Revision Rhinoplasty Risks
Although higher than in primary rhinoplasty, revision rhinoplasty overall has a low rate of complications. Individual surgeon’s results may vary widely, however. That’s why it is important to find an experienced surgeon with superior surgical judgment and meticulous technique, honed over years of specialized practice.
These are perhaps the most important risks your surgeon will discuss with you:
- Bleeding may be the most common risk of rhinoplasty or revisional rhinoplasty, since blood vessels may be damaged during each surgery. Most patients lose a small amount of blood during surgery and a very few may experience significant post-surgery blood loss. In the absence of a bleeding disorder, blood loss almost never rises to the level needing hospitalization or blood transfusion. Usually, nasal packing for 12-36 hours is all that’s needed. Blood-thinning medications, even mild ones like baby aspirin, can cause excessive bleeding, so you will be instructed to avoid certain prescription and non-prescription drugs and herbal supplements. Be gentle with your nose during the healing process, since forceful blowing of your nose or bumping the nose can also cause bleeding.
- Adverse anesthesia reactions are avoided when a highly qualified anesthesiologist administers general anesthesia (typically needed for revision rhinoplasty). Top surgeons work with only the best anesthesiologists to ensure patients are well cared for and properly monitored throughout the rhinoplasty procedure. General anesthesia involves both intravenous medications and an airway-protecting breathing tube. A physical exam prior to surgery to make sure your health is good and the investigation of any prior anesthesia reactions that you or your family members may have experienced helps forestall any problems.
- Nasal blockage or the sensation thereof can occasionally occur. As your nasal contours are reshaped, changes may need to be made to the septum and, in some cases, the overall size of your nose may need to be reduced. There will be initial swelling and numbness that may contribute to temporary breathing difficulties, which typically resolve as swelling decreases and you become accustomed to your new nose. In some cases, the nasal septum may be perforated or a weakened nose may collapse. Impeccable surgical technique and proper patient selection usually prevent these major problems. Scar tissue from initial and/or secondary rhinoplasties may narrow the airway. Rarely, a graft may slip out of place and partially block the nasal passage. A careful pre-surgery exam and detailed, well-executed surgical plan can prevent these complications in most cases. Make sure to describe any breathing problems you may have to your surgeon to ensure the complete repair of internal abnormalities.
- Infection is a rare risk since the nasal blood supply is fundamentally robust. Compromised nasal lining, prior drug use, scarred soft tissue coverage and the need for grafting can complicate matters. To help prevent problems due to infection, patients are instructed to watch for symptoms, such as a fever, excessive swelling, odorous nasal discharge or pain—and contact their surgeon right away.
- Dissatisfaction with the outcome is a risk that can be minimized with clear surgeon-patient communication and a meticulous well thought out plan prior to surgery. Unrealistic expectations are managed by a straightforward surgeon who honestly explains the improvements that can be achieved with corrective surgery. The corrections depend upon your desires/expectations, the quantity and quality of remaining tissue and structural support, scar tissue from prior surgery, the thickness and elasticity of skin and many other variables. Make sure the result your surgeon describes matches closely enough with your goals—and that your goals are realistic—before going forward with surgery.