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Possible Risks Of Rhinoplasty And How To Prevent Them

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Plastic surgeries, especially rhinoplasty treatments, have been known to go wrong for many reasons. Sometimes it can be because of mistakes made by the surgeon. It can also be because the patients do not do their research properly before going through the procedure and so, are unsatisfied with the results.

Rhinoplasty (more popularly known as “nose job” or nose surgery) is a plastic surgery procedure for correcting and reconstructing the nose, as well as improving the nose aesthetically and functionally. It can change the size, shape, or structure of the nose. It is an incredibly popular treatment and hundreds of people have undergone rhinoplasty surgery. But it is a very tricky surgical procedure, and it is important to get it right the first time. Most of the time, if the primary surgery goes wrong, it can be fixed by revision surgery. Revision rhinoplasty is an extremely complex procedure because once nasal anatomy is changed, it is very hard to re-correct. That’s why it is important to make sure that the surgeon you have selected is qualified and experienced.

Having a skilled rhinoplasty surgeon will increase the chances of a successful procedure, but the results of the procedure also depend on factors like your health, genes, or lifestyle habits. Not following post-surgery instructions also affects the results of the procedure. In this guide, we will discuss common rhinoplasty issues that could come up post-surgery. 

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How Can A Rhinoplasty Go Wrong?

Rhinoplasty is one of the most complicated cosmetic surgical procedures, and it takes years of training, skill, and expertise to perform it correctly. Patients are often dissatisfied with the primary rhinoplasty and have to go for revision rhinoplasty. Here are some complications that arise after a rhinoplasty:

  • Pollybeak Deformity:- Pollybeak deformity (also known as supratip deformity) is the most common cause for revision rhinoplasties. Over-enthusiastic and inexperienced surgeons sometimes fill the little dip above the tip of the nose a little too much. This gives the nose a rounded look, similar to the beak of a parrot.
  • Over-Extended Nose Tip:- This is another common mistake made by inexperienced surgeons. Over-extended nose tip (also called “Pinnochio nose”) is when the patient’s nose sticks out excessively, most often because there is too much cartilage supporting the tip.
  • Knuckling:- Knuckling or tip bossae occurs when the cartilage on the sides of the nose is over-cut, causing it to lose its springiness. This leads to twisted distorted cartilage that creates knuckles or bossae, which are lumpy and unsightly. This is a correctable issue, but most surgeons only provide short-term relief to their patients by cutting more of the cartilage. In time, this makes the cartilage weaker. The ideal solution is to replace the lost cartilage and restore the shape of the nose while also keeping it strong for the future.
  • Nasal Valve Collapse:- The nasal valve is the narrowest part of the nasal airway, located in the middle to lower part of the nose. Nasal valve collapse is also a common issue of “rhinoplasty gone wrong.” It can make it hard for the patient to breathe. Nasal valve collapse often requires a second or even third corrective surgery to fix. A good rhinoplasty surgeon can not only avoid this terrible scenario but can also fix it through corrective surgery for disappointed patients.
  • Distorted Tip:- There are many reasons why the tip of the nose may end up distorted after a rhinoplasty. The surgeon may remove too much cartilage during the procedure, because of which the nose may collapse. It is also possible that the nostrils may become too narrow and will look “pinched.” This can be avoided by choosing an experienced rhinoplasty surgeon.

What are the possible risks of nose surgery?

Like any major surgery, rhinoplasty carries risks like:

  • Anaesthetic Risks: Nose surgery is typically performed under total intravenous anaesthesia (TIVA). We avoid twilight anaesthesia due to its perceived risks.
  • Infection: While rare, infection is a potential complication. Patients are generally prescribed a preventive antibiotic course for the first week post-surgery.
  • Bleeding or Hematoma Formation: Septorhinoplasty poses a small risk of septal hematoma. “Haematoma formation" refers to blood collection outside blood vessels. It can happen after certain surgeries, like septorhinoplasty, and presents as a localised swelling. Early recognition is crucial for prompt treatment, usually manageable in the clinic.
  • Delayed Wound Healing: Smoking increases the risk of delayed wound healing. Smokers are advised to quit at least four weeks before and after surgery.
  • Excessive Scarring: Proper incision placement and post-operative scar management help minimise scarring. Full maturation of scars may take up to 12 months.
  • Numbness of Nose Tip: Temporary numbness or tingling in the nasal tip, often related to post-surgery swelling, typically improves within 3 to 6 months.
  • Persistent Pain: A rare complication, effectively managed with appropriate postoperative pain relief and avoiding activities that may increase nose swelling, especially strenuous exercise shortly after surgery.

Are there any rhinoplasty side effects?

  • Change in Skin Sensation (Numbness): Rhinoplasty may cause temporary changes in skin sensation, such as numbness, especially in the nasal area. This is usually temporary and improves over time.
  • Difficulty Breathing: Some individuals may experience temporary difficulty breathing after rhinoplasty, which is often due to swelling. This usually resolves as the healing process progresses.
  • Discolouration or Swelling: Post rhinoplasty, it's common to experience temporary discolouration or swelling around the nose and eyes. This is a normal part of the healing process and typically subsides with time.
  • Septum Perforation (Hole in Nasal Wall): In rare cases, rhinoplasty can lead to a hole in the nasal septum (the wall dividing the nasal cavities). This condition, known as septum perforation, requires medical attention and intervention.

How To Prevent These Issues?

The ultimate result of the surgery depends on many factors. Candidates with clear complexions, healthy immune systems, strong healing capacities, and the right genes are more likely to have a more satisfying outcome. It is also essential to follow the surgeon’s instructions carefully, both before and after the surgery. But the most important thing is to have realistic expectations.

There is no “one size fits all” with noses. The nose should suit the proportions of the face and blend harmoniously with other facial features. Just because a specific style of nose suits someone, does not mean that the same style will suit you. An experienced surgeon will hear you out and make sure to explain to you the best way to get the results you need. So, it is important to research carefully and select a fully trained and experienced surgeon who will ensure that you understand the possible results and the potential risks and complications.

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Dr. Ashish Davalbhakta is the Chief Plastic Surgeon and Managing Director at Advanced Aesthetics. He has trained internationally, in the US and the UK. He is board-certified and has 20 years of experience as a plastic surgeon. He will provide you with the best treatment and ensure that you will be satisfied with the results. Book an appointment today.

Rhinoplasty Results at Aesthetics Medispa:

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