Question: What kinds of complications can occur in rhinoplasty?
Answer:
Complications in rhinoplasty may be categorized as functional (related to breathing) or aesthetic (related to appearance); there may be elements of both. Problems after rhinoplasty commonly are due to underresection (not enough taken off), overresection (too much taken off), and/or asymmetry. Also, sometimes abnormal scarring is a problem after rhinoplasty.
In general, it is easier to fix problems relating to under-resection, because they can be fixed by going back and "taking a little more." Problems caused by overresection can be a little more complicated because material needs to be added, and technical factors arising from the need to add tissue must be considered. Asymmetries can usually be improved and at times can be completely fixed.

Question: What can I do before surgery to decrease the risk of complications?
Answer: See Choosing a Plastic Surgeon. Once you have chosen a surgeon, have a candid discussion with the surgeon regarding your goals and expectations of surgery. A discussion of the potential complications is critical, so that you understand the risks of a complication.

Despite the best efforts of a talented surgeon, a complication can still occur. Although most complications are relatively minor and correctable, more serious, debilitating, and uncorrectible complications do occur .

Question: Is there any way to be certain that I won’t have a complication?
Answer: NO. There is no way to be certain that a complication will not occur. For example, unanticipated technical problems can occur during surgery that can lead to a complication. Surgery is not an exact science, and results cannot always be anticipated. Despite careful pre-operative analysis and meticulous attention to surgical detail, unacceptable results may still occur.

No surgical procedure should be taken lightly; a slight but real risk is involved in all surgery. Fortunately, the overwhelming majority of plastic surgery results are highly satisfactory and pleasing when accompanied by careful presurgical planning, meticulous surgery, and full patient cooperation.

Question: What should I expect in the way of communication with my surgeon?
Answer:
The rhinoplasty surgeon must take great care to minimize the incidence of both functional and cosmetic complications. Your surgeon should be willing to take the time to explain the steps they take to minimize the risks of complications.
It is essential that the surgeon knows what the patient wants, and that the patient knows what the surgeon is planning. With this in mind, Dr. Becker has a clear conversation with his patients on this subject. Also, we review Computer Imaging with most patients to improve communication, to make sure the patient and surgeon are "on the same page.”

With computer imaging, Dr. Becker shows the patient an imaging result that is the goal for surgery, and he wants to be sure that the patient agrees to the goal. The patient understands that this is not a guarantee, but that this is our shared goal.

Question: What kind of planning does the surgeon do for my surgery?
Answer:
It has been said that a rhinoplasty surgeon should "perform" the surgery at least 6 times: first (mentally) during the patient’s first office visit, again upon additional reflection, a third time after careful review of the preoperative photography, a fourth time just prior to the actual surgery, a fifth time is the ACTUAL surgery, and then the sixth (and more) times after the surgery as review, "post-surgery analysis."
The patient should try to pick a surgeon who seems to care about and take a special interest in this unique operation, and who has demonstrated skill in the operation.

Question: How can I be sure he is a careful and conservative surgeon?
Answer:
It is difficult to know for sure. However, one should seek a surgeon who demonstrates a conservative approach to rhinoplasty, who avoids over-aggressive resection maneuvers, who focuses on maintaining structural support, who seeks a natural unoperated appearance.

Question: What can I do before surgery to decrease the risk of complications?
Answer:
Choose your surgeon carefully. Once you have chosen a surgeon, have a candid discussion with the surgeon regarding your goals and expectations of surgery. A discussion of the potential complications is critical, so that you understands the risks of a complication. Although most complications are relatively minor and correctable, more serious, debilitating, and uncorrectable complications do occur. Your surgeon will give you instructions for before and after surgery, be sure to follow them.

Question: If the surgeon does everything discussed here, can I be certain that I won’t have a complication?
Answer:
NO. Even if your surgeon does things well, a complication can occur. Just as an airplane can encounter unexpected turbulence, unanticipated problems can occur during surgery that can lead to a complication. Surgery is not an exact science, and results cannot always be anticipated. Despite careful pre-operative analysis and meticulous attention to surgical detail, unacceptable results may still occur.

Question: If I ask my surgeon what percentage of his rhinoplasties are perfect, what answer should I expect?
Answer:
A good surgeon is highly self-critical of his work. One famous master rhinoplasty surgeon was asked, toward the end of a career in which he had performed many thousands of rhinoplasties, how many "perfect" rhinoplasties he had done. After some thoughtful reflection, he replied, "two."
With this in mind, you can imagine that in many cases the surgeon may notice a relatively subtle abnormality that is amenable to correction, but the patient may not even notice it or may not be concerned by it.

For more detailed information, see the Appendix. Also, See Dr. Becker’s textbook chapter entitled Complications of Rhinoplasty

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