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.