What Happens when Rhinoplasty Goes Wrong?


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The first thing to remember if your Rhinoplasty hasn't gone right is not to panic. It is often reversible and the problems are minor and sometimes even unnoticeable (the irregularities being internal). Occasionally, however, the problems can be more than minor. The problems that can occur with Rhinoplasty include abnormal nose shape, infections, harm to the nerves, numbness and excessive scarring. It is generally believed that of those who have complications in their Rhinoplastic surgery, around 20% will need to have a second Rhinoplastic surgery, known as revision Rhinoplasty. If you need to have this second procedure then it is advisable that you wait at least a year before having it, and that you look for a surgeon who specialises in revision surgeries.

There are a number of different mistakes that can be made in Rhinoplasty; the most common of them have been listed below

Pollybeak Deformity

The first mistake that is made is called the 'Pollybeak deformity.' This is where the little dip above the tip of the nose is too full. It is called a Pollybeak deformity because when the dip is filled in it causes the nose to turn down giving it a beak like look. The causes of all Pollybeak deformities are preventable and can be caused by a number of mistakes. The first is through the surgeon not reducing the cartilage around the tip of the nose enough. The second cause may be the surgeon is too aggressive in reducing a nose that has thick skin. When this happens the skin does not contract and fill out over the nose like it should and so the area gets covered by a thick layer of scar tissue.

The Scooped Out Bridge

The second mistake that is often made in Rhinoplasty is called a 'scooped out bridge'. It is thought to be the most common mistake that is made in Rhinoplastic surgery, and normally occurs after reduction surgery. A scooped out bridge occurs when the surgeon files down the bump on the bridge of the nose too much. This mistake is more of a problem for men than women because it creates a feminine looking nose. One of the reasons this occurs is because many surgeons still use a chisel or an osteo-tome. This is because the use of the chisel means that when the surgeon performs the operation they have to take off everything they want in one go. Though this is mitigated through the use of a file rather than a chisel, many surgeons still prefer the use of the chisel making this problem fairly common. This mistake can be easier to make through closed Rhinoplasty as the operation occurs inside the nose and the bone is being taken from beneath the skin rather than above, making it harder for the surgeon to see what he or she is doing. The effect of a scooped out bridge is a childlike visage when viewed from the front; cartilage from other parts of your body is used to rebuild the bridge returning it back to normal.

The tip of the nose

The third problem is actually a series of related problems, all of them to do with the tip of the nose. Problems occur with the tip of the nose when there has been overly aggressive surgery which results in the tip becoming distorted and lacking the support that it requires. These problems normally occur when the surgeon has removed too much cartilage in an attempt to make the tip narrow; this can be seen in effect with Michael Jackson's nose which collapsed repeatedly. If too much cartilage is removed from the tip of the nose then it can become unstable or even collapse. Loss of too much cartilage can result in many complications and problems arising with the surgery including distorted nostrils, and the tip of the nose becoming too narrow and pinched looking. This is reversed through placing back some of the cartilage that has been removed, thus bringing the nose closer to its natural shape.

Over Extension of the Tip of the Nose

The fourth problem that occurs with Rhinoplasty is the over extension of the tip of the nose. This problem commonly occurs when patients get rid of the bump on the nose only to discover that this has caused the tip to become too prominent. Unfortunately fewer surgeons are trained in tip reconstruction or even simple Rhinoplasty on the tip because it requires more complex techniques to get the effect you desire.

Tip Bossae or Knuckling

The fifth mistake that can be made is called tip bossae, also known as knuckling. This is where the cartilage on the side of the nose is cut so aggressively that it becomes deformed and losses its' spring. This is a problem because over time the cartilage that is left becomes twisted and distorted under the weight of the skin. As the cartilage twists it creates 'knuckles' of cartilage under the skin that are called bossae which are visible as lumps. To fix this problem many surgeons cut away more of the cartilage which though a good solution for the short term, merely serves to weaken the cartilage in the long run. Instead of doing this, some surgeons opt instead to replace the cartilage and thus make the nose stronger. Though this can restore the cartilage in the nose and reverse some of the nose job, in the long run it is a far better solution.

Nasal Collapse

The sixth type of mistake that is made during Rhinoplasty, or occurs as a result of Rhinoplasty is nasal valve collapse. This is where the nasal cavities at the narrowest part of the nose collapse due to being weakened during the operation. A further operation is required to fix this problem.

Twisted Nose

The final mistake that will be discussed is a twisted nose. The twist can occur anywhere from the nasal bones right up to the top of the nose and the tip. It is one of the most difficult tasks of Rhinoplasty to get a nose completely straight, and is even more difficult when attempted through revision surgery. If the cartilage in the bone is twisted then it can be corrected through strengthening the cartilage with sutures.

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