In most cases, nose surgery is performed through incisions in the nostrils, leaving no visible scars. Bone and cartilage are trimmed, and the nose reshaped. Nostril packs and splints may be required. This procedure takes around two hours. Bruising and swelling may take three or four months to fully subside. Complications such as bleeding or infection are comparatively rare. Sometimes, a chin implant is inserted at the same time to balance the profile.

Rhinoplasty is a form of cosmetic surgery to repair or reshape the nose. Some people have rhinoplasty to correct a structural problem with their nose, while others do it for cosmetic reasons, or both. It is also called a 'nose job'.

What can rhinoplasty do?

Rhinoplasty can correct physical problems with the nose including:

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

Rhinoplasty can also be used for cosmetic reasons to straighten a crooked nose or to remove a hump or dent on the bridge of the nose.

The surgery may involve a procedure called septoplasty, which corrects a deviated septum (the bone and cartilage between the two nostrils).

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

Rhinoplasty might be needed to improve your health, but if you are thinking about having the surgery for cosmetic reasons, you should also think about whether your expectations are realistic.

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

You should be aware that:

• If you are under 18, general guidelines require your doctor to refer you for a psychological assessment and you will need to wait for a cooling off period of 3 months before having rhinoplasty.
• Cognitive behavioural therapy (CBT) or other behavioural therapy may help if you are feeling depressed, have low self-esteem or body dysmorphic disorder.
• Sometimes the operation is unsuccessful and you may need further surgery.

If you're considering purely cosmetic surgery for a child, specialists recommend it be delayed until the child's nose is fully grown, at around 16 years for girls and 17 for boys.

Choosing a surgeon

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

Questions to 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 rhinoplasty. Some questions you might want to ask include:

• What are the risks for a person in my state of health and stage of life?
• What is your success rate with rhinoplasty?
• What form of nose surgery, if any, do you recommend 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 my recovery likely to take?
• What is the cost?

Your surgeon needs a full medical history and will discuss your expectations. Take notice of any pre-surgery instructions given to you by your doctors.

Avoid medicines that contain aspirin or ibuprofen for 2 weeks before and after surgery to reduce the risk of bleeding.

Smoking makes recovery more difficult, so if you smoke, you will need to stop.

You will probably have pain, headaches, swelling and bruising. The bruising can take 7 to 10 days to disappear and the swelling several weeks. You will be asked to keep your head raised when resting, and your doctor might recommend ice packs to reduce the swelling. You might be prescribed medication to control pain and prevent infection.

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

Like any surgery, rhinoplasty comes with risks. You should discuss the risks in detail with your surgeon. You should also discuss the risks of anaesthetic with your anaesthetist.

The risks with rhinoplasty include:

• heavy nosebleeds
• an infection that may need antibiotic treatment or further surgery
• severe or ongoing pain
• permanent numbness around the nose or your front teeth
• reduced or (in rare cases) a loss of sense of smell
• abnormal 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.

The cost of rhinoplasty varies from patient to patient and includes:

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

Your surgeon must provide you with information in writing about the cost of rhinoplasty. This should include:

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