Dr. Serhan Derin, born in 1982, is a seasoned ENT specialist who graduated from Ankara University School of Medicine. He completed his residency at Kocaeli University in 2010. Dr. Derin is a highly skilled surgeon specializing in functional and cosmetic nose surgeries, including Primary Rhinoplasty, Revision Rhinoplasty, Ethnic Rhinoplasty, Septoplasty, Septorhinoplasty, Nasal Valve Surgery, and Sinus Surgery.
When thinking about having a rhinoplasty, you should consider all the aspects. Alongside all the cosmetic advantages and success rates, rhinoplasty risks are also present. These risks can vary from little inconveniences like swelling and bruising to major problems such as septal perforation or infection. It is important to know what you might encounter so you can be fully prepared.
We accept that these words sound a little scary, especially because complications like nasal septal perforation do not sound pleasant at all. But, as you will see in the article, the chances of experiencing rhinoplasty risks and complications can be significantly reduced by choosing the right surgeon and following the post-operative instructions.
In this article, we will talk about all the possible risks of rhinoplasty and what can be done to reduce or omit them. So, let us get started.
What are the risks of rhinoplasty?
Undoubtedly every surgical procedure is associated with risks and complications. Although rhinoplasty has a relatively high success rate, it is worth mentioning that a rhinoplasty surgery carries a risk of failure, which has been reported to be around 17% (2). Despite the low chances of many rhinoplasty risks and complications, you should know about them before you undergo the rhinoplasty surgery.
Some risks of nose surgery are more common than others, while few are extremely rare. Rhinoplasty patients are exposed to different risks and at different severities. So, what are the risks of rhinoplasty?
Risks | Common | Rare |
Asymmetry | X | |
Skin discoloration | X | |
Swelling | X | |
Bleeding | X | |
Infection | X | |
Scarring | X |
We can put the risks into three different categorizations:
- Risks associated explicitly with rhinoplasty
- General risks of a major surgery
- Psychological risks
Let’s discuss the sets of potential risks and what they include.
Risks associated explicitly with rhinoplasty
Some risks are specifically associated with the rhinoplasty procedure and the things that happen during the operation. The risks and complications of this cosmetic surgery can be permanent or temporary. These risks can include:
Aesthetic issues: Even though the main purpose of rhinoplasty is to improve appearance, it also possesses the risks of aesthetic issues. These rhinoplasty risks can be:
- Unsatisfactory results
- Nasal asymmetry after rhinoplasty
- Nasal skin discoloration
- Scarring
- Need for a revision surgery
Changes in the sense of smell: An unsuccessful nose surgery can cause problems to the smell system. The problems can vary from small changes in the sense of smell to not being able to sense anything at all.
Changes in nasal skin sensation: The surgery can lead to pain and numbness on the skin of the nose. This numbness can be permanent or last for a few months after surgery.
Breathing difficulties: Among the major problems of rhinoplasty can be the risks of breathing difficulties. Rhinoplasty can affect the breathing system by damaging some structures during the operation.
The possibility of nasal septal perforation: This is an uncommon problem following rhinoplasty and septoplasty in which a hole appears in the nasal septum. Additional surgery to repair the perforation is needed.
Risks related to cartilage and bone
Risks of damage to the cartilage and nasal bone are among the most common complications. As a result of modifying the nasal structure, problems with the cartilage and bone can happen.
Nasal asymmetry: A crooked nose after rhinoplasty is among the risks of an unsuccessful nose job. This can happen due to improper shaping of the nasal septum. Losing the support and strength can cause septal deviation and consequent breathing problems. Revision surgery will be required to address this problem.
Nasal bridge collapse: Another risk associated with rhinoplasty is the chance of the collapsing of the nasal bridge In case of an over-reduction of the nasal septum. This situation is also known as saddle nose deformity. Inadequate cartilage and lack of structural support can lead to the collapse of the nasal wall.
Nasal valve collapse: The nasal valve is the narrowest part of the airways of the nose. Nasal valve collapse happens when it becomes narrower as a result of the cartilage becoming weak after rhinoplasty. This leads to nasal obstruction, breathing issues, and the need for revision rhinoplasty.
Polly beak deformity: In this deformity, there is excessive tissue above the nasal tip and a convex dorsum. It can happen because of the improper way of addressing a dorsal hump. Having rhinoplasty with an inexperienced surgeon increases the chances of Polly beak deformity.
Rare risks
There are some risks associated with rhinoplasty that are extremely rare. In rare situations, nose surgery can lead to problems such as blindness or brain damage. If during the surgery, one vessel or nerve related to the eye is injured the chances of blindness increase. Brain damage due to lack of oxygen under anesthesia is another rare yet dangerous risk.
General risks of a major rhinoplasty
Some common risks may occur after every invasive and major surgery. These complications will probably happen after the rhinoplasty procedure as well. Yet the level of severity may vary between patients based on their health condition and the surgeon’s experience. The general risks of rhinoplasty are as followed:
Bleeding and hematoma: This is a procedure that involves altering nasal structures via incisions, cartilage removal, grafts, implants, or bone rasping. They can all lead to bleeding and eventual bruising after the surgery. Hematoma is almost always associated with swelling.
Infection: Whenever an incision is made on the skin, the risk of infection appears. When the skin is cut open and different layers are detached, bacteria can enter the body and find their way through the bloodstream. However, the chances of infection are relatively low.
Anesthesia risks: The risks of problems associated with anesthesia happening after a nose job can be quite high. They can vary from minor inconveniences to life-threatening situations. In addition to the anesthesiologist’s experience, the patient’s body response can contribute to the occurrence of these problems.
