Understanding Rhinoplasty

To understand how rhinoplasty can be a risky surgery, it’s important to first evaluate how your surgeon performs the procedure. Start by touching your nose, feeling the bones, skin and cartilage underneath. To reshape your nose, your surgeon must adjust each of these somewhat to achieve a slightly smaller or larger nose.

The surgical approach taken depends on your goals. Your surgeon may choose to make cuts inside your nostrils or in the septum that connects your nostrils to reach your nasal bone and adjust its appearance. If needed, your surgeon can harvest cartilage or bone from other body areas to build up a certain area in appearance.

You can take steps long before your surgery to minimize recovery time, according to A. Dean Jabs, MD, Ph.D., FACS, an American Board of Plastic Surgery-certified plastic surgeon practicing with Cosmetic Surgery Associates, P.A., based in Bethesda, Md., and McLean, Va.

“Eating a healthy diet is one of the key factors to skin healing time,” Dr. Jabs says. “Also, not taking aspirin or other medications that have blood-thinning side effects can reduce bleeding risk following surgery. Always disclose all medications, both prescription and over-the-counter, you are taking.”

Rhinoplasty Risk: Bleeding

If you’ve ever had a nosebleed, you know all too well how many blood vessels are present in your nose. While your surgeon will make every effort to minimize damage to blood vessels, it’s likely these may be disturbed during the rhinoplasty surgery. During a typical rhinoplasty surgery, you may lose about 50 mL of blood, which is about one-seventh a can of soda. You also may experience blood loss after surgery. Something as simple as sneezing too hard or forgetting your doctor’s instructions and blowing your nose can affect the damaged blood vessels and lead to bleeding. Although this occurrence is rare, it is possible to experience a post-rhinoplasty nosebleed that causes you to lose enough blood to need a blood transfusion or that results in severe symptoms. Talk to your doctor about the medications you are taking because certain medications, such as aspirin, can temporarily thin your blood and make you more likely to experience blood loss.

Rhinoplasty Risk: Anesthesia Reactions

Your doctor uses anesthesia during surgery to minimize discomfort and allow him to operate without fear for your safety or pain. The anesthesia type depends on your surgery. Local anesthesia that numbs only the nasal area will make you groggy, but not fully asleep, and is used for less-invasive surgeries.

If your surgeon is going to have to take a more-invasive approach, general anesthesia may be the best option. General anesthesia involves administering medications that will render you in an unconscious state, similar to a very deep sleep. Anesthesia can have a variety of risks — some people do not respond well to the medications, and they can cause nausea, constipation or allergic reactions that affect your breathing. If you’ve had a negative reaction to anesthesia in the past or your family members have a history of anesthesia reactions, always inform your surgeon.

Rhinoplasty Risk: Nasal Obstruction

Since rhinoplasty changes the appearance of your nose, it’s possible the surgery also can change the airflow in and out of your nose. If the area is too large, this can cause nasal mucus crusting that makes breathing harder. Scarring also can occur from the incisions in the nostrils that may cause scar tissue to develop and obstruct your nasal passages.

Rhinoplasty isn’t always for cosmetic purposes — the surgery also can help to correct a deviated septum or other airway obstructions that keep you from breathing at your best. While the aim of your rhinoplasty may be corrective, it’s possible the surgery will not effectively clear your airway obstruction.

Rhinoplasty Risk: A Result You Don’t Love

If your goal for rhinoplasty is an improved cosmetic result, there’s always the chance that when your skin heals, you may be unhappy with the outcome. This is where honest, open communication with your surgeon is most vital. Discussing your limitations and realistic expectations with your surgeon can ensure this risk does not come true. Many surgeons often use computer-imaging systems or a demonstration on your nose to provide you with projected imaging for how your nose should look post-surgery.