Yes. Rhinoplasty is one of the more technically demanding operations in facial surgery, and every patient accepts a degree of surgical risk. Understanding that risk properly is part of deciding whether to proceed.

It helps to separate two different things: the effects that are part of normal healing and happen to almost everyone, and the complications that are uncommon but can occur.

What to expect during normal healing

These are not complications. They are the expected course after surgery.

Swelling and bruising. Swelling around the nose and eyes is greatest in the first few days. Most visible swelling settles over the first six to eight weeks, but residual swelling continues to resolve for twelve months or longer, particularly at the tip. Patients with thicker skin take longer. This is why the photographs in our gallery state how long after surgery each was taken, and why a nose at six weeks does not look like the same nose at twelve months.

Nasal congestion. Internal swelling makes breathing through the nose difficult for the first one to two weeks. This is temporary and does not indicate that the surgery has failed.

Numbness. Reduced sensation in the nasal skin and tip is common and usually settles over several months.

Discomfort. Most patients describe the pain as moderate and manageable with simple analgesia. Pain that worsens after the first week should be reported rather than tolerated.

Complications

Bleeding. Minor bleeding in the first days is common. Significant bleeding is uncommon but occasionally requires treatment.

Infection. Uncommon after rhinoplasty. Where it occurs it is usually treated with antibiotics, and rarely requires further surgery.

Residual irregularity or asymmetry. This is the most common reason patients are dissatisfied. The nose is a three-dimensional structure and small changes in one area affect others in ways that are not entirely predictable. Revision surgery is required in up to 10 per cent of cosmetic rhinoplasty cases.

Breathing changes. Rhinoplasty alters the internal structure of the nose as well as its appearance. Breathing can be improved, but it can also be made worse, particularly where the nasal valve is narrowed. This is one reason functional assessment is part of every consultation rather than an optional extra.

Changes to smell. A temporary reduction in the sense of smell is common while the nose is congested. Persistent change is rare.

Septal perforation. A hole in the septum, which can cause whistling, crusting or bleeding. Uncommon, and more likely where septal surgery has been performed previously.

Scarring. In open rhinoplasty there is a small scar across the columella, between the nostrils. In most patients this fades to become difficult to see. Poor scarring is uncommon but possible.

Anaesthetic risk. Modern general anaesthesia is very safe. Serious complications are rare, and your anaesthetist will discuss your individual risk before surgery.

The result may not be what you hoped

This is worth stating plainly, because it is not the same as a complication. Surgery can go technically well and still not produce the outcome you imagined. The final shape of the nose depends on your skin thickness, your underlying anatomy and how you heal, none of which are fully controllable. This is why we discuss what is realistically achievable before surgery, and why Dr Oosthuizen will decline to operate where he does not believe surgery can deliver a worthwhile improvement.

What reduces risk

Choosing a surgeon with specialist qualifications and experience in nasal surgery specifically. Being honest about your medical history, medications and smoking. Following post-operative instructions, particularly around avoiding trauma to the nose. Attending your follow-up appointments, so that anything developing is identified early.

When to contact us

Contact us rather than waiting if you develop worsening pain after the first week, fever, bleeding that does not settle, increasing redness or swelling of the nasal skin, or any sudden change in vision. These are uncommon, but they need to be assessed rather than monitored at home.