What potential problems may occur with Rhinoplasty? Are they common?
What Are Potential Rhinoplasty Side Effects?
Doctor Answers 10
Rhinoplasty: Differentiating Side-Effects from Complications
The vast majority of rhinoplasty surgeries are successful when performed by an experienced rhinoplasty surgeon, and there are little if any post-operative problems. It is important to differentiate rhinoplasty complications from side effects.
- Nasal Obstruction: This is perhaps one of the most common "side effects" of rhinoplasty. A successful rhinoplasty should produce a nose that both looks good and functions well. With modern rhinoplasty techniques and an accurate analysis and diagnosis of the patient's nose before surgery, breathing problems can be avoided.
- Displeasure with Cosmetic Appearance: Because the goal of a rhinoplasty is to change the shape of the nose, it is possible for the patient to be displeased with the appearance post-operatively -- even if there is not any real deformity or abnormality. The chances of this can be reduced by clearly communicating with your surgeon before surgery to convey your goals and expectations. Computer morphing (simulation) or tracings overlying your pre-operative photographs can help ensure that you and your surgeon are in agreement with the proposed result.
- Bleeding: While rhinoplasty is generally not a , there is the risk for excessive bleeding - particularly post-operatively in the form of a nose bleed. Patients taking NSAID (non-steroidal anti-inflammatory medications such as ibuprofen, naproxen, aspirin), blood thinners, or those with a personal or family history of bleeding disorders are at higher risk.
- Infection: Any surgery carries the risk of infection. With close attention to sterile techniques, this risk can be reduced.
- Scarring: Obviously, an open rhinoplasty places a scar on the column of tissue between the nostrils. Usually this are heals well and the scar is not noticable at conversational distances. Scar bands can also occur on the inside of the nasal passages. These can block the airway and give rise to nasal obstruction
- Deformity: Uneven edges of the boney/cartilaginous framework, over or under resection of the bridge, tip distortion, are just some of the many cosmetic deformities that result from rhinoplasty
- Septal Perforation: If a tear forms in the lining of both sides of the septum, it is possible for a permanent hole to form. Usually, a septal perforation is not a significant problem, and the patient may not even be aware that it is there. When they are small, a whistling noise may be heard with respiration as the air rushes through the small hole. If large, the perforation can serve as a site for mucous to collect and form a crust. Septal perforations also have a tendency to contribute to nosebleeds.
The most common complication after rhinoplasty surgery is a nose bleed.
Dhaval M. Patel
Double board certified
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Side Effects Involved with Rhinoplasty
Rhinoplasty Risks and Side Effects
As with any cosmetic surgery, there are always risks and side effects of rhinoplasty. In addition to the risk of scarring and not having your goals achieved, there can be a worsening (very unlikely and usually avoidable) of nasal breathing. By finding an experienced rhinoplasty surgeon, these risks are reduced but not completely avoided.
Problems with Rhinoplasty
All of the answers touched on the fact that a true surgical complication with rhinoplasty is rare but should be discussed in detail at your consultation. The more likely problem that patients who have rhinoplasty run into is a poor aesthetic result and/or post procedure nasal obstruction. As beauty is in the eye of the beholder, it is important that you communicate clearly with your surgeon what your aesthetic is and this can sometimes be facilitated by computer imaging by the surgeon.
It is not uncommon to see a website of a surgeon which will present an example of a nose they think looks attractive which others may consider a "complication". Worsening of nasal obstruction is often a failure by the surgeon to account for nasal dynamics and airflow. A nose is intended to breathe as well as ideally look good. Chose your surgeon carefully and do your research. Try and find someone whose practice has a focus on rhinoplasty.
Also take into account your medical condition
Dr. Persky does an excellent job of outlining rhinoplasty risks. You should also be sure to speak with an experienced and trained surgeon and disclose your medical condition to them. Some of the risks of rhinoplasty are greater in patients with certain medical conditions and rhinoplasty should not be undertaken in some medical cases.
In reality not a lot :)
Rhinoplasty in most cases gets performed with little or no problem. A good rhinoplasty surgeon will try to avoid making your breathing worse, try to avoid magnifying any asymmetries, and try to leave you with imperceptible scars when possible.
The other things that can happen but are frankly rare in my opinion are, postop nosebleeds and septal perforations. Patients need to be really careful in the first 6 weeks to avoid hitting their new nose or wearing glasses/sunglasses that might move their healing bones.
Outside of these objective issues most complaints for patients surround the aesthetics of their nose after surgery and unfulfilled expectations of the outcome. This often results in a revision rhinoplasty.
Good preoperative teaching will keep those types of problems to a minimum.
Almost none and very rare
In more than 30 years, the most common complication I've had is the patient injuring themselves after surgery. Though bleeding, infection, anesthesia problems can occur, they are very rare. A bad result, which is not a complication, but rather a poor choice of surgeon is unfortunately not rare. Therefore, spend lots of time in choosing a competent surgeon and you should have a good result.
The Potential Side Effects of Rhinoplasty
Rhinoplasty has been described as "the most difficult of all facial plastic surgical procedures". As with all surgical procedures there are risks and benefits. When deciding whether to have the surgery, the patient along with their surgeon needs to weigh the benefits of rhinoplasty versus the risks and complications.
Fortunately in the hands of an experienced board certified rhinoplastic surgeon, the benefits of the procedure far out weigh the minimal risk of adverse events.
As with all surgical procedures the major risks involve infection, hemorrhage, and adverse reactions to anesthesia. Fortunately all of these are extremely rare. The most common "complication" following rhinoplasty is either a functional problem in breathing, or a cosmetic problem, both of which may in some cases require a revision surgery. Most competent rhinoplasty surgeons have revision surgery rates of about 3% to 7%.
Breathing problems following rhinoplasty can most often be corrected non-surgically with Somnoplasty of the inferior nasal turbinates which increases the internal nasal valve by using radiofrequency volumetric tissue reduction in a quick, safe, and in-office painless procedure.
If you are contemplating rhinoplasty, do your homework and choose you surgeon most carefully. It is your nose for the rest of your life, and I need not remind you that it lives smack dab in the middle of your face.
Good luck and happy, healthy Holidays.