What to Expect at Your Rhinoplasty Consultation

Starting the Conversation

Every rhinoplasty consultation begins the same way: I want to hear your story. What brings you here? What bothers you about your nose? How long have you been thinking about this?

The answers tell me a lot. Someone who has disliked their nose since childhood is in a different place emotionally than someone who developed a concern after an injury. Someone who avoids photographs from certain angles has different priorities than someone primarily concerned about breathing.

There's no wrong answer. I just need to understand what you're hoping to achieve so I can tell you whether it's realistic and how we might get there.

The 3D Imaging Process

After we've talked about your concerns, we take 3D photographs of your face. This involves standing in front of a specialised camera system that captures your face from multiple angles simultaneously.

The camera creates a detailed digital model of your face, which I can then manipulate on screen. This is one of the most valuable parts of the consultation because it allows us to communicate clearly about what changes are being discussed.

When someone says "I want my nose smaller," that can mean many things. Do you mean shorter? Less projected? Narrower? All of the above? With the 3D model, I can make specific changes and show you exactly what I'm proposing.

I'll typically work through the changes systematically:

• Dorsal reduction (removing the hump)
• Tip refinement (reshaping the end of the nose)
• Rotation (adjusting the angle between nose and lip)
• Projection (how far the nose sticks out from the face)
• Straightening (correcting deviation)

As I make each change, you can see the cumulative effect on your overall appearance. This helps us agree on what we're aiming for before any surgery happens.

Understanding What the Morphing Shows

The morphed image is not a guarantee. I need to be clear about that. It shows what I'm planning to achieve, and in most cases results come close to the prediction. But healing is unpredictable, and factors like swelling, scar tissue formation, and individual tissue responses can cause variations.

The front view tends to be less predictable than the side view. When I cut the nasal bones to narrow the nose, the healing process creates some bone thickening. This is normal. It means the nose may appear slightly wider than the morphed image predicted, particularly in the early months.

The side view is generally more reliable because we're primarily working with cartilage and soft tissue rather than bone.

I'll bring you back for 3D photos after surgery (usually at six months) so we can compare the actual result to what we were aiming for. This helps us both understand what was achieved and whether any refinements might be beneficial.

Examining Your Nose

Beyond the imaging, I'll physically examine your nose. This tells me things the camera can't.

External Examination

I'm looking at skin quality (thick or thin?), existing asymmetries, the relationship between your nose and other facial features, and the overall proportions. Thick skin can hide some refinements. Thin skin shows more detail but also shows more irregularities.

I'll note any deviation, whether the tip is bulbous or pinched, whether the nostrils are symmetrical, and how the nose relates to your chin and other facial proportions.

Cartilage Assessment

By gently pressing on your nose, I can feel the underlying cartilages. Are they strong or weak? Symmetrical or not? This affects what techniques will work best and what results are achievable.

Internal Examination

Using a light, I'll look inside your nostrils to assess the septum (the wall dividing your nasal passages), the turbinates (structures that can cause breathing obstruction), and the overall internal anatomy.

If you have breathing concerns, this examination is particularly important. A deviated septum or enlarged turbinates can be addressed at the same time as cosmetic changes.

Discussing Facial Asymmetry

Here's something that often surprises patients: almost everyone has some facial asymmetry. One cheek may be slightly fuller than the other. One eye may sit slightly higher. The jawline may be slightly different on each side.

Your nose exists in the context of this asymmetric face. When I'm planning surgery, I need to consider not just making the nose "straight" in isolation, but making it fit harmoniously with your specific face.

During the consultation, I'll point out any significant asymmetries. This isn't to criticise your appearance. It's to set realistic expectations. If your face is asymmetric, your nose will need to be slightly different on each side to look balanced. A mathematically perfect nose might actually look wrong on an asymmetric face.

The Nostril Discussion

One area that deserves specific attention is the alar rim, the curved edge of your nostrils. Some people have nostrils that sit quite high, showing more of the inside of the nose (alar retraction). Others have nostrils that hang down, covering too much.

These characteristics affect what happens after rhinoplasty. In particular, if you already have some alar retraction, surgery can sometimes make it slightly more pronounced due to scarring and tissue contraction.

I'll assess your alar position during the consultation and discuss whether this is a concern for your specific case. If it is, we can incorporate techniques to minimise or address it.

Discussing Risks and Recovery

Every surgery carries risks, and I'll go through these during your consultation. For rhinoplasty, the main considerations include:

• Asymmetry: Some difference between the two sides is normal, but occasionally it's more pronounced
• Contour irregularities: Small bumps or dips that may need filler to smooth
• Over or under correction: Results that need refinement
• Breathing changes: Usually improved, but occasionally affected
• Revision surgery: About 3-4% of my patients require revision
• Standard surgical risks: Infection, bleeding, scarring

For recovery, you'll have a splint on your nose for about a week. Bruising typically lasts 1-2 weeks. You'll look presentable at 2-3 weeks, though close friends might notice some residual swelling. Final results take 6-12 months to fully develop.

The Emotional Aspect

Many patients who come for rhinoplasty have been self-conscious about their nose for years or even decades. They avoid photographs. They angle their face in conversations. They've deleted countless photos before finding one they could bear to post.

This emotional weight is real and valid. Part of my role is to understand not just the physical changes you're seeking, but the impact those changes might have on how you feel about yourself.

At the same time, rhinoplasty can't solve all self-image concerns. If you have deeply rooted self-esteem issues or body dysmorphia, surgery may not help and could potentially make things worse. During the consultation, I try to assess whether your expectations are realistic and whether surgery is likely to bring the satisfaction you're hoping for.

What Happens Next

At the end of the consultation, you'll have:

• A clear understanding of what changes we're discussing
• 3D images showing the proposed outcome
• Knowledge of the surgical approach I recommend
• Understanding of risks and recovery
• A sense of whether we're a good fit to work together

I'll send you a written summary of everything we discussed, along with patient information leaflets about the procedure. You'll also receive a quote with potential surgery dates.

I never pressure patients to proceed. Many people need time to think, research, and make sure they're ready. Some decide surgery isn't right for them, which is completely valid. The consultation is for information-gathering and decision-making, not sales.

If you do decide to proceed, my patient care coordinators will guide you through the booking process and answer any practical questions you have along the way.