Rhinoplasty after trauma: doubts, costs and what really changes

Rhinoplasty: the doubt between fixing the nose or the self-esteem

Is it worth getting a nose job when the problem is no longer the nose? A facial trauma at 13 left a noticeable deformity and a teenage years of mockery at school. At 18 he wanted to go under the knife, but there was no money. Years passed, he normalized his new look "reluctantly" and now, with money, he is considering rhinoplasty again. His conclusion, written without embellishment: the physical changes of having a more harmonious face "I don't think would shape my life at all".

The consultation with an aesthetic medicine doctor is two days away. And that's where the first serious warning begins: aesthetic medicine is not surgery. A rhinoplasty should be performed by a specialist in Plastic, Aesthetic and Reconstructive Surgery or an ENT doctor with facial surgery training. The second warning is functional. A nose deformed by a blow almost always has a deviated septum, and the person telling the story doesn't know if he breathes worse than before the accident because he has no memory of how he used to breathe. If there is obstruction, septoplasty is covered by public healthcare and the aesthetic part can be resolved in the same operation: septorhinoplasty.

What are the risks of rhinoplasty and how many are revised

The figure that slows things down most is not the price, it's the probability of going back to the operating room. Revision rates in rhinoplasty usually range between 5 and 15%, and in post-traumatic cases they tend towards the higher end because the cartilage and bone were already damaged. With surgeons who perform many per year, the figure drops. You should ask the doctor's own percentage, whether a touch-up is included in the price during the first year, and how long to wait before judging the result: 12 months, because many early failures are swelling that hasn't gone down yet.

The other risk is smell. Temporary loss is frequent due to inflammation and nasal packing, and when smell drops, taste drops too; in the vast majority of cases it recovers. Permanent loss is documented but rare. Different is touching the turbinates: removing too much tissue can cause the so-called empty nose syndrome, the sensation of not breathing even though the nose is open. That's why today the tendency is to reduce the turbinate without removing it.

Does changing the face change the life of the person who has surgery?

Here the analysis splits. Some argue that changing the face doesn't change the past: that what is sought is to undo the schoolyard mockery and an operating room doesn't fix that, it just leaves the same man with another nose and considerably less money. Opposite is the less sentimental reading: if the deformity has conditioned self-esteem since age 13, having surgery is an investment in mental health, not a whim. The man himself offers the nuance that unsettles both sides: his relationships with women amount to two in his entire life, but he doesn't know whether the nose is crucial in that or whether the burden was the self-esteem it caused him.

With the consultation just around the corner, the state of affairs is this: doubts, a pending ENT appointment and no rush. Seeing a second surgeon costs nothing. Having surgery, that does.