Hello! My name is Mike Tyler and I'm going to talk to you about the complications of an open Rhinoplasty. We've already discussed the reasons why you might want to have a Rhinoplasty operation and we've also discussed what you have to go through when you have a Rhinoplasty operation. So I would like to just talk about the risks, it is very important you understand the risks before having any form of voluntary surgery. The risks can be divided into two groups, those that are associated with any operation because you are having a general anesthetic, and those that are specific for a Rhinoplasty operation.

Now those that are associated with any operation because of the anesthetic can be very, very rare. Most anesthetics are very safe. However, the most common and perhaps one of the most significant that I always mention to patients is the risk of the DVT. DVT stands for Deep Vein Thrombosis and it's the same as economy class syndrome that you may have heard of, and it's basically a clot that you get in your leg from result of immobility. You can get it for a number of reasons, traveling economy class, hence its name, to America, you can get it traveling on a bus, you can also get it when you are pregnant but anesthetic is known as a low risk factor. We take precautions against that, we give you flight stockings, we give you, but you can't get that risk absolutely to zero. So that is a small risk I think you have to take on board. The rests of the risks with anesthetic are extremely rare, an allergic reaction to anesthetic or untoward events and I am not going to discuss those any further, although if you have any specific concerns about anesthetics then obviously please feel free to contact us and we can discuss this with you.

Now those risks that are specific to the Rhinoplasty operation itself, again I am going to divide into those which occur immediately, and those which perhaps occur over a bit of time. In the first instance, the nose is a very vascular structure so there is always a risk of bleeding, that is why we keep you overnight because if you do get any bleeding after the operation, the nurses and the surgeons, myself, all the team can deal with the bleeding. It will be very rare, but it has happened that we have to take you back to theater if the bleeding was sufficiently large. Again, that's very rare, it is not something I personally have had to do yet in my career.

The other risk is associated with a Rhinoplasty, there's always a risk of infection. Infection is most common around about day five and you would notice the infection because the nose would get very swollen and very painful and probably your eyes would also puff up. Infections can range from a little bit of redness, that I would give you antibiotics for which settles very quickly, to serious infections. Very, very rarely there are people that have had significant infections in the base of their nose after a Rhinoplasty operation and that is something that we know is available and that is something that we wish to treat, that's why we wish to treat any infections long before it gets too serious, but out there in the world there are patients who have had serious infections after a Rhinoplasty operation and again it is something that you would just have to be aware of.

Wound healing is another complication of any surgery, thankfully the nose is very vascular and therefore it usually heals beautifully, but occasionally some patients do have some areas that do take a little bit longer to heal. Very rare that this actually affects the end result. People also notice the different amounts of swelling and although everybody gets swelling, some patients will get more swelling than others that takes them longer to settle down. So, swelling is another risk that you would undertake or prolong swelling. The nose will be numb, so again it is possible to injure the nose, especially in exposure to strong sunlight you can sun burnt without noticing it, or you can injure it perhaps in other ways. So one has to be a little bit careful, that's another risk factor.

I think one of the other main things to take on board with a Rhinoplasty is the affect of the operation cannot be absolutely guaranteed and it is very important to be aware of what the surgeon is trying to achieve and make sure that that corresponds with what you wish to have done to your nose. So most plastic surgeons that do Rhinoplasty operations have a revision rate, in other words a number of patients who come along and there is a little aspect of the operation that needs to be changed. Thankfully, if you have surgery as we do at BMI hospitals any change that we do within a year are done free of charge on the original price.

The sorts of things that I have had to do myself in the past for patients are perhaps if I have had a patient with a very large nose who I have made smaller and wish to have it smaller still, and we give that as a revision. The other things that I have noticed occasionally we have little bits of cartilage that would involve, that would just give you a little hard edges, so occasionally have had to go back in and do a little rasp just to notice the little imperfection on the dorsum of the nose. We obviously take a great deal of care in making sure that when we discharge the patient. They're as happy as we can possibly make them.

Those are the main risks. Obviously, that's not an exhaustive list but I think those are the key factors that you need to be aware of. Obviously, we'll be giving you more information if you decide to go ahead with the operation and if there's anything you would like to ask us about please don't hesitate to contact us. Thank You.