Rhinoplasty is also known as nose surgery, or a ‘nose job’. It is a form of cosmetic surgery to repair or reshape the nose. Some people have a nose job to fix a structural problem with their nose, others do it for cosmetic reasons.

When might you have a nose job?

Nose surgery can correct physical problems with the nose, including:

• breathing problems
• birth defects
• injuries
• damage caused by cancer or an infection

Nose surgery can also be used for cosmetic reasons such as straightening a crooked nose or removing a hump or dent on the bridge of the nose.

The surgery may involve a method called septoplasty, which opens up nasal passages that are blocked by a bent septum (The septum is the bone and cartilage between the two nostrils).

What questions should I consider when thinking about nose surgery?

Cosmetic concerns

Consider whether you really need a nose job. Different people have different ideas about what is the 'right' nose shape. You should not feel pressured by anyone into having surgery.

If you are thinking about having nose surgery for cosmetic reasons, think about whether your expectations are realistic.

If the appearance of your nose reduces your self-esteem or causes distress, cognitive behavioural therapy (CBT) or other psychological therapy may help. It can also help if you are feeling depressed or have body dysmorphia.

Cost and other restrictions

Generally, Medicare doesn't cover the cost of cosmetic surgery. Private health insurance often doesn't either. Before undergoing cosmetic surgery, discuss the costs with your doctor.

You should be aware that:

• If you are under 18, the Medical Board of Australia rules require your doctor to refer you for a mental health assessment. You will need to wait for a ‘cooling off’ period of 3 months before having rhinoplasty.
• Sometimes the operation does not work and you may need further surgery.

Specialists suggest cosmetic surgery is delayed for children until the child's nose is fully grown. This would be at around 16 years for girls, and 17 years for boys.

How do I choose a surgeon?

If you are considering nose surgery, it is important to choose a surgeon you feel comfortable with. Choose a surgeon who will speak to you honestly about the benefits and risks of this type of surgery.

The Australian Health Practitioner Regulation Agency (AHPRA) has a register of medical practitioners. You can check this register to ensure your surgeon is a Fellow of the Royal Australasian College of Surgeons (RACS). You can also check whether the surgeon has had any serious disciplinary action taken against them.

Some people consider having cosmetic surgery overseas, but there can be many problems with this. You should consider this carefully.

What questions should I ask before surgery?

There are many things to consider before having any operation. Ask your surgeon some questions about surgery in general, as well as about nose jobs. Some questions you might want to ask include:

• What are the risks with rhinoplasty for a person in my state of health and stage of life?
• What is your success rate with nose surgery?
• What form of nose surgery, if any, do you suggest for me?
• What will my nose look like once I have recovered from the operation?
• Can you show me 'before and after' photographs of other patients?
• How long is it likely to take for me to feel better after the surgery?
• How much will it cost?

You can also use the Question Builder tool to create your question list for the appointment. Prepare your list, then print or email it so you remember what you want to ask.

How do I prepare for nose surgery?

Your surgeon needs your full medical history and will talk about your expectations. Take notice of anything your surgeon tells you to do before the nose surgery.

You might be asked to:

• stop taking certain medicines, including those containing aspirin or ibuprofen, around 2 weeks before surgery
• quit smoking

What happens during nose surgery?

There are many ways to carry out nose surgery. Ask your surgeon to tell you what is planned.

You would usually have a general anaesthetic. The surgeon will make a small cut inside your nostrils or through the base of your nose.

From there, the surgeon might cut away some bone and cartilage to reshape your nose. If more cartilage is needed for a nose reconstruction, it can be taken from inside your nose, your ear, or if needed from other parts of the body.

The surgeon replaces the skin and tissue over the cartilage and then stitches up the cut. A splint is put outside the nose to hold it in shape as it heals. An internal splint also may be used, most commonly after septoplasty.

The splint and bandages are generally removed after about a week.

What should I expect after a nose job?

You will probably have pain, headaches, swelling and bruising. The bruising can take 7 to 10 days to disappear. The swelling may take several weeks or even months to go down. You will be asked to keep your head raised when resting, and your doctor might recommend ice packs to help the swelling go down. You might be given medicines to control pain and stop infection.

Expect some mucus or bleeding from your nose in the first few days. Don't blow your nose for at least 7 days.

If you are worried at any time after the nose surgery, ask for medical advice from your doctor.

What are the risks of nose surgery?

Like any surgery, nose surgery comes with risks. You should talk about the risks in detail with your surgeon. You should also talk about the risks of anaesthetic with your anaesthetist.

The risks with nose surgery include:

• heavy nosebleeds
• an infection that may need antibiotic treatment or further surgery
• strong or ongoing pain
• lasting numbness around the nose or your front teeth
• reduced sense of smell, or very rarely, a loss of sense of smell
• unusually thick scars
• dark skin under the eyes
• difficulty breathing because of narrowed airways

Some people find that after surgery, their nose is uneven or does not look how they had hoped. In this case, they may need further surgery.

How much will nose surgery cost?

The cost of nose surgery varies from patient to patient and includes:

• surgeon's fees
• anaesthetist's fees
• clinic or hospital fees
• medication, dressings and support garments
• medical tests

Your surgeon and anaesthetist must provide you with information in writing about the cost of nose surgery. This should include:

• the total cost
• details of deposits needed, information on refund of deposits and required payment dates
• payments for follow-up care
• possible further costs for additional revision surgery or treatment

Where can I get more information on nose surgery?

If you are considering a nose job, you should first discuss it with your doctor. More information is also available on the Australian Society of Plastics Surgeons website, and in our guide to guide to cosmetic surgery.