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Rhinoplasty - Medical Negligence Solicitors - Cosmetic Surgery


Negligent rhinoplasty surgery, colloquially known as a 'nose job gone wrong' occurs when a there is a less than satisfactory outcome from cosmetic surgery carried out on the nose due to a clinical error or negligent failure by a plastic surgeon. It should however be noted that an unexpected outcome from cosmetic surgery does not necessarily mean that the surgical procedure was carried out negligently. Provided that a substantial body of medical opinion supports the failed procedure and the surgeon warned the patient about known risk factors there will be no finding of negligence even though an alternative procedure may have had a more satisfactory outcome. Negligence implies that the surgery was carried out with less than reasonable skill and care when compared to other medical practitioners operating in the same discipline of medicine.

Reasonable Skill & Care

The majority of compensation claims for rhinoplasty negligence result from a less than satisfactory aesthetic outcome which may or may not be due to medical negligence on the part of the doctors or nurses concerned. Patients often have unrealistic expectations and a number of potential claims will fail if the results are reasonable as opposed to extraordinarily good. Provided that the doctor has performed the procedures with reasonable skill and care and has warned the patient in advance of known risk factors then there will generally be no finding of medical negligence however a growing number of surgeons think that their job is finished the moment they walk away from the operating theatre when in reality they remain liable to provide adequate after care in order to prevent or staunch unexpected infection which is one of the main areas of negligence and subsequent disfigurement.

Surgical Procedure

A rhinoplasy is one of the most common cosmetic procedures showing substantial year on year increases. This relatively complex procedure involves lifting the skin and tissue of the nose and reshaping the underlying bone and cartilage often with the necessity of a splint to retain the correct shape. There are a number of opportunities for things to go wrong and if this is as a result of lack of skill or error on the part of the plastic surgeon or subsequent nursing care then it may form the grounds for a medical malpractice compensation claim.

Nose Job Gone Wrong

Nose reshaping is one of the most common cosmetic surgery procedures and covers a number of changes including both reducing, enlarging and reshaping the profile of the nose. There are various reasons for carrying out a rhinoplasty which can be for purely cosmetic reasons or may be of a functional nature including the improvement of air flow. The issues associated with a nose job gone wrong relate to a number of matters including :-

  • post operative infection
  • severe bleeding
  • difficulty breathing
  • unacceptable scarring
  • unsatisfactory aesthetic outcome
  • contour irregularities
  • asymmetry
  • extruding implant
  • retrograde outcome
  • failing to meet contractual aspirations
  • loss of sense of smell
  • disfigurement
  • haemotoma

Compensation Awards

In addition to claiming compensation for the initial operation (including financial losses and the pain and suffering for physical and mental trauma) it may also be possible to claim compensation for any subsequent corrective surgery that may be necessary. Damages that can be claimed include :-

  • pain & suffering for physical injury
  • compensation for psychological injury
  • loss of wages
  • loss of lifestyle
  • loss of job opportunity
  • estimated future losses
  • medical expenses
  • reasonably incurred general expenses.

Rhinoplasty Surgery Facts - Nose Job Gone Bad - The Truth

People can have Rhinoplasties for several reasons. A rhinoplasty is a surgery that changes the shape or size of the nose. It can involve shaving of bumps off the nose, adding cartilage to increase a portion of the nose or thin out the nose. It can also involve breaking the nasal septum and realigning it into its proper position. Some people get rhinoplasties because they have had an injury to their nose and have had an undesirable outcome from that injury. Other people just don’t like the shape or size of their nose and see a cosmetic surgeon to reshape the nose to a more desirable shape.

Reasons to see a plastic surgeon for a rhinoplasty include changing the size of the nose in relation to other structures of the face, changing the profile of the nose (eliminating lumps or bumps), changing the width of the nose at the bridge of the nose, changing the tip of the nose, changing the size and shape of the nostrils and fixing any deviation or asymmetry of the nose. People who have completed the growth of their face (around 13 years of age), are physically healthy, have specific goals for what you want to accomplish with a nose job and do not smoke are all good candidates for a rhinoplasty.

