Can I get rhinoplasty after having radiation on nose due to cancer? (Photo)

The risk of poor blood supply to the nasal skin leading to loss of skin after rhinoplasty is high in any nose that has been radiated.  It also depends upon the amount of radiation that has been delivered.  If you're willing to accept the risk of possible skin necrosis and worsening of the nose and you can reach a rhinoplasty surgeon and discussed her options.  It would be helpful to assess the vascularity of the nasal skin using pinpricks and blanching techniques prior to deciding on surgery.RegardsDr. J

Good question!!!  Most surgeons would not recommend an elective cosmetic rhinoplasty, especially an extensive open rhinoplasty procedure.  Take of the cancer first, allow adequate healing - probably over one year.  Make sure there is no recurrence of your cancer.  Then get evaluated by an experienced rhinoplasty surgeon. You maybe a candidate for a minimal rhinoplasty, possibly an filler rhinoplasty.  Good luck, sorry about your cancer.

 First, it is important to make sure that cancer is under control/ healed and his not returning before undergoing elective cosmetic surgery on the nose. There is definitely added risk performing a rhinoplasty in irradiated tissues. Also important to note the total dosage of radiation.

All situations in medicine are unique, and there are often options available when a desired procedure is sought.1. I would suggest making sure the cancer is fully treated(you don't want to scar your new nose with a recurrence or adjacent cancer)2. Allow adequate time to heal; this depends on the size of the cancer, the type of reconstruction(if any) and the radiation dose.3. Try an injectable rhinoplasty to see if that works aesthetically for you as well as to test the skin's circulation and the skin's ability to re-drape.4. Fat grafts can restore circulation prior to a definitive rhinoplasty, if required.5. Consider using cartilage grafts outside the field of radiation.Hope this helps.

You would need to heal completely following radiation and be tumor free. As my colleagues have mentioned radiation significantly raises the risk of skin necrosis or healing issues following rhinoplasty. You can reduce this risk with an endonasal approach and a more limited procedure that does not compromise the nasal blood supply extensively. Regardless, you are taking on more risk than the typical rhinoplasty patient and need to be comfortable with that risk. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Hi,Thanks for sharing your pictures. I take it the tumour is excised and your nose will be irradiated over the course of forthcoming 4-6 weeks!To undergo an open/closed rhinoplasty even after 5 years of follow up would be extremely RISKY!(happy to share my personal experience if you were intersted)best wishesJ TaherychesterUK

It may be possible but depends on size of original cancer, extent of radiation and examination of your nose at the present time.  Because of the somewhat diminished blood supply after radiation, I would recommend that surgery be done through an endonasal approach (closed rhinoplasty), not an external (open) rhinoplasty.

Without in person examination and clearances from the radiation oncologist no PS would operate on your nose......

Although the answer depends upon the type and extent of the cancer (for example, skin vs. nasal cavity) and the dosage of radiation delivered, most surgeons would discourage performing an elective cosmetic procedure on freshly-irradiated nasal tissue. Radiation can harm the nasal tissue's ability to heal and permanently impacts the nasal cartilagenous support structure, lymphatics, and incites some scarring within the nasal soft tissues. This means that the risk of poor aesthetic outcome, infection, and other complications such as a septal perforation and chronic nasal dysfunction is elevated compared to non-irradiated noses. Despite these obvious risks, this does not entirely preclude your ability to have aesthetic surgery, especially if there is another medical indication for a nasal surgical procedure (i.e. correction of a septal deviation). A widely accepted, but mostly untested standard in the surgical field is to wait 10 years following irradiation prior to contemplating elective cosmetic surgery. Clearly, this pre-determined amount of time depends heavily on your condition and radiation dose received, as well as the degree of comfort of your surgeon in performing the surgery. However, although some surgeons might agree that rhinoplasty could potentially be performed safely within the 10 year window; most surgeons would also agree that nasal procedures that rely heavily on placing artificial nasal implants or large structural cartilage grafts (such as rib cartilage grafts) are contraindicated in irradiated noses. My recommendation to you would be to complete the therapy and achieve cancer remission or cure (5 years) and then sit down with your surgeon to discuss the surgical options for addressing your nasal cosmetic concerns. Best of luck!

Thank you for your question and photos and a complete history and discussion with your oncologist is really needed to answerDr Corbin