By Dr Scott J Turner, Specialist Plastic Surgeon (FRACS) | Bondi Junction, Sydney
Many people arrive at their first rhinoplasty consultation expecting something close to a sales meeting. They’re often surprised when it isn’t.
What actually happens instead is a structured clinical process, staged across multiple appointments with regulatory checkpoints built in. Some of it is administrative. Most of it is medical. If you’re considering rhinoplasty in Sydney and you’re not sure what you’re walking into, this breaks it down.
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The GP Referral Comes First
Before anything else: under current AHPRA cosmetic surgery guidelines, a GP referral is required before a rhinoplasty consultation can proceed. This has been mandatory since AHPRA updated its guidelines on 1 July 2023, and it applies regardless of age or procedure type.
A few things patients don’t always know. The referring GP must be independent, and they can’t work at the same clinic as the surgeon or hold any financial relationship with the practice. The referral itself must come from a real consultation, face-to-face or via video. A quick phone call or a questionnaire filled out at reception doesn’t satisfy the requirement.
Why does this matter? Your GP knows your health history in a way a surgical practice generally doesn’t. Prior medications, mental health history, a previous procedure, anything relevant to surgical decision-making surfaces here. Practical starting point: contact your regular GP, ask for a referral to Dr Scott Turner at FacePlus Aesthetics in Bondi Junction, and go from there.
What Happens at the First Consultation
The first appointment covers a lot of ground. Here’s what to expect.
BDD screening happens before anything surgical is discussed
Under current AHPRA guidelines, screening for body dysmorphic disorder is mandatory at every first cosmetic surgery consultation, and it has to be done by the operating surgeon personally. It cannot be delegated to a nurse or coordinator.
BDD is a recognised psychological condition involving persistent preoccupation with a perceived appearance flaw that others typically don’t notice. That’s different from feeling self-conscious about the bump on your nose or disliking your profile in photos. Most patients don’t have BDD. But the research matters: approximately 82% of people with the condition who go ahead with cosmetic surgery experience no improvement, or their symptoms worsen. Surgery doesn’t fix the underlying distress. Screening exists for that reason.
In practice, this is a structured conversation about your motivations and history, not an interrogation. If anything raises a flag, a referral back to your GP may be recommended. That’s not a rejection. It’s a clinical decision made with your interests in mind.
The physical examination
Once screening is done, the examination begins. I assess the nose from multiple angles: frontal, profile, oblique, base, both at rest and with the face in movement. The external structures tell part of the story: dorsal height, tip projection and rotation, base width, columella, any visible asymmetry.
The internal examination is just as important, and patients sometimes don’t expect it. Using a nasal speculum, I look at the septum, internal nasal valves, and turbinates. Plenty of people seeking cosmetic rhinoplasty are also dealing with a functional issue, such as a deviated septum, turbinate hypertrophy, or a compromised airway, that they may not even be aware of. If that’s present, it changes the surgical planning significantly. Addressing both together tends to produce better outcomes than treating them separately, which is where functional rhinoplasty or septoplasty becomes relevant.
Clinical photography
Standardised photographs are taken at the first appointment. Six angles minimum: frontal, both laterals, both obliques, and base. Consistent lighting, consistent positioning. These images form part of your clinical record and are used throughout the planning process.
There’s a practical reason to pay attention to this step. Most people look at their nose in a bathroom mirror, usually in passing, with variable lighting. A standardised photograph captures something different. More than a few patients see things they hadn’t fully registered before.
3D imaging
At FacePlus Aesthetics, we use Canfield’s Vectra 3D imaging system. It captures your face from multiple angles simultaneously and builds an interactive three-dimensional model that we can look at together, rotate, and use to simulate proposed changes in real time.
Worth being direct about what the simulation is and isn’t. It’s a communication tool. It helps you articulate what you’re hoping to achieve and gives me a clearer picture of your priorities. It is not a preview, a promise, or a contract. Real outcomes are shaped by tissue behaviour, healing, and anatomy in ways no software accurately predicts. The value of the imaging is in the conversation it enables.
