Rhinoplasty can change a small structure with several jobs: the nose supports the airway, contributes to facial proportion and contains bone, cartilage, skin, lining and blood supply in a compact space. That is why a useful discussion of risk has to go beyond a generic list.

Some effects—such as swelling, bruising and temporary congestion—are expected during recovery. A complication is an unwanted event or problem that may require monitoring, medication, a procedure or further surgery. The line between them depends on severity, duration and the individual clinical situation.

If you have already had surgery: follow the instructions provided by your treating team. Seek urgent advice for heavy or persistent bleeding, breathing difficulty, fever, rapidly increasing swelling, worsening redness, severe or escalating pain, visual symptoms, chest pain, shortness of breath or any symptom your surgeon has told you to report. In an emergency, call 000.

Is rhinoplasty safe?

There is no surgery without risk. Safety is not simply a yes-or-no question; it depends on the individual patient, the type and complexity of the procedure, the anaesthetic, the surgical facility, the experience of the treating team, and the care available if recovery does not follow the expected course.

A surgeon should explain both the potential benefit and the material risks that matter to you. That includes uncommon risks if their consequences would be serious, as well as the possibility that the result may not meet the agreed goals. A suitably conducted consultation can reduce avoidable risk and clarify uncertainty, but it cannot eliminate either.

The practice’s rhinoplasty procedure page covers assessment, techniques and recovery. This article is intentionally narrower: it is designed to help you prepare for an informed-consent conversation.

Expected recovery effects are not the same as complications

Commonly expected during healing	Needs prompt clinical advice when
Swelling and bruising around the nose or eyes	Swelling increases rapidly, is markedly one-sided, affects vision or comes with severe pain
Nasal blockage while tissues are swollen or splints are in place	Breathing difficulty is severe, worsening or different from the expected post-operative plan
Small amounts of blood-stained discharge early after surgery	Bleeding is heavy, persistent or not controlled by the instructions provided
Tenderness, pressure, stiffness or temporary altered sensation	Pain is severe, escalating, unexpected or associated with increasing redness or fever
An uneven appearance while swelling settles	A new structural change follows a knock or there is concern about wound or skin healing

This table cannot diagnose a complication. The instructions from the treating surgeon and hospital take priority because they reflect the operation actually performed.

General surgical and anaesthetic risks

Rhinoplasty shares risks found in other operations. These can include bleeding, infection, delayed wound healing, unfavourable scarring, pain, reactions to medicines or dressings, blood clots and anaesthetic complications. The likelihood and consequence vary with health, the extent of surgery and other factors.

Your surgeon and anaesthetist need a complete account of medical conditions, previous anaesthetic problems, allergies, prescribed and non-prescribed medicines, supplements, nicotine use and recreational drugs. Do not stop a prescribed medicine because of an online article. The relevant clinicians should provide an individual plan.

Risks specific to rhinoplasty

Possible nose-specific complications include:

Persistent or new nasal obstruction: swelling can block the nose temporarily; longer-term breathing difficulty can have structural or mucosal causes.
Septal perforation: a hole in the septum may cause crusting, bleeding, whistling or obstruction and can be difficult to repair.
Change in smell: smell can be reduced or altered; permanent loss is uncommon but possible.
Altered sensation: numbness or discomfort may affect the nose, upper lip or upper front teeth and can persist in some cases.
Skin or wound-healing problems: poor blood supply can cause delayed healing, scarring or skin injury. Nicotine exposure can increase wound-healing risk.
Contour irregularity or asymmetry: the bridge, tip or nostrils may remain or become uneven as tissues heal.
Structural weakness: inadequate support can affect shape or airway function.
Visible scarring: external incisions can heal as widened, raised, discoloured or otherwise noticeable scars.
Persistent swelling: subtle swelling can continue for many months, particularly in the nasal tip.
Dissatisfaction or need for revision: further treatment may be considered for a functional problem, healing change or result that remains outside the agreed goal.

The Australian Society of Plastic Surgeons and Healthdirect both list breathing difficulty, altered sensation or smell, scarring and possible further surgery among the matters that should be discussed before nose surgery.[1][2]

How often do rhinoplasty complications occur?

A single percentage cannot describe every patient or operation. Published studies use different definitions, follow-up periods, techniques and patient groups. Complication reporting may also miss events treated elsewhere or after a study ends.

A systematic review of 36 studies reported wide ranges across primary functional, cosmetic and combined rhinoplasty: revision from 0 to 10.9%, infection from 0 to 4%, bleeding from 0 to 4.1%, septal perforation from 0 to 2.6%, and nasal obstruction requiring revision from 0 to 3%.[3] These figures describe the included literature, not Dr Mohaghegh’s results and not your personal risk.

Ask the surgeon for an estimate relevant to the proposed operation and your health. It is reasonable to ask how the practice defines a complication, what follow-up captures and how a problem would be managed.

What can change an individual risk profile?

