Side Effects of Rhinoplasty – How Risky Is a Nose Surgery?

Whether motivated by cosmetic reasons, to correct breathing issues, or to repair damage from an injury, rhinoplasty can significantly improve a person’s quality of life and boost their self-confidence. Rhinoplasty is considered a relatively safe surgery, and every year, hundreds of thousands of individuals worldwide turn to this procedure, underscoring its popularity.

However, as with any surgical procedure, it has to be noted that rhinoplasty is not without potential side effects. While many people focus on transformative results, it’s equally essential to consider the risks and recovery process. (1)

This blog post aims to provide a guide on the potential risks and side effects of rhinoplasty to aid patients in making informed decisions about their health and well-being. Knowledge is, after all, the first step towards a safe and satisfying surgical journey.

Potential Side Effects and Risks of Rhinoplasty

Short-term Side Effects

1. Swelling and bruising: Following rhinoplasty, swelling and bruising are the most common side effects patients experience. This usually occurs around the nose and under the eyes. While the severity of bruising and swelling can differ between individuals, depending on factors like their health status and the specific surgical technique employed, it generally begins to subside after the first week. Full resolution of swelling, especially minor residual swelling, can take up to a year.
2. Pain and discomfort: Post-operative pain is typically present but is usually mild to moderate and can be effectively managed with medications prescribed by the surgeon. Most patients describe a feeling of congestion or pressure rather than significant pain. Remember that everyone’s pain tolerance is different, and it’s important to communicate with your healthcare team if your discomfort is not adequately controlled.
3. Bleeding and stuffiness: It’s normal to experience some degree of bleeding from the nose during the first few days after surgery. Your surgeon will provide specific instructions on how to handle any bleeding that may occur. Alongside this, you may also experience stuffiness due to swelling inside the nose, similar to the feeling of having a cold. This sensation is temporary and generally improves over several weeks as internal swelling subsides.

Long-term Side Effects

1. Difficulty in breathing: Rhinoplasty, particularly when performed for cosmetic reasons, can occasionally lead to functional issues such as difficulty in breathing. This could be due to a number of factors, including excessive removal of tissue, alteration in the structural support of the nose, or development of internal scar tissue. It’s essential to discuss this potential side effect with your surgeon, especially if the purpose of your surgery is to improve nasal breathing.
2. Numbness: Numbness or altered sensations in the skin of the nose can occur after rhinoplasty. This is usually temporary and improves over several months as nerves regenerate. However, in some cases, these changes may be more prolonged or even permanent.
3. Scarring: All surgeries result in some degree of scarring. In rhinoplasty, particularly the open approach, a small scar is usually present on the underside of the nose. However, experienced surgeons place these incisions strategically to ensure the scars are as inconspicuous as possible. Over time, these scars often fade and become less noticeable.

Serious Risks and Complications

1. Anaesthesia risks: Rhinoplasty typically requires general anaesthesia or sedation, which carries its own set of potential risks. These can range from minor side effects like nausea, vomiting, and dizziness to rare but more serious complications such as allergic reactions, cardiovascular events, or breathing problems. A thorough pre-operative evaluation, including a discussion with the anaesthesiologist, will help minimise these risks.
2. Infection: Although postoperative infections are rare due to the rich blood supply of the facial region and the use of prophylactic antibiotics, they can occur. Symptoms may include persistent pain, prolonged swelling, redness, or the presence of pus. It’s important to contact your surgeon promptly if you suspect an infection, as it could lead to serious complications if not treated.
3. Unsatisfactory aesthetic result: Despite thorough planning and discussion, there’s a risk that the final result may not meet the patient’s expectations. This could be due to unforeseen healing issues, pre-existing asymmetry, or miscommunication in the desired outcome. In some cases, a secondary or revision rhinoplasty might be considered to make further adjustments. This highlights the importance of having clear and open communication with your surgeon about your expectations.

Understanding these potential side effects and risks can help you prepare for the procedure and recovery process. It’s crucial to have an open and honest discussion with your surgeon about all these possibilities before deciding on surgery. The next section will discuss strategies to manage and minimise these potential side effects.

Managing and Minimising Side Effects

Despite the potential side effects and risks associated with rhinoplasty, many can be managed effectively with appropriate care and precautions. A patient’s journey towards a successful rhinoplasty doesn’t end in the operating room; it continues well into the postoperative period.

