Postoperative Complications of Rhinoplasty

If there is one thing one should not undermine when considering cosmetic surgery is that there is a slight possibility of encountering postoperative risks and developing complications. Choosing a reliable cosmetic surgeon and strictly following postoperative care instructions can greatly contribute in reducing the occurrence of such possibilities. However, it is still always best that you prepare yourself that this may happen after your procedure.

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Rhinoplasty is by far the one of the most popular surgical cosmetic procedures for both men and women. Despite it being a cosmetic procedure that is performed to enhance on a seemingly simple anatomical facial feature, the slightest mistake can have an impact on the overall aesthetic outcome and functionality of the nose. To say that it is one of the most demanding of facial cosmetic surgeries is an understatement. It requires careful scrutiny of the nose preoperatively, clear judgment on the right technique to use and a meticulous execution of the procedure.

But as stated earlier, the possibility of postoperative complications may likely to happen. Let us look into the possible complications that may arise after a successful rhinoplasty procedure and the factors that can cause it.

Complications that can happen during or after a rhinoplasty procedure are generally divided into four categories.

• Intraoperative – This is a complication that happens during the surgery. This can result from a reaction of certain medicine or due to the type of anesthesia being used.
• Immediate Postoperative – This is a complication that happens immediately after the surgery. When this happens, this needs to be immediately handled by the surgeon.
• Early Postoperative – This type of complication happens the patient has been discharged and upon return to normal routine.
• Late Postoperative – This complication may occur weeks after the performance of the procedure. This can result to poor postoperative care or due to the nose not healing well independently. For both Early and Late Postoperative complications, the patient must immediately seek the surgeon to treat or correct the complications.

Common Postoperative Complications

Excessive Bleeding

This is probably the most common complication that can happen within any of the four types of complications. Intraoperatively, this can happen due to either genetic or acquired coagulopathy, which is a clotting and bleeding disorder where the blood’s ability to clot or coagulate is impaired. Excess bleeding during the surgery can contribute to difficulty in performing the surgery and increase operating time. That is why if you have a history of genetic coagulopathy, this should be discussed during your consultation. Also, acquired coagulopathy is oftentimes drug induced and can be prevented by taking note of preoperative instructions on which vitamins, supplements or medications you should avoid prior to a rhinoplasty.

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Minimal bleeding may occur during the first few days after the surgery. However, this can aggravate with improper or neglecting postoperative care instructions by your surgeon.

Scar Hypertrophy

In a previous post, we have discussed the risk of keloid scarring after a rhinoplasty, which is rare to develop in the nose area. On the other hand, hypertrophic scars, which look similar to a keloid scar, may likely to happen if the procedure uses the open rhinoplasty technique. This usually forms near the columella, the soft tissue between the nostrils, where the incision is made. Again, similar with keloids, hypertrophic scars rarely develops in the nose area and when it does form, this usually fades over time.

If you are concerned with scar formation, you may seek the advise of your doctor to perform the procedure using the closed technique, however, this can cause visual limitations for your doctor.

Tip Deformities

One common possible complication with rhinoplasty is tip asymmetry, where the tip of the nose deviates either to left or to the right causing a noticeable imbalance of the nose symmetry.

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Another complication that can result to the tip of the nose is tip projection deformity, which can be assessed as inadequate or excessive. This can be addressed by your doctor by performing a simple palpitation on the nose tip to determine whether the nasal tip is well supported by septal cartilage. From there, an appropriate surgical course will be determined. Yet another tip deformity is the development of either broad or narrow tip.

Saddle Nose Deformity

This happens when the nasal dorsum, or nose bridge, is too low. This can result from an overaggressive surgery or over reduction of the dorsal septal cartilage, nasal bone or both. This can be corrected by augmenting the nasal dorsum with cartilage or bone grafts or the use of custom-sculpted implants.  

