Nasal Surgery (Rhinoplasty)

Common Risks

Complications involving nasal surgery are unusual. With all surgical procedures, however, there exists the remote possibility of complications. Fortunately, most are troublesome but temporary. Rarely serious, most complications resolve with simple treatment, the passage of time, or sometimes further surgery. The most common complications are:

1. Bleeding—
   Slight oozing of blood may be expected for several hours to a few days following surgery; however, heavy bleeding is unusual and treated with head elevation, quiet, and patience. If persistent, packing may be necessary. If aspirin and aspirin-containing products are avoided for two weeks before and after surgery, this complication is very rare, occurring in about one out of one hundred (or 1%) of cases in our experience.
    
2. Infection—
   Antibiotics are usually administered just before, during, and after surgery to prevent infection. Still, mild nasal infection occasionally occurs, requiring further antibiotic treatment, in one out of fifty cases. In rare instances, an infection may extend to sinuses, bone, or cartilage, possibly requiring further antibiotics, hospitalization, or additional surgery.
    
3. Breathing difficulty—
   Most common during the first few weeks before swelling has resolved, breathing difficulty can also result from persistent septal deviation, bone enlargement, polyps (growths created by fluid accumulation), and scarring between the septum and nasal bones. This usually resolves with time, although correction may require further surgery.
    
4. Septal perforation—
   When extensive septal work is performed to straighten a distorted septum, small holes can develop, causing whistling or crustiness. This condition is unusual but correctable by further surgery if necessary.
    
5. Undesirable shape or irregularities—
   Six months to a year may be required before the nose stabilizes and the final shape can be discerned. It is important to withhold final judgment until sufficient time has passed to allow complete healing and resolution of swelling. If revision surgery is indicated (in about 2% of cases) it can be performed at that time.
   
   If swelling is the complaint, conservative measures (i.e. the passage of time, taping, dilute Kenalog injections) should be exhausted before a second surgical procedure is attempted. Palpable irregularities due to bone or cartilage healing often resolve if given sufficient time. Application of digital pressure for ten seconds once or twice per hour while you are awake will assist in the resolution of swelling and irregularities. Use your index finger and gently apply continuous pressure. (Do not exert pressure to the point where you hurt yourself.) The softer areas will begin to flatten first; the harder areas may take longer. You can also use your index fingers or thumbs to gently pinch the sides or tip of your nose to decrease swelling.
    
6. Deviation of the nose—
   In some cases, deviation of the nose can only be completely corrected with major bone and cartilage reconstruction. This is due to springiness or "memory" of the cartilage. Most people have a slight deviation to their nose, and correction is not usually necessary.
    
7. Skin reactions—
   Small pimples, tape reactions, and small spider veins occasionally develop and are easily treatable. Less common are increased or decreased pigmentation and scarring from pressure or prolonged tape reaction. If you notice any unusual skin irritation, notify our office at once.

Again, complications are unusual. The vast majority of our patients are very pleased with their new, natural looking nose and improved breathing.

A NOTE ON SATISFACTION AND DISSATISFACTION
It is important that you work with the doctor to establish realistic appearance goals. More than seventy items contribute to a surgical result. With aesthetic surgery, good results are nearly always achieved. When you are willing to reserve final judgment for a period of six months to a year, our results are usually excellent.

Beautiful paintings and sculptures by world-renowned artists have small imperfections, but these are rarely scrutinized. Instead, one sees the overall beauty and mastery of the art. In order to remain natural looking, cosmetic surgery will result in small imperfections when closely scrutinized. To avoid these, the doctor would have to use techniques such as over-correction and distortion of the features. Instead, we utilize an artistic approach while maintaining your safety. We strive for a youthful, yet natural look—the mark of an artist.

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