Q. What side effects are there if this is my first nose surgery?

Hello. I’m Director Seo Chan-eol of AB Plastic Surgery.

Today, I’d like to look at something that first-time nose surgery patients may be curious about.

For those considering their first nose surgery, the word that likely feels especially relevant and that many of you have searched a lot is “side effects.”

You may have seen many words like “it will definitely get worse,” “your nose will get blocked,” “it will become crooked,” or “the tip will drop,” all of which create worries.

To give you the conclusion first: "It is possible, but the chances are low, and if you manage things well before and after surgery, it can be minimized." Let’s take a look at the side effects of first-time nose surgery.

Among the possible side effects, the biggest issue is inflammation.

Inflammation is also one of the causes of contracture, which I’ll explain later. In some cases, acute inflammation causes the nose to swell or turn red, requiring implant removal. In other cases, chronic inflammation with no symptoms can excessively form scar tissue and create a contracture nose.

Inflammation is mostly under 1%, but it is difficult to predict. However, to reduce this likelihood, surgical factors must be minimized. It is necessary to use preventive antibiotics, perform the surgery in a clean sterile environment, and reduce risk factors such as bleeding during the operation. In addition, it is helpful for patients to avoid smoking and drinking for at least one month to reduce these risks.

Silicone, the most common implant material, does not cause inflammation at a higher rate than other materials. It is a safe material that has been used in medicine for a long time, and since older L-shaped implants are no longer used, this frequency can be said to have decreased even further. However, if there are unusual findings after surgery, such as the nose swelling or turning red, or increased nasal discharge without a clear cause, like a pimple that appears on the face after excessive fatigue or strenuous activity, it is important to visit the clinic and take immediate action.

The second issue is that the implant may move or become crooked.

When you raise your head, the columella, which is the bridge of the nose, and the nasal tip may appear crooked, or when viewed from the front, the nasal bridge may appear generally shifted to one side. In such cases, physical impact may have been applied before the implant fully settled, or if the existing bone structure or facial axis is asymmetrical, this may have been insufficiently taken into consideration.

Also, if the height is made too high, the structure may not withstand the force and can become bent or drop. For these reasons, it is important to confirm through preoperative examinations and to adjust expectations through sufficient discussion with the surgeon. If such problems occur, revision surgery may be needed to adjust the implant position or reinforce the supporting structure using cartilage, dermis, and similar materials.

The last issue is contracture.

If contracture occurs, it can appear in various forms, such as a upturned nose, asymmetry of the nostrils, or the tip or outline of the implant becoming visible. When an implant is inserted, a capsule forms around the implant as part of a normal immune response, enclosing it and separating it from the surrounding tissue. In addition, after surgery, inflammation, hematoma, and individual constitutional factors can lead to scar tissue forming inside.

If these reactions progress excessively, deformities can occur due to the capsule and scar tissue. The nasal tip cartilage and skin may be pulled upward, shortening the nose and creating an upturned nose shape. Because these changes are asymmetrical, asymmetry of the nostrils can occur. The skin of the nasal tip may be compressed by the implant and become thin and visible. If it becomes more severe, the skin around the implant may be pulled inward, making both sides of the implant’s outline visible.

In the early stages, it is important to carefully check for inflammation or swelling and to monitor the condition regularly. If deformity occurs due to contracture, revision surgery can be considered.

Today, we looked at the possible side effects of nose surgery. In the end, because problems such as side effects, though rare, are more often exposed in the media, it seems only natural that people become more afraid. And because of these concerns, many people hesitate about surgery and instead undergo procedures such as thread lifting or fillers. However, there are inevitably clear limitations to how much such procedures can improve shape or function.

If you proceed with the right surgery after accurate preoperative examinations, consultations, and planning, and then follow proper post-operative care, you can minimize these side effects and have a stylish, beautiful nose. You can also see review photos of various noses on the hospital website. I hope this was helpful, and I’ll end here.