Dr Scott J Turner | Specialist Plastic Surgeon (FRACS) | Sydney
The rhinoplasty consultation is the most important step in the surgical pathway. It is where candidacy is assessed, the procedure is explained, expectations are aligned, risks are discussed, and the decision to proceed (or not) is made. Under the AHPRA cosmetic surgery framework that came into effect in July 2023, two consultations are mandatory before any cosmetic surgical decision can be made, with a cooling-off period in between. The structure exists specifically to support careful, unhurried decision-making.
Dr Scott J Turner is a Specialist Plastic Surgeon (FRACS) practising at Bondi Junction and Manly in Sydney. This article walks through exactly what happens at a rhinoplasty consultation, from the GP referral that comes before, through the two consultations themselves, the cooling-off period, and the steps that follow if surgery is decided. The intent is to help you arrive prepared, ask the right questions, and use the consultation framework to make a confident, well-informed decision.
Before the First Consultation: The GP Referral
Under AHPRA’s cosmetic surgery framework, a valid GP referral is required before the first consultation with the operating surgeon. This is not a procedural formality, it is a regulated step that exists to ensure your overall medical health is reviewed before you proceed with elective surgery.
The GP referral typically covers:
- Confirmation that you are in general good health for elective surgery
- Review of any medical conditions, medications, or previous surgeries
- Discussion of your motivations and any psychological factors that may be relevant
- A specific referral letter directed to the operating surgeon
Where rhinoplasty is being considered for a functional reason (deviated septum, breathing obstruction, post-traumatic deformity), the GP referral is also required for any Medicare rebate to apply. The clinical criteria for functional eligibility need to be documented in the referral. For more on this, see will Medicare cover my rhinoplasty.
Consultation #1: The Initial Assessment
The first consultation is approximately 60 to 90 minutes. It is the most thorough part of the assessment process and covers ground that cannot reasonably be rushed. The consultation fee is $450 and is paid at the time of booking.
What You Will Be Asked to Bring
- Your GP referral letter
- A list of all medications and supplements (including over-the-counter and herbal products)
- A summary of any previous nasal surgery, nasal trauma, or breathing concerns
- Photo identification
What Happens During the Consultation
Initial discussion of concerns and motivations. The consultation typically begins with you describing what you are concerned about and what you are hoping to change. Dr Turner will ask you to identify specific features rather than generic dissatisfaction. Patients who can articulate “I want to reduce the dorsal hump and refine the tip” tend to have more productive conversations than patients who describe feeling generally unhappy with their nose.
This phase also covers motivations. Why now? How long have you been thinking about it? Are there external pressures involved (partner, family, social media)? Honest answers help shape the conversation.
Medical history review. A detailed medical history covering any current or past medical conditions, surgeries, allergies, medications, and supplements. Particular attention is paid to factors that affect surgical risk or healing: smoking status, bleeding disorders, autoimmune conditions, diabetes, and cardiovascular health. The medications and supplements list is reviewed for items that may need to be stopped before surgery (aspirin, NSAIDs, fish oil, vitamin E, ginkgo, garlic, ginseng, St John’s Wort).
External nasal examination. Dr Turner examines the external nasal anatomy from frontal, lateral, and three-quarter views. The assessment includes the bony pyramid (upper third), the cartilaginous middle third, the nasal tip and lower third, the alar base, the dorsal aesthetic line, and the relationship between the nose and surrounding facial features. Skin thickness is assessed because it significantly affects what surgical refinement actually shows through to the surface. For more on this, see thick skin in rhinoplasty.
Internal nasal examination. The internal anatomy is examined, including the nasal septum, the internal nasal valve, the external nasal valve, and the turbinates. Where breathing concerns are part of the picture, the Cottle test (gently pulling the cheek skin outward to see if breathing improves) helps assess valve function. In some cases, a nasal endoscopy may be performed at this consultation or at a follow-up.
Photography. Standardised clinical photography is taken from multiple angles (frontal, lateral, three-quarter, and base view) under controlled lighting. These photographs are used for surgical planning and become part of your clinical record. They are also used for the 3D imaging simulation.
3D imaging simulation. Dr Turner uses the Vectra 3D imaging system to capture a three-dimensional digital model of your face from multiple angles simultaneously. The simulation software allows the model to be modified to show potential changes to the dorsal profile, tip projection, alar width, and other features. For more on how this is used and its limits, see 3D imaging in rhinoplasty.
The simulation is a communication tool, not a guarantee. Real surgical outcomes are influenced by individual healing, skin thickness, and intraoperative findings that cannot be predicted from imaging alone. This limit is explained explicitly during the consultation.