Hanging Columella

A hanging columella, or columella show, can occur for a number of reasons. This can result from an excess caudal septum, excessive medial crural footplate or from excessive or lack of reduction of the membraneous septum. However, if this complication does occur, it can easily be remedied by evaluating the medial crural footplate to see if this is the cause of hanging columella or by appropriate reduction of the caudal septum.

Pollybeak Deformity

Most complications, which include the Pollybeak Deformity, actually arise from over correction of nose abnormalities instead of aiming to achieve for conservative and natural-looking results. This occurs when the area above the supratip, or the tip of the nose on the bridge, over projects when seen on a profile view. This gives the nose a look similar to that of a parrot’s beak.

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This is caused by excess residual septal cartilage, prominent nasal tip cartilage, subcutaneous scar tissue and tip drooping or over-resectioning of the bridge above the supratip. Remedies for this complication include reducing the dorsal septum, removing scar tissue or restoring tip support and projection.  

Breathing Problems

More than the aesthetic-related complications, one of the greatest possible concerns is breathing problems. After all, even if you have achieved a balanced result, but have trouble breathing, then your rhinoplasty is brought to naught and can pose a serious problem. While it is uncommon, airway obstruction can still occur even after recovering from the procedure.

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Breathing problems after a rhinoplasty can occur from the development of scar tissue in the nose, uncorrected deviated septum or collapse of nasal skin because of inadequate support. If breathing problem does happen, seek the help of your doctor to see the cause and so that he can perform the appropriate treatment for this complication.

These are just some of the more common complications that may occur after a rhinoplasty. Medscape has a comprehensive list of other postoperative rhinoplasty complications.

Complications are Extremely Rare

Complications after a cosmetic surgery is indeed something that can cause worry and even hesitation. However, the occurrence of complications is extremely rare, especially when you are in the hands of a well-trained, experienced and credible cosmetic surgeon. Also, a great factor in a healthy recovery and result is following the postoperative care instructions of your doctor.

If you want to get your nose improved without worrying about the high chance of complications, you can rely on Dr. Ahnsup Andrew Kim of Advance Cosmetic Beauty Surgery. Dr. Kim has an extensive experience in performing rhinoplasty and has produced natural-looking results without a glitch from a number of satisfied patients. You can schedule a free consultation with him to discuss how he will safely perform the procedure on you with the appropriate and safe techniques. Call now to book your free consultation with Dr. Kim.

Rhinoplasty: How to Shorten Your Recovery Period

The recovery process is a very crucial part in the success of a rhinoplasty procedure. This final stretch can actually make or break the outcome, and it highly relies on the way you follow aftercare protocols set forth by the surgeon. 

In this article, I will be sharing 8 best tips that you can follow to shorten your recovery period.

1. Arnica Montana

This is a homeopathic treatment that can shorten recovery time because it reduces the swelling and bruising. These two are actually the main culprits for prolonged healing because it also lengthens the time that a wound closes. Arnica comes in two forms, the pill and the cream form. The pill can be taken  several days before and after surgery, while the cream is applied on the surgical site once the wound has totally healed.

2. Bromelain

This is a natural enzyme that is derived from pineapples, and it can significantly reduce swelling and pain. Just like arnica, this treatment can also be taken a week prior to surgery and one to two weeks after surgery. Bromelain is marketed under a variety of brands in the market today.

3. Elevate your head.

Elevating your head is also important in reducing swelling because it drains the excess fluids, which is a result of healing. Thanks to the force of gravity, fluids will naturally flow out of your system reducing swelling and bruising.

Related Post: Asian Rhinoplasty- The Risks of Using Nasal Silicone Implants 

4. Avoid foods that would require a lot of chewing.

It is advisable to keep steaks off bay as you heal from rhinoplasty because the constant motion can create strain on the area.

5. Lessen the intensity of your exercise regimen for at least two weeks after nose surgery.

It is best to avoid strenous exercise for the first two weeks after surgery. Doing this can lengthen healing time because it stresses the body out. Take it easy, and let your body heal. Also, rigorous exercise just might damage the result with all the movements that you make.

