Risks of Rhinoplasty? How likely is it that that risk can occur and how can it be avoided?

Question

I was researching the risks or rhinoplasty online today and I would like to know if they are true, if so how likely is it that that risk can occur and how can it be avoided? - the possibility of heart attack or stroke because of a blood clot( it was not explained) - lose of sense of smell - lose of feeling in nose - bad reaction to anesthesia as a health 20 year old woman should I be very concerned about these things?

William Franckle, MD, FACS · Answer

There are always risks associated with general anesthesia that are distinct from the specific surgical procedure risks.  Heart attack, arrhythmia (irregular, insufficient heart beat), respirator y depression (too sleepy to breathe), DVT (blood clots), malignant hyperthermia (severe atypical reaction to anesthesia) and pulmonary embolism are scary but thankfully rare complications of any surgery involving anesthesia.  The risk in an individual patient is related to the health status and family history.   

	 

	This is why it is so important to see a board certified doctor in the specialty which covers the procedure and to use an accredited facility that has been inspected and certified as safe.  In my opinion, any surgery that requires general anesthesia or deep sedation, as rhinoplasty typically does, should have the anesthesia performed by a board certified anesthesiologist.  This is to manage those scary risks, ensure that the patient is a good anesthesia risk, and to be present with the necessary expertise should an emergency occur.  Although problems are very rare, this is just good medicine.

Donn R. Chatham, MD · Answer

There is no "risk-less" surgery just as there is no "risk-less" driving or eating, for example. A number of factors lessen complications as a result of surgery: the better your health, the less your risk. The more qualified the surgeon and anesthesiologist, the lower your risk. The better you follow your pre and post operative instructions, the less risk you have. Even then, there are no guarantees. But overall, the risks are not high. We surgeons try hard to avoid potential problems such as excessive bleeding, unwanted drug reactions, over-operated looking noses, the need for a second surgery, and so forth. The best advice is to have a candid conversation with your surgeon (but not a fearful one!) about risks and potential problems. Then make a decision you are comfortable with once you know all the real facts!

Jonathan Kulbersh, MD · Answer

In general, the possible risks of rhinoplasty may include the following:

	 

	1) Bleeding (hematoma)
	2) Infection
	3) Asymmetry
	4) Scar tissue buildup
	5) Broken blood vessels
	6) Nose being overdone from an over-aggressive surgery
	7) Chronic swelling
	8) Nasal obstruction

	If you are in good health and cleared for surgery following a physical exam, the possibility of a heart attack occurring is very slim. Numbness in the nose is not uncommon following surgery, but this will likely resolve itself. There is a risk of nerve damage to the nose, but this is very slim. Your anesthesiologist will speak with you about your history and help determine the best combination of medications for you. There are drugs that will be prescribed which will help prevent post-surgical nausea. Thanks and I hope this helps!

William Portuese, MD · Answer

The risks of rhinoplasty in experienced hands are very minimal. The chance of a heart attack or stroke during a rhinoplasty for a 20-year-old is extremely rare during brief anesthesia and as long as you are in good health, there should be no anesthetic complications. Patients do not lose sense of smell from a rhinoplasty. However, patients do experience a decreased sense of smell for 1-2 weeks after surgery, which is due to swelling inside the nose. Most patients initially experience some numbness in the tip of the nose, which almost always goes away in the first couple of months after the surgery. It is important to have this type of surgery performed in a licensed certified ambulatory surgery center, not in an office, with a board certified physician anesthesiologist.

William B. Rosenblatt, MD · Answer

The risks are very low. Talk to your doctor, I have been doing noses for 30+ years -- minor things can happen , but death and blood clots are VERY unlikely.

Michael L. Schwartz, MD · Answer

Major risks of anesthesia that you are asking about are very rare in healthy patients with no individual or family risk factors. Many anesthesiologist quote a risk of 1 in 20,000 since that is supposed to be the risk of randomly getting hit by a car as you cross the street. This is facetious of course but meant to provide some perspective.

Francis R. Palmer, III, MD (retired) · Answer

I have performed Rhinoplasty for 25 years and IMHO, the risk of a healthy 20 year-old having a serious medical issue is very unlikely (though nothing is guaranteed). IMO, you are at much higher risk of not getting the desired aesthetic result if the Rhinoplasty Surgeon doesn't understand and follow the proper aesthetics of facial (and nasal) beauty for the creation of a naturally more attractive nose and face. This is all part of what is discussed during the personal consultation with an experienced Rhinoplasty Surgeon. Hope this helps.

George J. Beraka, MD (retired) · Answer

Hi.

	The risk to your health is REALLY tiny.  The realistic risk is that 5% of rhinoplasty patients need a touch up.

Robert Shumway, MD - Account Suspended · Answer

Individual risks vary, of course, but a healthy twenty year old with no significant risk factors constitute one of our best candidates for rhinoplasty.

Richard W. Fleming, MD (retired) · Answer

Risks associated with rhinoplasty vary depending on the health of the patient and what needs to be done during the surgery. Just like the surgery which is individualized for every patient the discussion of risks is also unique to each individual.

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