Reducing Complications in Rhinoplasty

The nose plays a functional role in nasal breathing and an esthetic role because it represents the most prominent and central facial feature. That the nose has enormous psychological, emotional, social, and symbolic importance is indisputable [1]. Studies suggest that most rhinoplasty patients benefit psychologically from the operation [1]. Although rhinoplasty can be a satisfying procedure for the patient and the surgeon, the literature reports an incidence of postoperative rhinoplasty complications ranging from 8% to 15%. The rhinoplasty surgeon must take great care to minimize the incidence of functional and cosmetic complications [2–10]. Ultimately, success in rhinoplasty is based on well-developed judgment, wisdom, and accumulated knowledge and experience. Similar to most surgeries, rhinoplasty is a science and an art. Skill comes from experience and wisdom, combined with a measure of talent. The surgeon must have a detailed understanding of the multiple anatomic variants encountered. The surgeon also must have accumulated the appropriate surgical techniques and experience. Specifically, the surgeon must acquire knowledge of the surgical alternatives, and how healing forces affect the result. This skill set is acquired by careful follow-up of operated patients over time. There is no ‘‘standard’’ rhinoplasty. Each operation is unique in that it must be tailored to the specific anatomic components involved and the desires of the patient. By developing a consistent, meticulous routine in which the patient’s nose is analyzed with regard to its anatomic components and their complex interrelationships, the surgeon can best select the appropriate incisions, approaches, and techniques for the patient’s nose.