Surgery is carried out under general anaesthesia with an overnight stay in the hospital. The procedure lasts around 2 to 3 hours. The risks of general anaesthesia include clots to the legs (deep vein thrombosis) and very rarely clots in the lungs (pulmonary embolus), and we take several precautions to minimise these risks. The other risks of general anaesthesia include chest infection. The risk of a life-threatening complication under general anaesthesia is approximately 1 in 100,000.
The risks relating to rhinoplasty surgery itself include:
Bleeding – This can occur during or after the operation and rarely (less than 1 in 100) may require a return to theatre. Heavy bleeding may require a blood transfusion. Bleeding can also occur in the first few weeks after surgery if there is an infection affecting the lining of the nose.
Rarely blood can collect between the lining of the nose and your septum and can become infected (septal haematoma/abscess risk: less than 2 in 100).
Infection – The surgical site can become infected, and this usually settles with antibiotics. Deep infection can also occur and very rarely this can lead to the collapse of the bridge of the nose and require re-operation.
Swelling and bruising – Swelling and bruising are to be expected, and most of the swelling settles by six months. Residual swelling may be present up to 18 months after surgery particularly at the tip of the nose.
Breathing difficulty – Sometimes breathing can be worsened, and there is a higher chance of this if you already have problems with breathing or allergic rhinitis. In most patients with pre-existing breathing problems, we aim to improve breathing after surgery rather than worsen it.
Scar – You will have a permanent scar on the under surface of your nose (columella), and very rarely this may be red and thickened. The scars from the cuts inside your nose are hidden.
Numbness – It is common to have small areas of numbness, and these usually recover with time.
Reduced sense of smell – Uncommon (less than 1 in 100 risk) and usually recovers with time.
Under or over correction – Removing too much or too little tissue.
Unsatisfactory cosmetic outcome – It is essential to have realistic expectations of what can be achieved. The healing process is difficult to predict, and it can take up to 18 months before everything settles completely. A residual hump can come back, or nasal bones can thicken if you have overactive bone healing. Scar tissue can prevent your skin from shrinking to the right size. There may also be minor irregularities that you can see or feel under the skin.
Perfection is rare in rhinoplasty surgery, and free revisions will only be offered to correct complications or outcomes that fall below what is expected of a typical result. Revision surgery will not be provided to correct minor imperfections.