6. Steer clear from hot showers.

Hot showers are not advisable during the initial weeks of healing because the hot temperature can only worsen the swelling. It is also important that you keep hot water from hitting the surgical site directly because these areas are still fragile.

7. Keep your glasses off for the meantime.

If you wear glasses, it is best that you keep them off for the first three weeks after the cast has been removed. This is to avoid any pressure on the healing structures underneath. Every surgeon has their own time frame, so it is best to clarify this with your surgeon first.

8. Make sure to inform you surgeon of all the medications you are taking.

It is very important that you inform the surgeon of any medications or supplements that you are taking. Some of these medications may cause bleeding or it could generally prolong healing time. When your surgeon is informed of these, he can coordinate with your primary care physician on temporarily stopping the medication or going for alternatives.

Post – Rhinoplasty Questions and Answers

Right after your new nose is revealed, you may feel a sense of disappointment or even horror. 

And you may ask yourself these questions:

What if things gone wrong?

What if I will not be satisfied with the result?

In this article, I will be sharing answers to frequently asked questions after getting rhinoplasty surgery. In this way, you will not be powerless over your worry and anxiety after getting the procedure. Though I recommend that you take up these concerns with your surgeon.

How long is the recovery period for rhinoplasty?

The recovery process will differ for every individual, and it will also vary depending on the procedure done. But usually it would take a full year before you can have the final result. However it doesn't mean that you’ll end up being a hermit for the entire duration. The nose will look normal but the process of healing internally will often take 12 months, sometimes even more.

What possible risks should I prepare for?

Temporary swelling and bruising is something that should be expected after the procedure. Other potential problems associated with rhinoplasty include bleeding, skin necrosis, complications to anesthesia, scarring, nasal blockage, septal perforation and infection.

What can I do to safely reduce recovery time?

Yes, it is possible to reduce your recovery time and you can do this safely too. You can take arnica tablets so that swelling and bruising can be minimized. You can also do the same by taking pineapple extracts and vitamin C supplements, sleeping with your head elevated and immediate application of cold compress over the area.

Related: Pre-Rhinoplasty Questions and Answers

How can I effectively conceal bruising during recovery?

Makeup will be a very good friend when to cover up bruising. Take note that bruising will still be present for months, although it may lighten over time. But you don’t want any sign showing that you had something don right? So try concealing products like BB creams, concealers and foundations.

What activities should I avoid during the recovery period and how long should I steer clear from them?

You should not do heavy lifting or any contact sports during the early recovery period. However, most patients can do light activity such as driving, go out in public or does office work within days after surgery. Full contact sports should be avoided for 6 months, but light exercises can be done after a few weeks.

Every surgeon has their own recommendations or post-surgical recovery protocols, and you have to follow these accordingly because surgeons also base their instructions on your particular case.

What if I will not be satisfied with the result?

If you find your rhinoplasty result short of what you expect, you can ask your surgeon about revisions. It is best to take this up during consultation so that you will know if he does revisions for free, or if you have to cover part of the expenses. Usually surgeons would wait a couple of months before they perform a revision.

How many possible revisions can I get?

Surgeons can’t give you an absolute number as to when a rhinoplasty will become dangerous or more at risk to fail. But it is always true that complication rate increases the more surgeries are perform. The number of revisions will also be dependent on the soft tissue, and with the subsequent procedures done, this can cause the skin to thin out. 

Factors that may affect the rhinoplasty revision surgery is the formation of scar tissue and the type of rhinoplasty done. For example, reductive rhinoplasty will make revision more difficult because it does not restore structural support. 

How many months after my first surgery can I get a revision?

Generally, surgeons would wait at least 6-12 months before a surgical revision is done. Within this time, the nose can undergo some physical changes, and scar maturation will also take place. These will determine re-operation. It also takes months for certain bumps, lumps and asymmetries to disappear and the final result can be observed.

For any other questions, please make an enquiry by calling (02) 9280 3632. We offer patient financing and free consultation to our valued patients.