DR CAMERON
MCINTOSH

Rhinoplasty

Frequently Asked Questions
I’m sure you have lots of questions, Thankfully, we have the answers.

FREQUENTLY ASKED QUESTIONS

What is a Rhinoplasty or Nose Job?
It is a complicated operation to improve the shape and function of your nose. A detailed history and examination is mandatory and very often a number of specialized additional tests need to be performed such as air-flow/pressure and CT Scans of the nose, septum and sinuses. What is visible on the outside as unsightly is probably caused by an internal problem such as a deviated septum. There are two parts to a Rhinoplasty operation. The one part is the cosmetic part which is all about bringing harmony to your nose and face. The other part is dealing with the functional aspects. As a dual Board Certified ENT and Facial Plastic Surgeon I am trained to deal with both aspects of your surgery.
How much will it cost me?

The total cost of an operation is split between the hospital costs, the anesthetist and the surgeon. The three most important factors influencing your quote will be the level of difficulty of the operation, if you have medical aid and the type of medical insurance you have.

It can range from R 20 000 (USD 100) for a fully-insured purely functional patient, up to R 90 000 (USD 6 000) for a non-insured purely cosmetic patient.

How long will the operation take?

Depending on the level of difficulty of your procedure it can be anything from 90 minutes up to 6 hours. On average I take between 2 and 3 hours for a rhinoplasty.

What are the risks?

There are aneasthetic and surgical risks. Being under a General Anesthesia has inherent risks. You will be evaluated by the aneasthetist before your operation and under no circumstances will this elective surgery proceed if you are unfit for the operation.

From a surgical point of view there are early and late complications. The early complications are bleeding, obstruction and infection. A small amount of oozing is normal however a large amount of bleeding is abnormal and you should return to the hospital immediately. Your nose may feel more blocked between the second and fourth day after surgery due to the natural inflammation that is taking place. However a completely blocked nose is unusual and could mean you have a septal hematoma and you need to report to the hospital as soon as possible. I do not routinely prescribe anti-biotics so that in the very rare case of an infection being picked up I am able to prescribe these accordingly. Any signs of infection such as swelling, redness, tenderness, fever or a fast heart rate are indications to return to the hospital as soon as possible.

Late complications are a decrease in the nasal function and unplanned cosmetic deformities from abnormal wound healing.

How painful is the operation?

You should not have any pain. You may experience a level of discomfort from having been under general anesthesia for a few hours and the inflammation associated with the surgery. However severe pain is a warning sign that something untoward may be taking place and you should return to the hospital.

What will I look like afterwards and how long will it take for the bruising and swelling to subside?

You will wake up with an aluminum splint on your nose which has to stay on for 7 days. In 13% of my patients who often have a severely deformed septum, I insert a soft silicone nasal splint that I remove the following day.

Depending on the complexity of the surgery and your natural healing process you could look normal apart from the dressing; or you could look bruised and be swollen under your eyes.

After 7 days you will return to the practice where I will remove all the dressings and sutures.

Initially your nose will feel more puffy from the edema and swelling, have a harder tip from the functional reconstruction and you will have a degree of numbness on the tip due to nerve damage from surgery. Over the following days to months this will settle.

Although the final result is best viewed a year after surgery you should be close to what the outcome will be 2 months after your operation.

Will I need a second operation?

For a primary rhinoplasty I never plan on doing a second surgery. However due to the 3D complexity on a dynamic organ with differing patient healing factors you can never say never and thus about 4% of my patients may need a smaller revision procedure.

In more complicated secondary cases the chances of another operation are higher but we plan for this before surgery.

Will my medical aid cover the operation?

In your first visit after a detailed history and examination I will be able to give you a fair indication if your surgery will be covered. Some medical aids are far more supportive of functional rhinoplasty than others. I will submit a detailed motivation to your medical aid as to why you would need the surgery to improve your nasal function. Medical aids do not pay for cosmetic rhinoplasty.

When can I start exercising again?

You need to be patient with your body by resting and relaxing for the first week. Once your dressings and sutures have been removed you can slowly ease back into your routine. Contact sports should only be started again 6 weeks after surgery.

Where will the operation take place?

I operate in both the Netcare Greenacres Hospital as well as the Life St George’s Hospital.

Will I have to stay overnight?

As a general rule most of my patients are sent home after their operation. However, should it be a longer than usual operation, finish late in the afternoon or a costal/rib cartilage was harvested then overnight stay is highly recommended.