Preoperative Serotonin Antidepressants Are Associated With Increased Postoperative Complications Following Rhinoplasty: A Propensity Score-Matched Analysis

Zontag N, Skorochod R, Wolf Y.

What this paper says

In 4,917 matched pairs from a global records database, rhinoplasty patients taking serotonergic antidepressants had higher 30-day rates of readmission, opioid use and bleeding or hematoma, but the same one-year revision rate.

Overview

Many rhinoplasty candidates have anxiety or depression and take SSRIs or similar drugs, which affect platelet function. Using the TriNetX Global Collaborative Network, the authors compared adults who had rhinoplasty with documented preoperative serotonergic antidepressant use against those without, after 1:1 propensity matching on demographic and clinical variables. Outcomes were measured at 30, 60 and 90 days and at one year.

Sections of note

4,917 patients in each matched cohort.
Within 30 days: readmission relative risk 1.793 (P = .01), opioid use RR 1.361 (P < .0001), bleeding/hematoma RR 1.596 (P = .005).
The elevated risks persisted at 60 and 90 days.
Revision surgery rates at one year were comparable between groups.
Level of Evidence 3.

What it means for a patient

Taking an SSRI or similar antidepressant was linked to more short-term problems, mainly bleeding and readmission, in this database.
The drugs were not linked to a higher chance of needing revision surgery.
Patients should tell their surgeon about antidepressant use; the study does not say whether stopping the drug helps, and stopping should never be done without the prescribing doctor.

Why this paper matters

It is the largest analysis of antidepressant use and rhinoplasty complications, drawn from real-world records. Limits: retrospective database coding, no information on dose or duration, and association does not prove the drug caused the complications.

Terms

Serotonergic antidepressant: drugs such as SSRIs and SNRIs that raise serotonin levels; serotonin also affects platelet clotting.
Propensity score matching: a statistical method that pairs treated and untreated patients with similar characteristics.
Relative risk (RR): the ratio of event rates between two groups; 1.6 means 60% more events.
Hematoma: a collection of blood under the skin after surgery.
TriNetX: a large network of de-identified electronic health records.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

From the abstract

“Rhinoplasty is a common facial aesthetic procedure, but a high proportion of candidates for rhinoplasty present with anxiety and depressive disorders. Serotonergic antidepressants are widely used to manage these disorders, and recent reports linking these medications to increased postoperative complications suggest…”

Excerpt; the full abstract is on PubMed.