Rhinoplasty - Complications
- Undercorrection. The most common complication of rhinoplasty is undercorrection of a large nose, or inadequate refinement of the nasal tip. Sometimes there is a persistent irregularity of the dorsum (see "Redo Rhinoplasty") or a profile that remains suboptimal. These are amenable to reoperation. It is important to recognize that skin thickness will limit the degree of refinement possible in patients with thicker skin and attempts to thin the skin are dangerous. Prudence can be a virtue.
- Overcorrection is usually a more difficult problem to deal with than undercorrection and usually calls for the use of grafts. We have all seen example of over-resection among celebrities. It is important to avoid this because it is much more difficult to restore a natural appearance for an overly resected nose than it is to further refine a nose. Rebuilding is much more difficult than trimming down.
- Infection. Because of the excellent blood supply of the nose, infection is unusual. Sometimes an infection can develop in the presence of an implant and will only clear up after removal of the implant. (See Patient K.T.)
- Scarring. Intranasal scars are concealed within the nose and therefore not visible. The columellar scar used in the open rhinoplasty usually heals well and is not very conspicuous. When the nostrils are narrowed, there are scars at the nostril bases. These incisions are usually placed in the natural crease around the base of the nostril to hide them.
- Body Dysmorphic Disorder is not a physical complication resulting from cosmetic surgery. It is a psychological condition - an obsession with a physical detail that seems insignificant to others, but starts to consume an inordinate amount of a patient's time and attention. A patient with body dysmorphic disorder will never be satisfied, regardless of the surgeon's skill and efforts. Unfortunately, this problem invariably comes to light after surgery, not before. Most plastic surgery patients and surgeons tend to be perfectionists. It is perfectly acceptable for a patient to be discriminating, as long as this perfectionism does not become an obsession that defies realistic expectations. Patients suffering from this disorder are not good candidates for cosmetic surgery.