Rhinoplasty like any operation, may has some complication. The complication may be due to the surgeon, patient, the operation itself and nose healing.
Some complication we can avoid and some are not. But when complications occur , we can deal with it.
One of the complication is patient unsatisfaction with the result. In other word, the patient is unhappy after rhinoplasty surgery.
The patient is unhappy after rhinoplasty surgery because the result didnot meet his high expectation or there were some complications occured after surgery.
So, one of most important step before rhinoplasty surgery , is good consultation. In the consultation before surgery, patient and doctor should agree with each other about the expectation after surgey. If the patient had high expectation, and this expectation was difficult to achieve from the surgeon side of view, then the surgeon should be honest with the patient and tell him what he can do and how he can reach with the surgery result. The patient and doctor should meet in the same point of expectation about the surgery.
An example of lowering the patient high expectation, if the patient had thick skin and broad nasal tip ( boxy tip or bulbous tip ), the patient may expect that nose job or rhinoplasty can make his nasal tip very defined and small. This is called high expectation, and the doctor should tell the patient that he cannot do this because of his thick skin. The result will be moderately good but not like what the patient expect.
Another example, when the patient had severe crooked nose. The patient may expect that, the nose will become straight 100% after surgery. But this is very difficult to achieve this straight nose, and there will be very small asymmetry. This is because the memory of cartilage and bone to return to their nature curvature and deviation affect the result even if the nose become corrected at the end of surgery.
Another category of complications and problems after rhinoplasty is related to the operation itself like nose bleeding , nose infection, nose skin injury, allergy , skin necrosis, nasal cyst, nasal surface irregularity, the nose become crooked, nostril irregularity or asymmetry , nasal retraction, over shortening of the nose, over rotation of the nose, nose drop, nasal saddling, nose edema, implant or cartilage show under thin skin, difficult breathing, nasal valve collapse, loss of smell, septal perforation and nasal deformities after years of rhinoplasty or nose job.
Nose infection after rhinoplasty or nose job can be avoided by strict following surgeon's instruction after surgery. First before surgery, the nose should be examined and if there is discharge purulent and nasal congestion or inflammation, surgeon should prescribe some medication before surgery and the operation postponed until the inflammation subside.
After surgery, the surgeon prescribed prophylactic antibiotic to avoid infection of the wound. If there was no nasal pack, the patient instructed to clean his nose by cotton tip applicator soaked with saline and antibacterial ointment like bactroban ( bactricin). The patient should clean the outer skin incisions and intranasal. This will prevent nasal crustation, bacterial colonization, and nasal infection.
How could we know that there is infection or the posoperative period is not well? How could we suspect that there is infection?
If there were nose pain which increase in severity over the time, nasal oedema and the nose tip become over swelling and red in color, purulent discharge appear comming from nasal opening, then we should suspect nasal infection, cellulitis or nasal abscess. We should call and visit our surgeon to confirm if there is infection. If the infection was in its early phase, medication and irrigation can be prescribed. If there was abscess, the nose should be drained and cleaned in the operating room.
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