The risks of anesthesia include:
- Nausea and vomiting
- Allergic reaction to anesthetic medications.
- Sore throat
- Dental injury
- Postoperative delirium or cognitive dysfunction
- Breathing problems during and after surgery
- Injury to nerves
- Awareness during surgery under anesthesia
- Stroke
Financial risks
The common questions about rhinoplasty risks are “how safe is rhinoplasty” or “is rhinoplasty dangerous?”. But there are also financial risks associated with a nose job.
There may be hidden costs for the procedure, that may collide with your budget. Sometimes unexpected complications after surgery may require immediate intervention. The medical intervention may cost you more than you would expect. Ask about all possible expenses during your rhinoplasty consultation. It will give you an estimation of how you can manage your finances.
Psychological risks
Among the risks of nose surgery, psychological problems are common. If the patient is not pleased with the final aesthetic outcome, they get disappointed. This can increase the risk of psychological issues such as depression. To prevent such incidents, it’s important to find a skilled nose surgeon with good communication skills and manage your expectations.
How to manage expectations
Every surgery possesses risks to some extent. You should know the rhinoplasty risks before you undergo this cosmetic surgery. Consult your surgeon and ask about all the possible risks of rhinoplasty. This will help you have realistic expectations and be prepared for what you might face. Having realistic expectations leads to less post-op disappointment and depression, and can eventually help you handle the situation more wisely.
Factors that increase rhinoplasty risks
Some factors can contribute to increasing the risks of rhinoplasty. By managing these factors, you can reduce the risks and post-op complications to high extents. To be able to manage the factors, you should know them first:
- Smoking
- Medications
- Health conditions
- Surgeon’s experience and skill
Smoking
Smoking affects the circulation system and oxygen delivery to the tissues. that’s why it is a risk factor for excessive post-op bleeding, delayed healing, and tissue death. This effect on the blood flow can even cause problems during the surgery.
Medications
Some medications interfere with the natural healing process and may elongate the recovery time. Some medicines can also cause post-op bleeding and swelling. In more severe cases, some medications can interfere with anesthetic medicines and cause life-threatening issues.
Health conditions
Some underlying health conditions may greatly increase the risks of complications of rhinoplasty. These health conditions are:
- Bleeding disorders
- Uncontrolled diabetes
- Cancer
- Mental disorders
- Obstructive sleep apnea
- Cardiovascular diseases
Surgeon’s experience and skill
Undeniably practice makes perfect. If the nose surgeon is not experienced or skilled enough the chances of successful outcomes decrease while the risks increase. An experienced rhinoplasty surgeon starts the procedure even before the operation. A doctor with less experience is still capable of carrying out a fruitful procedure, but the risks of problems are high. The use of proper surgical techniques plays a crucial role in the final aesthetic results. An inexperienced surgeon may not be able to perform all types of rhinoplasty and surgical techniques. This can lead to unsatisfactory results and other issues.
How to minimize rhinoplasty risks
By following some easy steps, the risks of rhinoplasty can be diminished. A great percentage of rhinoplasty risks can be reduced by the active participation of the patient in the process. But how? Let us explain!
- Choose an experienced rhinoplasty surgeon
- Give a proper medical history
- Quit smoking
- Follow the post-operation instructions precisely
Choose an experienced rhinoplasty surgeon
As we mentioned earlier, a surgeon with many years of experience is capable of performing different types of rhinoplasty through appropriate techniques. They have a deep understanding of what the patients desire and will try to achieve their aesthetic goals. They are also highly trained to manage an emergency situation. So it is important to choose your surgeon with proper research. Look at the doctor’s success rates, and before-after pictures, and read patients’ reviews. This way you can find the best rhinoplasty surgeon for you.
Undergoing a nose job with an experienced surgeon may reduce these rhinoplasty risks, but there always be the chance of unexpected events.
Give a proper medical history
During your pre-operation consultation, tell your doctor everything about your health status. Tell them about your previous surgeries, current health conditions and diseases, the medications you take, and your family history if required. Your doctor will consider everything and will make a personalized treatment plan for you. They will tell what to do before the surgery to reduce the risks to the lowest possibility.
Quit smoking
As you already know, smoking has a great impact on the whole rhinoplasty process. To reduce the possible risks it is recommended to quit smoking. If not quitting, stop smoking at least 2 weeks before the surgery. You should not resume smoking until 3 months after the operation. This is to ensure the initial recovery period is completed and your healing process will not be hugely affected by your smoking habits.
Follow the post-operation instructions precisely
Another effective way to decrease rhinoplasty risks is to follow exactly what your surgeon has told you. Attending regular follow-up visits to evaluate the healing process, can prevent many problems. In case of an issue contact your doctor immediately. The faster you act, the lesser the complications will be.
This has been our article on rhinoplasty risks. Hope it could help you find the answer to all your questions. If you still require more information or have more questions, do not hesitate to ask us. We will be overjoyed to help you in your rhinoplasty journey by providing you with the pieces of information you need.
References:
(1) Rettinger G. Risks and complications in rhinoplasty. GMS Curr Top Otorhinolaryngol Head Neck Surg. 2007;6:Doc08. Epub 2008 Mar 14. PMID: 22073084; PMCID: PMC3199839.
(2). Ibrahim Khansa, MD, Lara Khansa, PhD, Gregory D. Pearson, MD, Patient Satisfaction After Rhinoplasty: A Social Media Analysis, Aesthetic Surgery Journal, Volume 36, Issue 1, January 2016, Pages NP1–NP5, https://doi.org/10.1093/asj/sjv095