What are the potential risks and complications of rhinoplasty?
A cosmetic rhinoplasty or alteration of the bony and soft tissue cartilaginous structures of the nose is one of the more common cosmetic procedures. Nasofacial imbalance and proportion is extremely common and a cosmetic rhinoplasty can be one of the most aesthetically beneficial procedures that we have in plastic surgery. The alteration of the shape and structure of the nose is also delicate and fraught with potential risks and complications and, so, potential rhinoplasty patients should seek out physicians with a tremendous amount of experience and expertise in this specialized area of aesthetic plastic surgery. The Number one complication following rhinoplasty is a failure to achieve the aesthetic outcomes that the patient desired. Usually this is not because of the surgical technique failing, but that the plastic surgeon or rhinoplasty surgeon did not communicate the type of outcomes that can generally be achieved. I am fortunate in having been trained in both plastic surgery and ear, nose, throat, head and neck oncology and aesthetic rhinoplasty has been one of the most common procedures I have performed over the past 20 years. I have found that the most valuable technique pre-operatively during the consultation is to sit down with the patient after listening to their nasal concerns and aesthetic goals and then outline using 2D and 3D computer imaging the kind of outcomes that I’m able to achieve after almost two decades of rhinoplasty surgery. By carefully reviewing the type of changes that incur to the bridge and the tip the patients get a very real sense of the kind of outcomes that will likely be achieved virtually eliminating the risk of having the aesthetic outcome that the patients had not anticipated.
Once one has achieved a common outcome pathway with the patient other complications following rhinoplasty are quite uncommon. Other complications include functional changes such as slightly or moderately restricted airflow, particularly during reduction rhinoplasty and this often necessitates a prophylactic septoplasty and airway surgery at the same time. Intermittent nosebleeds, sinus headaches and migraines have all been reported, but are very uncommon following rhinoplasty. One of the more common structural complications includes displacement of small fracture fragment following the osteotomies necessary to reduce a bridge bump. These small little bumps and irregularities can be palpable or palpable and visible. If palpable and not visible they’re generally left alone. If visible they can be improved with a secondary smoothening of the bony fragment usually under local anesthesia.
Rhinoplasty itself is generally performed by competent rhinoplasty surgeons in one hour and fifteen minutes to one and a half hours. Approaches can be entirely internal or a combination of internal and external. Most scars heal very well and scar revision and rhinoplasty is far less than 1%. In my practice more than 95% of patients are extremely happy following a rhinoplasty and the key to a great outcome is communication between a talented rhinoplasty surgeon and a motivated and realistic rhinoplasty patient. I hope this information has been of some assistance and best of luck.
For more information, please review our rhinoplasty page.
To schedule a consultation fill out an online consultation form and one of our live online client service attendants will service your needs. R. Stephen Mulholland, M.D.
Certified Plastic Surgeon Yorkville, Toronto
Complications following rhinoplasty are very uncommon. Infections rarely occur. Airway obstruction can sometimes result if a nasal reduction is overdone. I think the biggest risk of rhinoplasty surgery is not achieving the desired result – either due to poor planning, poor execution, or unpredictable healing. Always consult a surgeon who has experience in performing this procedure.
Read about the procedure