Pre-operative care and precautions

Preparing for rhinoplasty plays a crucial role in minimising potential side effects. First and foremost, choosing a qualified and experienced plastic surgeon ensures the procedure is performed safely and competently.

Before the procedure, patients should maintain a healthy lifestyle, which includes a balanced diet, regular exercise, and avoidance of smoking, as these factors can significantly impact the body’s ability to heal.

Avoiding certain medications and supplements that increase the risk of bleeding, such as aspirin, non-steroidal anti-inflammatory drugs (NSAIDs), and Vitamin E, is also advised.

Finally, having a detailed discussion with your surgeon about your medical history and medications can help them plan for any potential complications.

Post-operative care and treatment

Adhering to the post-operative instructions provided by your surgeon is paramount in minimising side effects and ensuring a smooth recovery. This may include:

• Pain management: Using prescribed pain medications as directed can effectively manage discomfort.
• Reducing swelling and bruising: Elevating the head, applying cold compresses, and avoiding strenuous activities can help reduce swelling and bruising.
• Wound care: Keeping the surgical site clean and dry is crucial to prevent infection. Follow your surgeon’s specific instructions regarding wound care and cleaning.
• Follow-up appointments: Attend all follow-up appointments so your surgeon can monitor your healing progress and promptly address any issues that may arise.

Importance of following surgeon’s instructions

Your surgeon’s instructions are tailored to your specific case and should be followed closely. They are designed to ensure your body has the best conditions for healing and to help you avoid potential complications. Whether it’s the type of food you should eat, medications you need to take or avoid, or specific activities you should or shouldn’t engage in, these guidelines play a vital role in minimising side effects and achieving a satisfactory outcome.

Remember, the key to a successful rhinoplasty involves not only the surgery itself but also the care and precautions taken before and after the procedure.

FAQ

Is rhinoplasty permanent?

Yes, the changes made to your nose during rhinoplasty are generally permanent. However, several factors may influence the long-term outcome.

1. Healing Process: The body’s natural healing process can somewhat alter the initial results. The final shape of your nose will gradually emerge as the swelling subsides, which can take up to a year and even longer in some cases. Small changes can continue to occur for up to a couple of years.
2. Age: As we age, our face, including the nose, undergoes changes. The skin loses elasticity, and there can be shifting in facial fat and bone structure. These normal ageing processes can slightly modify the appearance of the nose over time.
3. Trauma: Any significant trauma to the face could potentially alter the results of a rhinoplasty.
4. Lifestyle Factors: Certain lifestyle factors like significant weight fluctuations or smoking can also affect the long-term results.
5. Revision Rhinoplasty: In some cases, patients may choose to undergo a secondary or revision rhinoplasty to make further adjustments or corrections to the initial results.

Can rhinoplasty go wrong?

Yes, like any surgical procedure, rhinoplasty carries certain risks and potential complications, and in some cases, it can go wrong. Potential issues include anaesthetic complications, bleeding, infection, poor wound healing, or an unsatisfactory aesthetic result. Sometimes, the surgery might lead to structural problems or breathing difficulties, or the final outcome might not align with the patient’s expectations.

These risks underline the importance of choosing a qualified and experienced surgeon, communicating effectively about expectations, and following all pre-and post-operative care instructions. If a patient is dissatisfied with their rhinoplasty result, a revision rhinoplasty may be considered, although this tends to be more complex than the initial surgery.

What is the success rate of rhinoplasty?

Rhinoplasty generally has a high success rate, both in terms of functional improvement (like breathing issues) and cosmetic satisfaction. However, quantifying an exact success rate can be challenging as it heavily depends on patient satisfaction, which is subjective and can vary greatly.

Some studies suggest that up to 80-90% of patients report being satisfied with their surgical outcomes. However, a smaller percentage, around 10-15%, might seek revision surgery, often due to aesthetic dissatisfaction or unmet expectations rather than medical complications.

Keep in mind that the “success” of rhinoplasty is a complex combination of patient satisfaction, improvement in quality of life, and absence of complications, among other factors. This emphasises the importance of clear communication with your surgeon about your expectations and understanding the potential risks and outcomes.

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Sanjay Rai

Sanjay is a Senior Clinical Member at Berkeley Square Medical carrying over a decade of experience. He has assisted over 1500 surgeries carried out at the hospital supporting patients both pre and post-surgery throughout their treatment journeys. This article was written with the contribution of Dr Taimur Shoaib, our Consultant Plastic Surgeon.

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