incredible-marketing Arrow

6 Biggest Rhinoplasty Risks

Rhinoplasty, or nose job, continues to be the number one facial cosmetic surgery performed in the United States. This frequency means the public should be aware of risks, and the 6 biggest risks from a rhinoplasty was recently highlighted in an article from Realself. Since rhinoplasty is the most common surgery I perform, I thought it would be a good idea to review these here.

#1 Nosebleeds, or epistaxis. Bleeding is very common after a rhinoplasty, but it should be minimal. A nasal drip pad that catches the oozing is all that is required and frequently bleeding stops after a few days. However, a major nosebleed- called epistaxis- is a true emergency. This is nonstop frank bleeding that persists despite pressure. The incidence is low, ranging from 1% to 3%, but it’s very patient-dependent. Those with preexisting bleeding disorders, those who bruise or bleed easily, and those who take certain medications or supplements are at a higher risk of epistaxis. If this occurs, you need to seek medical attention immediately. Treatment depends on the severity; light to medium packing for one to four days is common. Rarely, a patient may need to be anesthetized so that an endoscope can be inserted, to see where the bleeding is coming from, and heat cauterization may have to be used to stop it. If you want to minimize risk of epistaxis, it is crucial you follow your surgeon’s instructions on medications and supplements to avoid both before and after surgery.

# 2 Septal perforation, or when a hole develops in your septum, is another major risk of a surgery that involves septoplasty—or surgery of your septum. The incidence is also rare, with studies quoting anywhere from 1% to 5%. It’s rare that the hole is big enough to cause an issue. But it this happens, the perforation usually manifests around three to six months after surgery. Symptoms usually include a whistling noise when breathing, nose bleeds, trouble breathing, and nasal crusts. A history of trauma to the nose, past surgeries, having a severely deviated septum, and intranasal drug use before or after surgery can all increase the risk of this complication. Treatment options range from conservative ointment and sprays to revision surgery. Fortunately, most perforations don’t require surgery because surgery to repair a septal perforation is a technically challenging surgery.

# 3 Worsened breathing after surgery is not a good complication. Fortunately, rhinoplasties performed by experienced board-certified surgeon carry very low risk of this happening. But if nasal valve integrity is not respected during surgery, developing worse nasal airflow can occur and can be very bothersome. Your surgery might have gone well, but if your nose looks better but you are breathing way worse, that is not a good scenario. Significant nasal obstruction can have a serious negative impact on your quality of life. Treatment also depends on the reason, but commonly a revision surgery to improve nasal function may be the only option to improve your breathing. You should keep in mind however that any revision nasal surgery carries higher risks of dissatisfaction and failure. That is why experienced rhinoplasty surgeons respect proper nasal function and reinforce or reestablish function when they do rhinoplasties the first time.

# 4 Altered sense of smell or taste is very rare—much less than 1%. Bear in mind you will experience temporary loss of sense or taste in the immediate recovery period because your nose will be congested. However, no return of your sense of smell or taste months postop is very rare. Unfortunately, there are no treatments to fix this.

# 5 Skin discoloration is another uncommon but unpleasant complication after a nose job. If this does occur, it most likely will be seen around the tip of the nose and the nostrils. Usually, one sees red skin or skin that has a bluish-purple shade, a result of damage to the blood vessels in the area. Again, skin discoloration is quite rare, and is much more likely to occur in people who have had multiple nose surgeries or who have a history of filler in the nose because every time you cut through that vascular supply during a surgery or even push on it with filler, you’re traumatizing and weakening the blood vessels of your nose. Unfortunately, there’s no way to fix this. And keep in mind that if you already have this type of discoloration and are seeking another rhinoplasty, your surgeon may not be willing to do another surgery. Damaging that blood supply even further can lead to the skin dying, which becomes a major problem.

#6 Need for revision surgery is the sixth biggest risk from rhinoplasty. Rhinoplasties are considered the most challenging cosmetic surgeries due to the intricate details of your nasal structures and how even millimeters of changes can result in unintended consequences. Studies cite revision rates of anywhere from 5% to up to 30%. Reasons why a revision are necessary can be due to patient-surgeon miscommunication, challenging patient anatomy, or the surgeon’s inexperience with certain techniques applicable to that patient’s specific anatomy. You also need to know that the likelihood of dissatisfaction, failure and any of the other, aforementioned risks increases with each and every revision.

No surgeries carry zero risks of complications. However, in the hands of an experienced board-certified facial plastic or plastic surgeon, your risks of major complications will be low. The odds of you having a successful outcome outweigh the risks of bad complications.

For more information about San Antonio rhinoplasty, please visit our interactive website at Dr. Kenneth Yu Facial Plastic and Reconstructive Surgery is a qualified team of experts serving the San Antonio, Texas area. To schedule a consultation, please contact our Concierge Patient Coordinator at (210) 876-6868 or