Unintentional Complications After Uneventful Rhinoplasty Operations: Case Reports and a Review of the Literature

Overview

Some complications after rhinoplasty are unrelated to how the operation itself went, and surgeons may not recognise them. The authors searched their records of 1,400 patients operated over eight years and present four such cases, together with a review of similar events reported in the literature.

Sections of note

• Records of 1,400 patients operated from 2007 to 2015 were reviewed.
• Cases 1 and 2: a 26-year-old woman and a 30-year-old man developed herpes simplex virus infections after first-time septorhinoplasty.
• Case 3: a 25-year-old woman developed periorbital emphysema, air trapped in the tissue around the eye, after first-time rhinoplasty.
• Case 4: a 22-year-old woman developed a second-degree burn on the bridge of the nose.
• All four patients healed without lasting damage or scars.
• The literature review lists other reported events including bleeding disorders, allergic reactions, dermatitis, visual loss, gastric bleeding, positional vertigo, false aneurysm, air within the skull, Tapia's syndrome, cavernous sinus syndrome and skin reactions to suture material.

What it means for a patient

• These events are rare. Four occurred among 1,400 operations at this centre, and each of the four resolved fully.
• A cold sore outbreak can be triggered by surgery in someone who already carries the virus, which is why history taking matters.
• The list of reported events from the literature includes some serious ones, but these are individual case reports rather than measured rates.
• The authors' recommendations, careful history taking, consistent routines, radiological examination and frequent follow-up visits, are stated rather than tested.

Why this paper matters

Rare complications only enter practice through published case reports, and a surgeon who has never seen one may misread it. Assembling four from a defined denominator of 1,400 operations gives a rough sense of how uncommon they are. Whether the suggested precautions actually prevent them is untested.

Terms

• Herpes simplex virus: the virus causing cold sores, which can reactivate after surgery.
• Periorbital emphysema: air trapped in the soft tissue around the eye.
• Second-degree burn: a burn damaging the skin below its surface layer.
• Septorhinoplasty: rhinoplasty combined with straightening of the nasal partition.
• Sequel or sequela: a lasting consequence remaining after an illness or injury.