ASJ Aesthetic Surgery Journal · 2021

Risk of Venous Thromboembolism Following Rhinoplasty

Okland TS, Wadhwa H, Patel PN, Most SP.

What this paper says

Among 55,287 rhinoplasty patients in a national insurance claims database, 111 developed a blood clot, with previous clots, central lines, rib graft harvest, older age and inflammatory bowel disease raising the odds.

Overview

Blood clots in the veins are known to be rare after rhinoplasty, but earlier studies were small and the risk factors were unknown. This population based retrospective study analysed insurance claims from patients who had rhinoplasty between 2007 and 2016, collecting established clot risk factors, demographics, procedural details and the absolute number of clot events.

Sections of note

Retrospective analysis of a nationwide insurance claims database; 55,287 patients from 2007 to 2016.
Mean age 38.74 years, range 18 to 74; 54 percent female.
One hundred and eleven clot events occurred: 70 deep vein thromboses and 41 pulmonary emboli.
Previous clot carried the highest odds ratio, 52.8, 95 percent confidence interval 35.2 to 78.6, P less than 0.0001.
Central line or peripherally inserted central catheter placement had an odds ratio of 19.6, P less than 0.05.
Rib graft harvest had an odds ratio of 4.6, 95 percent confidence interval 2.3 to 8.5, P less than 0.0001.
Age 41 to 60 had an odds ratio of 2.65 and age 61 to 74 an odds ratio of 2.4.
Inflammatory bowel disease had an odds ratio of 2.6, P less than 0.05.

What it means for a patient

Clot risk after rhinoplasty was about 2 per 1,000 patients in this database.
A previous clot was by far the strongest predictor, raising the odds roughly fifty fold.
Taking a rib graft, which lengthens the operation and adds a chest wound, raised the odds around fourfold.
Insurance claims data depends on billing codes, so events and conditions can be missed or miscoded, and the study cannot show cause.

Why this paper matters

Clot prevention protocols in cosmetic surgery are debated because the underlying risk in short elective procedures is low. This is the largest dataset applied to rhinoplasty specifically and it identifies which patients sit above that baseline. Whether preventive treatment changes the rate was not tested.

Terms

Venous thromboembolism: a blood clot forming in a vein and possibly travelling.
Deep vein thrombosis: a clot in a deep vein, usually in the leg.
Pulmonary embolism: a clot that has travelled to the lungs.
Odds ratio: how much more likely an event is in one group than another.
Central line: a catheter placed into a large vein for medication or fluids.

Summary written by rhinoplasty.cc from the abstract, 2026-09-09; not medical advice. The authors' own abstract follows.

From the abstract

“Although prior studies have identified a low risk of venous thromboembolism (VTE) in rhinoplasty, these studies are limited by small samples and associated risk factors remain unknown. Objectives: The aim of this study was to discern the incidence of VTE following rhinoplasty in a large patient population through…”

Excerpt; the full abstract is on PubMed.