What Are the Chances of Rhinoplasty Going Wrong?

The complications you mentioned are very uncommon. Collapse and baad scarring can be related to an inexperienced surgeon, so selecting an experienced rhinoplasty surgeon is encouraged.

Infection is quite uncommon, though often preventative antibiotics are given after surgery.

The good news is that the risks of any of the potential complications that concern you the most, and are listed in your question, are extremely small if not negligible.

Most rhinoplasty surgery can be performed through incisions on the inside of the nose so that there are no visible scars. While infection may occur, it is very uncommon, and I recommend a course of preventative antibiotics in order to minimize this risk. Nasal implants may occasionally be used in rhinoplasty surgery, increasing the risk of infection slightly.

Collapse of the nose can only occur if too much of the nasal septum is removed during rhinoplasty surgery. Unless the nose is extremely crooked on the inside, with obstruction of the nasal airway throughout its length, this risk is low when the surgery is performed carefully.

In my practice, rhinoplasty is performed most commonly using intravenous sedation, otherwise known as “twilight sleep”. This eliminates the risk of a general anesthetic, and also happens to be less expensive and with a quicker recovery time immediately following the surgery. Nasal deformity can occasionally occur after rhinoplasty surgery; however, with careful surgical technique and post-operative care and close post-operative follow-up, this can be avoided.

Many of the issues you describe (bleeding, infection, death) are risks of any surgery. This risk depends on patient health, type and length of procedure and the setting of the operation. Rhinoplasty is usually performed on healthy individuals under general anesthesia in an outpatient surgery center. In these cases, risk is exceptionally rare. You have to discuss your personal risk with your surgeon who knows your health status, etc. Risk of an undesired cosmetic outcome also depends on surgeon skill, specialization, and the complexity of the nose. Of course, patient expectations are also important since some patients may be unrealistic. In revisions, traumatic and congenitally disfigured noses, the risks are higher. Again, this is something to discuss with your surgeon who should be able to give you a clear assessment of your risk. Meet with at least two or three surgeons and determine who best communicates with you about your questions. Always go with a facial plastic surgeon or plastic surgeon who specializes at least 25% of their practice to rhinoplasty. Talk to others in your community who have had nasal surgery with the surgeon (although one may be a great breast or eyelid surgeon, noses are completely different). In general, the greatest risk a patient takes on the day of their surgery is in the car riding to and from the surgery center.

Though any patient can have a serious complication, these are EXTREMELY rare. The complication that I have seen the most of in 35 years of revision rhinoplasty is a poor aesthetic result. Make sure your aesthetics and the surgeon's agree and make it quite clear what you want!

You ask an excellent question, the answer will be different for every surgeon. Some surgeons will have higher rates of infection or need for revisions. Skilled, experienced surgeons most likely will have lower numbers. The average revision rate for rhinoplasty (need to go back to operating room to do additional work) is around 10%. There are many surgeons who have rates much lower than this. If your surgeon claims their revision rate is zero, don't believe them. Because of all the potential variables in rhinoplasty surgery, everyone will have the occasional case that doesn't turn out as well as everyone would expect.

For healthy, non-smoking patients, rhinoplasty surgery has a very low complication rate-less than 1% in most cases.

Ultimately, you will have to interview several surgeons, ask questions and make a decision.

Hope this helps...

Rhinoplasty is the most challenging of any cosmetic surgery and the one with the highest revision rate.  Odds are that 5-15% of all rhinoplasties need some form of revision and this can be higher in less experienced hands. For that reason choosing a physician who is very comfortable with this complicated operation is important. That being said, rhinoplasty patients are some of the happiest patients I have with this operation being able to fundamentally change a part of their appearance that has bothered them for years. The key with this operation is that the benefits must outweigh the risks and your expectations must be realistic. If you meet these criterion and your surgeon agrees, then go for it and you will likely wonder why it took you so long.

Best of luck

Vincent Marin, MD, FACS

San Diego Plastic Surgeon

Your question is a bit interesting and unusual. Major disasters eventuating from a rhinoplasty as you described are extremely rare particularly when performed by competent board certified plastic surgeons or facial plastic surgeons. Relatively minor problems, aesthetic deficiencies or patient dissatisfaction with the result is an inherent risk with rhinoplasties and may range generally from around 5 - 20% depending a variety of factors.

Death, destruction, permanent scaring, infection, collapse, and yes rot are all rare following rhinoplasty. An occasional nosebleed is seen. Changes in the airway, not many. The problems in rhinoplasty are imperfections in the result, or poor aesthetics (not the best result). Experience trumps all, so choose carefully. Nationally the 'revision rate' has been estimated at 20%, though if you ask anyone, revision is rare in their practice. The bottom line safety with experience.
Best of luck,
peterejohnsonmd

It is an operation which requires the attention of an expert plastic surgeon who has performed at least hundreds of rhinoplasties.The revision rate  is proportional to the inexperience  of the surgeon.

In skilled hands, the chance of exceeding bad results like you name are very small.  The chances of minor problems such as a less than perfect aesthetic result requiring repeat surgery are about  10%.

I can not stress enough, make sure that you find someone that is good at rhinoplasty.  They MUST be board-certified in Facial Plastic Surgery or General Plastic Surgery and specialize in rhinoplasty.