Showing posts with label nose surgery risks. Show all posts
Showing posts with label nose surgery risks. Show all posts

Friday, 6 June 2014

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.

Image source: http://www.cosmopolitan.com/


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.

Image source: http://www.clker.com/


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.

Image source: http://uxash.wordpress.com/


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.

Image source: http://www.unitedmask.com


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.

Image source: http://homeremedies4everything.blogspot.com/


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.

Wednesday, 10 October 2012

Medpor Nose Implants and the Risk for Infection


“infection rate was extremely high and startling” explained by Dr Andrew
Dr. Andrew Winkler who is a cosmetic surgeon from the University of Colorado in Denver spearheaded a research regarding the infection rate of nose implants. What spurred the research was the increasing incidence of the implants protruding from the surgical wound, making the area vulnerable to infection. The popular brand that was observed to have an increased amount of infection than originally expected is Medpor.

In the study they found out that in as much as five nasal surgeries which used Medpor nasal implants resulted into infections. What happened is that the surgical wound was compromised due to the implants poking out from them. It then creates a good entry for bacteria, which can lead to mild to serious infection.

Medpor is one of the popular nose implants in the US alongside Gore-Tex. The study, which was the largest of its type concerning synthetic nasal implants, showed that the incidence rate of infection was quite alarming. That is why Dr. Winkler along with other colleagues found the need to look into this matter so that proper caution can be given to the patients.

He said that Medpor nose implants can still be used as an option but additional caution and education should be provided by the surgeon to the patients.

During the study, researchers found that there were 151 cases of nasal surgeries that used Medpor and Gore-Tex. It was established that Medpor has a higher infection compared to Gore-Tex, with the first having 19%, while the latter only has 5%. There were a total of 19 infections that developed infections and all but one showed the implants protruding through the wound.

What causes this is that Medpor is made out of a firm material in order to support and improve the structure of the nose. It is a high density polyethylene that is also porous in nature. That is why it is more prone to poke through the skin.

Gore-Tex is flimsy by nature as it is made out of polytetrafluoroethylene. It is inserted at the ridge of the nose to add height to the entire structure.

Grafting may be a good option, but Dr. Winkler suggests that it may not be as practical as when they use implants. A graft is when a piece of the patient’s nose, ribcage, or ear cartilage is removed in order to be placed into the patient’s nose. There may be complications involved but these are minimal, however it is expected to cost more because it requires more incisions.

The problem when these implants cause infection is that in order to relieve it, the patient has to undergo another operation yet again to remove or replace the nasal implants. An antibiotic treatment would not suffice that is why reopening of the wounds would have to be done.

But there are also others who say that the results of the studies are simply blown out of proportion because the numbers are actually low. This is not significant enough to cause alarm. They claim that what creates the problem is that there is an increased risk for infection due to the need of another surgery for corrective purposes.

Another is that the tissues of the nose have already been tampered with that is why it is at a higher risk for complications.

However according to Dr. Winkler this information is still very valuable and it will serve as a caution to those who are planning to get Medpor nose implants for rhinoplasty. This should be part of the planning process because it cannot be avoided that there are cases that would need the particular hold and structure that a Medpor implant creates.

If you have questions about rhinoplasty in Sydney and Melbourne, contact us at:

Advance Beauty Cosmetic Surgery, Sydney

Enquiry Hotline: (02) 9280 3632
Physical Address: Suite 2/270 Elizabeth St. 
Surry Hills. NSW 2010

Advance Beauty Cosmetic Surgery, Melbourne

Enquiry Hotline: (02) 9280 3632

Physical Address: Suite 636/1 Queens Rd. 
St Kilda Tower. Melbourne. VIC 3004