A rhinoplasty is often started by taking pictures of your nose and sometimes using computer graphics to give you an idea of what your nose will look like. When you have decided on the kind of nose you want, you get scheduled for surgery. The surgeon will put you under general anaesthesia and will often make an incision underneath the upper lip to have access to the bones and cartilage of the nose. The nose and septum will be manipulated to make sure the nose is the way you wanted it to be. The incision is closed with sutures and a splint is put on the nose in order to keep the changes in the right position. Sometimes the nose is packed with gauze to keep the septum in the right place and to soak up any bleeding. These are removed after several days and you then heal without a splint or any gauze.

Normal side effects after having a nose job include localized swelling that passes after a couple of weeks, bruising of the nose and lip that lasts for a couple of weeks, haematoma, which are blood clots that can form under the skin or within the nose, and local infection, which is treated with antibiotics and which almost always heals.

When does having a rhinoplasty become medical negligence? There are many situations that can lead to or can be termed medical negligence. The first is a lack of agreed objectives. If you wanted your nose job to turn out a certain way and to look a certain way, and the nose job did not look the way you wanted it to, this is medical negligence. The nose can conceivably look worse than it did before you had the surgery. The surgery can cause you to look disfigured - as though you obviously had a bad surgery that everyone can now see. You can lose your sense of smell following some nasal surgeries, which really shouldn't happen. You may need another surgery in order to correct problems that cropped up because of the first surgery. You can have a severe infection that causes undue hospitalizations and disfigurement, especially if it isn't treated promptly.

If you have an unacceptable outcome from your rhinoplasty or nose job, you need to consider whether or not you should have the same surgery perform the revision of the surgery. After all, it was this surgeon that caused the problem in the first place. On the other hand, do you want to pay for another surgeon to do the repeat rhinoplasty? It doesn’t seem fair to pay twice for the surgery to turn out the way you want it to. This might be the time to get legal representation to help you negotiate whether or not you should use the same surgeon and how much is fair, if any, you should pay to have the surgery turn out the way it should turn out.

You should definitely get a second opinion as to what needs to be done to repair the damage caused by the first surgery. A lack of smell can usually not be fixable but alterations in the shape or size of your nose may be able to be repaired with a second surgery. The doctor who does your second opinion should be Board Certified in Cosmetic and Plastic Surgery and should have years of experience behind them doing surgery on noses. He or she should have all of your previous medical and surgical records, including pictures before and after the surgery and, if possible, a picture of what you wanted your surgery to look like at the end of things. This doctor may offer to redo the surgery for you or could refer you to another specialist (or back to the same surgeon), depending on the history and physical examination.

If you sustain a haematoma requiring surgery or an infection, these are things that usually resolve quite easily. You may have to use local heat for both conditions and you will likely need antibiotics. Infections tend to cause undue discomfort and prolonged healing but they do not usually ruin the rhinoplasty. In some cases, however, the infection causes breakdown of tissues that were supposed to stay together after the surgery, you may need further surgery to overcome the breakdown that occurred because of the infection. You shouldn't have to pay for this surgery as it is up to the doctor to maintain a sterile field and do everything possible to prevent an infection from occurring in the first place.

If you look worse after the nose job, this is a dire situation indeed. It means the surgeon probably wasn't as capable as you thought they were and you should consider having another surgeon do the corrective surgery you need to have done to look the way you want to look. This is where it helps to have legal representation because you don’t want to have to pay for another surgeon to do the surgery. One way to minimize the chances of having a worse outcome than you started out with is to make it clear to the surgeon exactly what you want, be realistic about your expectations and use a surgeon who is board certified in facial plastic surgery. You should make sure he or she specializes in rhinoplasties and has done hundreds, if not thousands of previous rhinoplasties. Practice, in plastic surgery, does make perfect so the more practised the surgeon is, the greater is the chance of a good outcome.

Many surgeons offer multiple testimonials and pictures (before and after) of previous patients. The best predictor of future behaviour is past behaviour so looking at these pictures might give you a better idea of what you'll get out of your rhinoplasty and more peace of mind when selecting the surgeon who will do your procedure. Don't be afraid to ask questions and to get a second opinion before the surgery takes place.



The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here