it to you for review. If you have any questions about the price of your procedure and the variety of payment methods we accept here at The Layt Clinic, we will be happy to assist you.

Specific Pre-Operative Instructions

WASHING: Wash the evening prior to surgery and the day of surgery, paying particular attention to the face. This decreases the bacterial count and should decrease the risks of infection.

PRODUCTS: Do not apply moisturisers, make-up, perfume/deodorant, nail polish, or hair products after washing. Remove all jewelry.

CLOTHING: Wear loose, comfortable clothing and footwear. A shirt with a button or zipper opening is ideal for removal.

HAIR: If you have long hair it should be tied up in a ponytail using a simple elastic band. This will keep it out of the way during surgery.

FASTING: You should have nothing to eat or drink for 6 hours before your operation. If you are required to take medication during this time, please speak with your physician to check if this can be taken before the 6-hour fasting period or after your procedure.

SMOKING: Smoking increases the risks of complications significantly and should be ceased 6-8 weeks prior to surgery.

MEDICATION: If you are having the operation as a day case, you will be given a script for antibiotics and pain relief tablets that you will need to purchase from the chemist and bring with you on the day of your procedure. Do not take these prior to surgery. The nursing staff will advise you and your carer after your procedure on how to administer them.

Certain over-the-counter products and prescription medicines can cause complications before and after surgery. They can reduce the ability of your blood to clot and could increase your tendency to bleed during and after surgery. Do not take any medication containing or related to aspirin 2 weeks prior to your procedure. This includes NSAIDS, anti-inflammatory medications, and blood thinning medications. Please see your doctor regarding if and when to cease medications. *This is not an all-inclusive list*.

Also avoid Vitamin E supplements and red wine. Stop all herbal medications before surgery. The most common herbs used are Echinacea, Ephedra, Garlic, Ginseng, Ginkogo, Kava, St. John’s Wort, and Valerian. They may adversely affect anaesthetic drugs, prolong bleeding, and impair healing after surgery. Please consult your physician before ceasing any medication.

ADMINISTRATION: Unfortunately, paperwork is a necessary evil. Each theatre complex has its own procedures. We have attempted to make it all easy by providing a simple series of steps to follow titled “THINGS TO DO FOR YOUR PROCEDURE” specific to the surgery centre you are attending. If you have any queries about this or anything else, don’t hesitate to contact us on (07) 5597 4100.

Specific Post-Operative Instructions

NASAL PACKING: Dr Layt usually is able to avoid nasal packing after surgery. If you have bled slightly more than usual during your operation, or if there is some other reason, he may occasionally use packing. With packing in place, you will have to breathe through your mouth, and you will have somewhat more swelling than usual. If nasal packing is in place it will usually be removed in 24 – 48 hours.

INTERNAL SPLINTS: If you have had surgery on your septum as part of your rhinoplasty, plastic splints will be sutured inside your nose. Although these take up some room, your nasal passages should not be totally obstructed. Dr Layt or one of his nurses will usually remove the splints from 7 to 10 days after surgery.

SPLINT: The splint put on your nose at the end of surgery is intended to provide protection, serving as a sort of small external skeleton. It will be removed in 7-10 days.

POSITION: Keeping your head (and nose) elevated tends to reduce swelling. If possible, sleep on two or three pillows.

CLEANSING: After surgery, some oozing and bleeding usually occurs for a day or two, and dried blood will collect in the nostrils. Keep the nostrils clear using wet cotton buds to gently wipe away any crusts. You may want to carry some tissues with you for a few weeks after surgery, as your nose may “drip.”

ACTIVITY: You should limit any strenuous activity during the first 2 – 3 weeks. Thereafter, you can steadily increase your activity level within the limits of discomfort. Heavy exercise or straining can cause bleeding or swelling during the first few weeks.

TED STOCKINGS: You may be required to wear TED stockings for compression to prevent DVT (blood clotting) post-operatively. If required these will be fitted at the hospital on your admission day. The nursing staff will advise you on how long you need to wear these for.

MEDICATION: Take your pain relief and antibiotic medication as directed. Any medication you ceased prior to surgery must not be taken after your surgery until you are completely healed or as directed by your physician.

Contact Us

To schedule a consultation with Dr Craig Layt or to learn more about rhinoplasty (nose surgery), please contact our practice.