Risk is influenced by more than the operation’s name. Factors that may matter include:

medical conditions that affect bleeding, circulation, immunity or healing;
smoking, vaping or other nicotine exposure;
medicines and supplements that affect clotting or anaesthesia;
skin thickness and the strength of the existing nasal framework;
a substantial deviation, previous fracture or functional obstruction;
previous rhinoplasty and the presence of scar tissue;
the amount and source of any cartilage grafting;
combined procedures and the length or complexity of surgery; and
the ability to follow restrictions and attend post-operative reviews.

Revision rhinoplasty has a different planning context because normal anatomy may have been altered and septal cartilage may already have been used. The separate revision rhinoplasty guide explains those considerations without treating revision surgery as a routine extension of primary rhinoplasty.

Open and closed approaches have different trade-offs—not a universal winner

An open approach includes a small incision across the columella as well as internal incisions. A closed approach uses incisions inside the nostrils. The choice affects access and scar location, but neither label by itself predicts the quality or safety of the result.

Published evidence does not support turning the approach into a simple “safer versus riskier” marketing claim. The required correction, anatomy, surgeon’s reasoning and execution all matter. Ask why the proposed access is suitable for the work planned and what approach-specific risks apply.

Questions to ask before giving consent

About the plan

What exact anatomical concerns are you proposing to treat?
Is the aim cosmetic, functional, reconstructive or a combination?
What alternatives are reasonable, including no surgery?
Which parts of my concern are unlikely to change?

About personal risk

Which risks are most relevant to my health and anatomy?
How might my medicines, nicotine exposure or medical history change the plan?
Could this operation worsen nasal breathing?
What uncertainty comes from previous injury or surgery?

About the surgeon, facility and anaesthesia

What is your registration and recognised surgical specialty?
How often do you perform the proposed type of rhinoplasty?
Where will surgery take place, and is the facility appropriate and accredited for the procedure?
Who will provide the anaesthetic and post-operative care?

About complications and aftercare

What symptoms should prompt a routine call, an urgent review or emergency care?
Who can I contact after hours?
How often will you review me, and for how long?
If a complication or revision occurs, who manages it and what costs could arise?

The Australian Government also provides a printable list of questions to ask before cosmetic surgery.[5]

Recovery and aftercare are part of risk management

A written recovery plan should explain wound and splint care, medicines, activity restrictions, follow-up and warning signs. Arrange practical support before surgery, not after you discover that driving, work, caring duties or exercise are restricted.

Swelling can take many months to settle, so early appearance is not the final result. Use the practice’s rhinoplasty recovery guide and swelling timeline as background only; your own discharge instructions remain the authority.

Australian safeguards for cosmetic surgery

Patients seeking cosmetic surgery in Australia need a referral from an independent GP or another non-cosmetic medical specialist. The Medical Board’s requirements include at least two pre-operative consultations, at least one in person with the doctor performing the surgery, and a cooling-off period of at least seven days after informed consent before the surgery can be booked or a deposit paid.[4]

Assessment also includes psychological suitability and screening for body dysmorphic disorder using a validated tool. If screening identifies significant concerns, independent evaluation may be required. These are safety measures, not administrative hurdles.

Frequently asked questions

Can rhinoplasty make breathing worse?

It is possible. Swelling commonly blocks the nose temporarily, while structural narrowing can cause persistent obstruction. Airway support should be considered during planning, particularly when breathing is already limited.

Is revision surgery always a complication?

No. Revision may be considered for a complication, residual concern, healing change or a result that remains outside the agreed goal. The reason, timing and expected benefit need a new assessment.

Can choosing an experienced surgeon remove the risk?

No. Qualifications, relevant experience, sound assessment and appropriate facilities matter, but they cannot make an invasive operation risk-free or guarantee a result.

Is non-surgical rhinoplasty safer?

It is a different procedure with a different risk profile. Nasal filler can cause serious vascular complications and cannot correct structural obstruction. Surgical and non-surgical options should not be compared as though one were a risk-free substitute. See the dedicated non-surgical rhinoplasty safety article.

What if I am not ready to accept the risks?

Do not proceed. Cosmetic rhinoplasty is elective, and choosing no surgery or taking more time is valid. Consent can be withdrawn.

About the clinical reviewer

Dr Mohammad Hassan Mohaghegh is a registered medical practitioner and Specialist Plastic Surgeon with specialist registration in Surgery—Plastic Surgery. His qualifications are MD, MPhil and FRACS (Plast); AHPRA registration MED0001627149.

For general procedure information, read about rhinoplasty at the Edgecliff practice. An individual consultation is required to discuss suitability, risks, alternatives and expected recovery.

This article is general education for adults and is not medical advice or a complete consent document. All surgery carries risks. Individual risks, recovery and results vary, and no outcome can be guaranteed.

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Rhinoplasty Risks and Complications: Questions to Discuss Before Surgery