I'm planning to get an open rhinoplasty with dorsal augmentation and tip cartilage. Am I at risk for necrosis?

Question

Hello, I am planning on getting my first ever rhinoplasty. It will be an open approach and will include dorsal augmentation and additional tip cartilage. Am I at risk for necrosis? Do cartilage grafts increase the risk? Or is it just injections and fat? Also, do splints cause pressure necrosis? Thanks

Randal Haworth, MD, FACS · Answer

Unless you are a smoker or have diabetes the risks are negligible in capable hands. Skin necrosis is a rare complication but can be treated with a combination of PRP and fat graft.

Surgeons should avoid the application of tight metal external splints on large dorsal nasal grafts as it can lead in some rare cases to necrosis.

Selcuk Inanli, MD · Answer

Hello! Thank you for your question. So for the beginning the necrosis means the tissue deaths simply. If you do not smoke or do not have any blood circulation sickness, you have very little necrosis risk. Please follow your surgeons guide about that. If you can provide photos from front of your face, from the side of your face and 1 meter away I would be able to make a proper evaluation. It would be more convenient to decide with face-to-face consultation. Best Regards!

Oakley Smith, MD, FRCSC · Answer

The incidence of getting skin necrosis after rhinoplasty surgery is low even if it involve placing cartilage grafts. This rare complication happens if there was a complication during surgery. The external splint is safe and function to support the nose during the first few days of healing.

Ryan Rebowe, MD · Answer

Skin necrosis is always a risk in rhinoplasty but is low in primary rhinoplasty, especially in non-smokers. Any additional surgical maneuver will increase the risk but none of the ones that you mention increase that risk in particular unless performed incorrectly. For example, the cartilage grafts are excessive and place additional tension on the skin. Splints can cause pressure necrosis when placed too tightly or left too long. As long as the surgeon performing the surgery is a board certified plastic surgeon, ENT, or facial plastic surgeon, you should be at an overall low risk for skin necrosis.

Eric M. Joseph, MD · Answer

That said, the results of your procedure are largely dependent upon your surgeon's expertise. Cartilage grafts do not lead to necrosis, and neither does a well suited dorsal nasal implant. Dorsal implants may become infected, or shift and appear crooked. Hope this helps! Dr Joseph

Oguzhan Oguz, MD · Answer

There is always a risk of tissue necrosis (death of tissue) with any surgical procedure, including rhinoplasty. However, the risk of necrosis is generally low for most patients undergoing open rhinoplasty with dorsal augmentation and tip cartilage.
Necrosis can occur if there is a disruption in blood flow to the tissues, which can be caused by a variety of factors including trauma to blood vessels, excessive tissue dissection, and prolonged pressure on tissues. However, experienced and skilled plastic surgeons take great care to minimize these risks by carefully planning and executing the procedure and monitoring the patient's condition during and after surgery.
Some factors that may increase the risk of necrosis include smoking, diabetes, and other medical conditions that affect blood flow and healing. It's important to discuss your medical history with your surgeon before the procedure and follow their pre- and post-operative instructions to minimize your risk of complications.
If you have concerns about the risk of necrosis or any other potential complications, it's important to discuss them with your plastic surgeon prior to the procedure. Your surgeon can provide you with specific information about the risks associated with your particular procedure and any steps you can take to minimize those risks.

William Portuese, MD · Answer

In our practice for over 30 years, we have only performed closed rhinoplasty with all the incisions placed on the inside of the nose. No external incisions are required, and no painful packing is required either. We have never seen skin necrosis from closed rhinoplasty

I'm planning to get an open rhinoplasty with dorsal augmentation and tip cartilage. Am I at risk for necrosis?

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