Procedure plan discussion. Based on the assessment, Dr Turner will discuss what surgical approach may be appropriate (open or closed, structural or preservation, primary or revision techniques) and what specific surgical work may be involved (dorsal reduction, tip refinement, alar base modification, septoplasty, turbinate reduction, cartilage grafting). The discussion is detailed enough that you understand what is being proposed and why.
Risks discussion. A frank discussion of the specific risks for your case. General surgical risks (bleeding, infection, anaesthesia, scarring) and rhinoplasty-specific risks (asymmetry, irregularity, pollybeak deformity, tip drop, breathing change, the published 5% to 15% revision rate) are all covered. For more depth, see understanding rhinoplasty risks and complications.
Realistic expectations. Where the simulation or your goals exceed what surgery can realistically achieve given your specific anatomy, this is discussed openly. A surgeon who agrees to everything you want without addressing limits is not operating with appropriate honesty.
Recovery and timeline. What the first week looks like (cast, swelling, bruising), what weeks two through six involve (return to work, activity restrictions), and what the longer maturation phase looks like (final settled result at 12 months, sometimes 18 months in thick-skinned patients).
Indicative cost picture. A general indication of cost, with a formal itemised quote provided after the consultation.
Between Consultations: The Cooling-Off Period
Under the AHPRA framework, there is a mandatory cooling-off period between the two consultations and again before any surgical decision is finalised. This is not a delay tactic, it is a regulated patient-protection step.
During this period:
- You receive a written summary of the consultation findings and proposed plan
- You receive a formal itemised quote covering surgeon fee, anaesthetist fee, hospital fee, and any post-operative care costs
- You receive written information about the procedure, including risks
- You have time to consider the information without the pressure of being in front of the surgeon
- You can write down questions to ask at the second consultation
- Where psychological evaluation is indicated, this can be arranged in this window
Patients are encouraged to use this time genuinely. Rhinoplasty is a permanent decision. The cooling-off period exists specifically to support a decision made without time pressure.
Consultation #2: The Decision Consultation
The second consultation is typically 30 to 60 minutes and focuses on questions, refinement of the surgical plan, and the surgical decision itself.
What Happens at the Second Consultation
Question and answer. This is the most important function of the second consultation. The questions you have written down during the cooling-off period are addressed in detail. Common questions include:
- About my specific case: what are the technical challenges? What is the realistic outcome given my anatomy?
- About the procedure: what grafts will be needed? Where will they come from? What if intraoperative findings change the plan?
- About recovery: detailed timeline, when can I exercise, when will I look “normal” in public, when will I look “normal” in close-up photos?
- About cost: what is included if I need a touch-up procedure? What is the policy if I am unhappy with the result?
- About risks: what is your specific revision rate? What complications have you seen in cases similar to mine?
A surgeon who takes these questions seriously, answers in detail, and does not minimise risks is operating with appropriate transparency.
Surgical plan refinement. Where the surgical plan has been refined since the first consultation (sometimes additional imaging or specialist input is sought between consultations), the updated plan is reviewed. The 3D simulation may be updated.
Surgical consent process. If you decide to proceed, the formal surgical consent process is initiated. This is not a formality. The consent process covers the specific procedure, the realistic outcomes, all of the major and common risks, and the alternatives. You sign the consent form only when you have understood and accepted these.
Cooling-off period before surgery. Under AHPRA’s framework, there is a further cooling-off period between the formal consent and the surgery date. Surgery is not scheduled to occur immediately after the consent process is completed. This provides another opportunity to reconsider before the operation date.
Surgical scheduling. Once the cooling-off period requirements are met, surgery scheduling is finalised. The pre-operative requirements are discussed (medication cessation, smoking cessation if applicable, the timing of any pre-operative tests).
What Happens Between the Decision and Surgery
The period between the surgical decision and the surgery day involves:
- Pre-operative tests where indicated (blood tests, ECG for older patients or those with cardiac history)
- Specialist clearance where indicated (cardiology, anaesthetics, endocrinology depending on medical history)
- Medication adjustment in consultation with the prescribing doctor (stopping aspirin, NSAIDs, anticoagulants, supplements that increase bleeding risk approximately two weeks before surgery)
- Smoking cessation for at least four weeks before and four weeks after surgery
- Pre-operative photographs for clinical record
- Anaesthetic consultation typically arranged in advance of the surgery date
- Pre-operative instructions about what to bring on the day, what time to arrive, what time to fast from
A pre-operative phone call from the practice team a few days before surgery confirms the arrival time and reviews the instructions.
Psychological Evaluation Where Indicated
Under AHPRA’s framework, psychological evaluation is required where clinically indicated. This is most often relevant where:
- Body Dysmorphic Disorder is suspected
- The patient’s motivations appear to be external rather than personal
- There is a history of multiple cosmetic procedures with persistent dissatisfaction
- The patient appears emotionally distressed or unable to articulate stable goals
Where psychological evaluation is indicated, referral to a registered psychologist or psychiatrist is arranged. The evaluation is a clinical assessment, not a screening designed to disqualify patients. Where the evaluation supports proceeding, surgery proceeds. Where it raises concerns, the conversation about whether surgery is the right path continues.