How long the consultation takes
A typical rhinoplasty consultation runs 45 to 60 minutes. That covers medical history review, BDD screening, nasal examination, clinical photography, and a discussion of surgical options.
The appointment is deliberately unhurried. Rhinoplasty planning is highly individual, and there’s rarely a useful shortcut. If additional assessment is needed, for airway obstruction, a history of prior surgery, or anything that warrants further investigation, a follow-up consultation may be scheduled before planning proceeds.
Skin and Cartilage: The Two Variables That Shape Everything
Two factors determine what’s achievable in rhinoplasty more than anything else: skin thickness and cartilage quality. Neither is fully apparent from photographs. Both are assessed at the physical examination.
Skin thickness varies between patients and even across different zones of the same nose. Thick, sebaceous skin tends to conceal fine cartilage detail. Getting visible tip definition in a nose like that usually requires stronger structural grafting. Thin skin, on the other hand, reveals everything, including any subtle irregularities in the underlying framework. Different challenges, different technical solutions.
Cartilage strength matters for long-term stability. Weak or previously injured cartilage may need grafting to maintain the corrected shape over time. Graft material typically comes from the septum first, then the ear, and in cases requiring larger volume, the rib. For bony work on the dorsum, ultrasonic rhinoplasty may be appropriate depending on the anatomy. This is all assessed during the consultation and affects how complex the procedure will be.
For patients who’ve had a prior rhinoplasty, the soft tissue envelope changes after surgery and that factors into any new plan. The rhinoplasty procedure page and the dedicated page on revision rhinoplasty provide more context on how previous surgery changes planning.
Two Consultations. Seven Days. No Exceptions.
AHPRA requires a minimum of two pre-operative consultations before cosmetic surgery can proceed, with at least a seven-day cooling-off period after the second consultation before surgery is scheduled or a deposit paid.
The first consultation is a lot of information at once: anatomy, technique, risks, costs, recovery. The gap between appointments is time to go home, think, talk to people who know you, and come back with questions that didn’t occur to you the first time. The second consultation is where those get answered and the plan is confirmed. If you decide surgery isn’t the right move, that’s a legitimate conclusion.
How to Get More Out of Your Appointment
Come in knowing what specifically bothers you. “I don’t like my nose” gives a surgeon almost nothing to work with. “The bridge has a bump that’s obvious in photos and the tip looks droopy from the side” is something we can actually assess and plan around. Rank your concerns if you have more than one. Know which matters most to you.
Write your questions down beforehand. Things that seem obvious in the car ride over disappear once you’re in the room. Useful ones: What surgical approach would you recommend and why? What does my anatomy limit? What does recovery look like week by week? What’s included in the surgical fee and what’s billed separately?
Be straightforward about your medical history. Prior nasal trauma, previous surgery, chronic sinusitis, medications, smoking, any history relevant to body image. It’s not information to hold back. It affects surgical planning directly.
Keep expectations grounded. Rhinoplasty can produce significant, lasting changes to both appearance and function. What it can’t do is override biology. Healing varies. Individual results vary. A good consultation sets realistic parameters, not impossible ones.
Booking Your First Appointment
FacePlus Aesthetics is at 39 Grosvenor St, Bondi Junction NSW 2022. You’ll need a GP referral to Dr Scott Turner before the appointment can be confirmed. Once that’s in place, use the contact page to get in touch with the practice.
Travelling from regional NSW or interstate? The practice has resources specifically for out-of-town patients that are worth reading before you plan your trip.
Frequently Asked Questions
Dr Scott J Turner is a Specialist Plastic Surgeon (FRACS) with a practice limited exclusively to facial plastic and reconstructive surgery. FacePlus Aesthetics is located in Bondi Junction, Sydney. For more about Dr Turner’s background and approach, visit the about page.
