Incidence of Postoperative Adverse Events after Rhinoplasty: A Systematic Review

Overview

Consent forms list rhinoplasty complications but no source quantified how often each occurs. Without that, patients cannot assess their risk and consent is incomplete. This registered systematic review assembled the first comprehensive quantitative account of adverse events after rhinoplasty.

Sections of note

• Registered on the PROSPERO database, registration CRD42018081826, in April 2018.
• Eligible articles were peer-reviewed with available abstracts and full text, covering primary functional, aesthetic, and combined rhinoplasty.
• Data extracted: study size, population characteristics, indication, surgical approach, concomitant procedures, and incidence of adverse events.
• 3,215 publications were screened by title and abstract; 322 went to full-text review; 36 met final inclusion criteria.
• 13 adverse events were reported across those studies.
• Reported ranges: need for revision 0 to 10.9 percent, infection 0 to 4 percent, wound separation 0 to 5 percent, bleeding 0 to 4.1 percent.
• Also: septal perforation 0 to 2.6 percent, nasal airway obstruction requiring revision 0 to 3 percent, hypertrophic scarring 0 to 1.5 percent.

What it means for a patient

• These are ranges across studies rather than single rates, so the true figure depends on the surgeon and the operation.
• Revision is the most common of the listed events, reported up to about 1 in 9.
• Only 36 of 3,215 screened publications reported adverse events well enough to include, which itself indicates how poorly they are reported.
• Limits: heterogeneous study designs and definitions, so the ranges reflect reporting differences as well as real variation.

Why this paper matters

Meaningful consent requires numbers, and this is the first attempt to supply them systematically for rhinoplasty. The wide ranges are themselves the finding: reporting is inconsistent. The authors call for standardized adverse event reporting to narrow them.

Terms

• Adverse event: An unwanted outcome occurring after treatment.
• Systematic review: A structured search and appraisal of all studies on a question.
• PROSPERO: An international register where systematic reviews are recorded before they begin.
• Septal perforation: A hole through the wall dividing the two sides of the nose.
• Dehiscence: A surgical wound separating rather than healing closed.