What to Ask at Your Consultation
A short list of questions worth raising at the consultation:
About the surgeon and procedure:
- What are your qualifications? (Specialist Plastic Surgeon, FRACS)
- How many rhinoplasty cases do you perform per year? What proportion are revision?
- What hospital admitting privileges do you hold?
- What is your approximate revision rate?
- What technical approach are you proposing for my case and why?
About my outcome:
- What is realistic given my specific anatomy?
- What can this surgery NOT achieve for me?
- Show me before-and-after photographs of cases similar to mine
About risks:
- What are the specific risks for my case?
- What is your protocol if a complication occurs?
- What is included in the cost if revision is needed?
About logistics and cost:
- What is the total cost (surgeon, anaesthetist, hospital, post-op care)?
- What is your policy on revision or touch-up?
- What is the timeline from decision to surgery date?
For a detailed framework on evaluating any rhinoplasty surgeon, see how to choose a rhinoplasty surgeon you can actually trust.
Consultation Fees and Booking
The consultation fee at Dr Turner’s practice is $450 for the initial consultation. The fee for the second consultation may vary depending on the situation, this is confirmed at the time of booking.
Where rhinoplasty is being considered for a functional reason and Medicare eligibility may apply, a portion of the consultation may be claimable through Medicare with a valid GP referral. The practice team will discuss this at the time of booking.
Frequently Asked Questions
How long is a rhinoplasty consultation?
The first consultation is approximately 60 to 90 minutes. It includes detailed medical history, external and internal nasal examination, standardised clinical photography, Vectra 3D imaging simulation, discussion of the proposed surgical plan, risk discussion, and an initial cost picture. The second consultation is typically 30 to 60 minutes and focuses on questions, surgical plan refinement, and the surgical decision itself.
Do I need a GP referral for a rhinoplasty consultation?
Yes. Under AHPRA’s cosmetic surgery framework that came into effect in July 2023, a valid GP referral is required before the first consultation with the operating surgeon for any cosmetic surgical procedure. The GP referral covers your general medical health, current medications, motivations, and any psychological considerations. Where rhinoplasty is being considered for a functional reason, the GP referral is also required for any Medicare rebate to apply.
Why are two consultations required before rhinoplasty?
The two-consultation requirement is part of the AHPRA cosmetic surgery framework and is mandatory for cosmetic surgical procedures in Australia. The first consultation covers the comprehensive assessment, examination, imaging, and discussion of the surgical plan. A cooling-off period follows. The second consultation focuses on questions, refinement, and the surgical decision itself. The structure is specifically designed to support careful, unhurried decision-making rather than same-day surgical decisions.
How much does a rhinoplasty consultation cost?
The consultation fee at Dr Turner’s practice is $450 for the initial consultation. The fee for the second consultation is confirmed at the time of booking. Where rhinoplasty is being considered for a functional reason and Medicare eligibility may apply, a portion of the consultation may be claimable through Medicare with a valid GP referral. The full surgical cost (surgeon fee, anaesthetist, hospital, post-operative care) is provided as a formal itemised quote following the first consultation.
What should I bring to my rhinoplasty consultation?
Bring your GP referral letter, photo identification, a list of all current medications and supplements (including over-the-counter and herbal products), and a summary of any previous nasal surgery, nasal trauma, or breathing concerns. It is also useful to bring written notes about what you are hoping to change and any specific questions you want to discuss. Reference photographs of features you like or dislike can help with the discussion, but discussion of celebrity comparison is generally not productive and is sometimes a candidacy concern.
Consult with Dr Scott J Turner
Dr Scott J Turner is a Specialist Plastic Surgeon (FRACS) with a focus on facial aesthetic and rhinoplasty surgery. He consults at Bondi Junction and Manly in Sydney, and at clinics in Brisbane (Spring Hill, Herstellen Clinic) and Canberra (Campbell ACT, Friday consultations). Surgery is performed in Sydney at Bondi Junction Private Hospital, Delmar Private Hospital in Dee Why, and East Sydney Private Hospital.
The consultation framework follows the AHPRA cosmetic surgery requirements in full: GP referral, two consultations, psychological evaluation where clinically indicated, and cooling-off periods at each decision point. The clinical assessment is structured, the documentation is comprehensive, and the time is genuinely yours to ask questions, take the information away, and decide without pressure.
Contact the practice to arrange a consultation, or read more about Dr Turner’s background and training. Before booking, you may also want to read am I a good candidate for rhinoplasty.
