What is a nose job?

Rhinoplasty is also known as nose surgery or a ‘nose job'.

It's a surgery to change the shape of your nose.

When might you have a nose job?

Nose surgery can correct a physical problems with your 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
• changing a hump or dent on the bridge of your nose

The surgery may involve a method called septoplasty. This is a procedure to open up nasal passages that are blocked by a bent septum. The septum is the bone and cartilage between your 2 nostrils.

What should I consider when thinking about nose surgery?

Rhinoplasty may not be best for every person. There are different things you should consider before having 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, you can try cognitive behavioural therapy (CBT) or other psychological therapies. These can help you:

• prepare for cosmetic surgery
• if you are feeling depressed
• if you have body dysmorphia

Cost and other restrictions

If you are having a rhinoplasty for medical reason like breathing problems, Medicare may cover the cost.

Generally, Medicare doesn't cover the cost of cosmetic surgery. This includes nose surgery for cosmetic reasons. Private health insurance often doesn't cover cosmetic nose jobs either.

Before undergoing cosmetic surgery, discuss the costs with your doctor.

Under 18 years old

If you are aged under 18 years, the Medical Board of Australia guidelines require:

• your doctor to assess your ability to consent to the procedure
• a 7-day ‘cooling off' period after you consent to rhinoplasty before having the procedure

Specialists suggest cosmetic surgery is delayed for children until the child's nose is fully grown. This is around:

• 16 years of age for females
• 17 years of age for males

Other considerations

Your surgeon may only be able to work with the bone and cartilage in your nose. This means that there may be a limit to how the shape of your nose can be changed. It is important to discuss what your expectations are with your doctor before the procedure.

How do I choose a surgeon?

If you are considering nose surgery, it's important to choose a surgeon you feel comfortable with. Your surgeon should 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 also check this register to ensure your surgeon is a Fellow of the Royal Australasian College of Surgeons (RACS). You can also see whether the surgeon has had any serious disciplinary action taken against them.

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

• the surgeon has the same level of training as one in Australia
• the operating theatres must meet the same standards — such as cleanliness
• you will get the same level of aftercare

What questions should I ask before surgery?

There are many things to consider before having any operation. Consider asking your surgeon some questions about surgery in general. You can also ask about:

• the risks of rhinoplasty for a person in your state of health and stage of life
• your surgeon's experience with nose surgery
• how much the procedure will cost
• how long recovery will take
• what your nose will look like after recovery, including any scarring
• what medicines and follow-up you will need after the procedure

You can also ask to see 'before and after' photographs of other patients.

How do I prepare for nose surgery?

Before your surgery, you should be as fit as possible. Your surgeon needs your full medical history and will talk about your expectations. Take notice of anything your surgeon tells you to do before surgery.

You might be asked to:

• stop taking certain medicines, including NSAIDs like aspirin or ibuprofen
• quit smoking at least 2 weeks before surgery

What happens during nose surgery?

Nose jobs are usually done under a general anaesthetic.

There are different ways to carry out nose surgery. Your surgeon will make a small cut inside your nostril or through the base of your nose. You can ask your surgeon to tell you what is planned for your surgery.

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
• other parts of your body

Your surgeon will replace the skin and tissue over the cartilage before stitching up the cut. A splint is put outside your 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 one week.

What should I expect after a nose job?

After your surgery, you will probably have:

• pain in your nose
• a headache
• bruising
• swelling

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. You should avoid:

• blowing your nose for at least 7 days
• rubbing your nose for at least 8 weeks

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 your nose or front teeth
• a reduced sense of smell, or very rarely, the loss of your sense of smell
• unusually thick scars
• dark skin under your eyes
• difficulty breathing because of narrowed airways

The results of your nose surgery might take up to 12 months to emerge.

You may not have the exact outcome you were hoping for. In this case, further surgeries may be needed.

You should contact your surgeon or see your doctor if:

• you have a fever
• you have heavy bleeding from your nose
• if the pain feels like it's getting worse
• if the redness increases

How much will nose surgery cost?

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

• 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
• information about of deposits needed and refund of deposits
• required payment dates
• payments for follow-up care
• possible costs for additional revision surgery or treatment

Resources and support

If you are considering a nose job, you should first discuss it with your doctor.

More information is available in our guide to guide to cosmetic surgery. You can also visit the Australian Society of Plastics Surgeons website for more information.

You can call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.