Why is rhinoplasty difficult?

Rhinoplasty is certainly the most challenging surgery plastic surgeons perform. There are many reasons. The nose is a complex structure of skin cartilage and bone. It is three dimensional. It is unforgiving and any problems are easily visible and hard to hide. Training in rhinoplasty varies tremendously so some plastic surgeons starting out in practice have had more extensive experience than others. And it’s an operation that can take years to knock the bugs out of. As a result many plastic surgeons don’t really promote that strongly as a part of their practice and prefer to do less risky things. There are surgeons that do fifty noses or more a year and those who do only a few or none. Fortunately you can readily determine who does many good noses by looking on their websites. It’s a smart way to narrow down the field of surgeons to consult with.

Rhinoplasty is one of the most challenging operative
procedures
we do in plastic surgery. Careful attention must be taken when working with noses.
As an art, it is a matter of millimeters and experience with little to no
margin for error.
When it comes to your nose, it’s essential to try to get it right the first
time. You need a
true expert to do your Rhinoplasty. An expert is one who is Experienced and performs this
operation frequently at least 2-3 times a week, has Expertise and has written and teaches
others about the rhinoplasty, and one who can show you Excellent results.

Rhinoplasty involves shaping multiple layers of a three dimensional structure. We shape or reduce or augment bone, cartilage and soft tissue. Further, the skin can occasionally compromise the result during the healing process. We're also trying to reduce and shape your nose without compromise the structure that allows you to breathe. The bottom line is that there are many moving pieces of the rhinoplasty puzzle and they need to be put together perfectly and they need to heal in a predictable fashion. Experience is critical to ensure the best possible outcome. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

The quick answer is that rhinoplasty surgery is not cookie-cutter surgery where one size fits all. To perform rhinoplasty well, a plastic surgeon has to perform a proper assessment of the problem(s) at hand, make the correct decisions of what maneuvers must be performed, have the technical prowess to execute said plan and be able to address any curveballs in the healing process. The nose is a three-dimensional structure that can change over time, sometimes healing in unexpected ways. Furthermore, issues such as nasal breathing and patient satisfaction are very subjective and may not be optimal, even after a successful surgery from the surgeon's perspective.

 Rhinoplasty is a very unique operation that requires not only surgical skill and experience, but artistry and the ability be able to think in a three-dimensional approach. There 2 nasal bones, 4 cartilages, the septum and the skin lining on the inside and the outside of the nose and they're all factors in the healing process. In addition, different skin types contract and heal differently over the cartilaginous framework of the nose. The contraction forces of healing can also distort the nose months later from when the procedure was finished at the end of the surgery. In addition, thin skin allows minor little irregularities to show through, while thick skin thickens even more so, and blunts the effect of the surgery. Since the nose is a three-dimensional structure, it must look good in all dimensions, and it must breathe appropriately. Experience performing rhinoplasty  is of the utmost importance, so choose a rhinoplasty surgeon based on that premise