Tip Rhinoplasty Consent
This is an informed consent document that has been prepared to help inform you concerning tip rhinoplasty surgery, its risks, and alternative treatment.
It is important that you read this information carefully and completely. Please initial each page, indicating that you have read the page and sign the consent for surgery as proposed by your plastic surgeon.
Tip rhinoplasty is a surgical procedure that can produce changes in the appearance and structure of the tip of the nose. Tip rhinoplasty can reduce or increase the size of the nasal tip, change the shape of the tip, narrow the width of the nostrils, or change the angle between the nose and the upper lip. This operation can also help correct birth defects and nasal injuries.
There is not a universal type of tip rhinoplasty surgery that will meet the needs of every patient. Tip rhinoplasty surgery is customized for each patient, depending on his or her needs. Incisions may be made within the nose or concealed in inconspicuous locations of the nose in the open tip rhinoplasty procedure. Some techniques of tip rhinoplasty use cartilage grafts or other man-made materials to enhance the projection of the nasal tip. Internal nasal surgery to improve nasal breathing can be performed at the time of the tip rhinoplasty.
The best candidates for this type of surgery are individuals who are looking for improvement, not perfection, in the appearance of their nose. In addition to realistic expectations, good health and psychological stability are important qualities for a patient considering tip rhinoplasty surgery. Tip rhinoplasty can be performed in conjunction with other surgeries.
Alternative forms of treatment consist of not undergoing the tip rhinoplasty surgery. Risks and potential complications are associated with alternative forms of treatment that involve surgery such as a standard rhinoplasty that changes the appearance of the nasal region.
RISKS of TIP RHINOPLASTY SURGERY
Every surgical procedure involves a certain amount of risk and it is important that you understand the risks involved with tip rhinoplasty surgery. An individual’s choice to undergo a surgical procedure is based on the comparison of the risk to potential benefit. Although the majority of patients do not experience the following complications, you should discuss each of them with your plastic surgeon to make sure you understand all possible consequences of tip rhinoplasty surgery.
Bleeding- It is possible, though unusual, to have problems with bleeding during or after surgery. Should post-operative bleeding occur, it may require emergency treatment to stop the bleeding or drain an accumulation of blood (hematoma). Do not take any aspirin or anti-inflammatory medications for ten days before surgery, as this contributes to a greater risk of bleeding. Hypertension (high blood pressure) that is not under good medical control may cause bleeding during or after surgery. Accumulations of blood under the skin may delay healing and cause scarring.
Infection- Infection is quite unusual after surgery. Should an infection occur, additional treatment including antibiotics may be necessary. Cartilage grafts, if used, may require removal should an infection occur.
Scarring- Although good wound healing after a surgical procedure is expected, abnormal scars may occur both within the skin and the deeper tissues. Scars may be unattractive and of different color than the surrounding skin. There is the possibility of visible marks from sutures. Additional treatments including surgery may be needed to treat scarring.
Damage to deeper structures- Deeper structures such as nerves, blood vessels and cartilage may be damaged during the course of surgery. The potential for this to occur varies with the type of tip rhinoplasty procedure performed. Injury to deeper structures may be temporary or permanent.
Numbness- There is the potential for permanent numbness within the nasal skin after tip rhinoplasty. The occurrence of this is not predictable. Diminished (or loss) of skin sensation in the nasal area may not totally resolve after tip rhinoplasty.
Unsatisfactory result- There is the possibility of an unsatisfactory result from tip rhinoplasty surgery. The surgery may result in unacceptable visible or tactile deformities, loss of function, or structural malposition after tip rhinoplasty surgery. You may be disappointed that the results of tip rhinoplasty surgery do not meet your expectations. Additional surgery may be necessary should the result of tip rhinoplasty be unsatisfactory.
Cartilage grafts- Cartilage grafts may be needed if the goal of surgery is to change the projection of the nasal tip. These grafts can be obtained from donor locations within the nose (nasal septum) or from other parts of the body. Complications including nasal septal perforation may occur from the procurement of cartilage graft material. More than one location may be needed in order to obtain sufficient amounts of cartilage.
Asymmetry- The human face is normally asymmetrical. Variation from one side to the other may result from a tip rhinoplasty procedure.
Chronic pain- Very infrequently, chronic pain may occur very infrequently after tip rhinoplasty.
Skin disorders/skin cancer- Skin disorders and skin cancer may occur independently of a tip rhinoplasty.
Allergic reactions- In rare cases, local allergies to tape, suture material, or topical preparations have been reported. Systemic reactions which are more serious may result from drugs used during surgery and prescription medicines. Allergic reactions may require additional treatment.
Delayed healing- Wound disruption or delayed wound healing is possible. Some areas of the nose may heal abnormally or slowly. Areas of skin may die, requiring frequent dressing changes or further surgery to remove the non-healed tissue.
Long term effects- Subsequent alterations in nasal appearance may occur as the result of aging, sun exposure, or other circumstances not related to tip rhinoplasty surgery. Future surgery or other treatments may be necessary to maintain the results of a tip rhinoplasty operation.
Nasal septal perforation- Rarely, a hole in the nasal septum will develop. Additional surgical treatment may be necessary to repair the nasal septum. In some cases, it may be impossible to correct this complication.
Nasal airway alterations- Changes may occur after a tip rhinoplasty or septoplasty operation that may interfere with normal passage of air through the nose.
Surgical anesthesia- Both local and general anesthesia involve risk. There is the possibility of complications, injury, and even death from all forms of surgical anesthesia or sedation.
Most health insurance companies exclude coverage for cosmetic surgical operations or any complications that might occur from cosmetic surgery. If the procedure corrects a breathing problem or marked deformity after a nasal fracture, or a birth defect, a portion may be covered. Please carefully review your health insurance subscriber-information pamphlet.
ADDITIONAL SURGERY NECESSARY
There are many variable conditions in addition to risk and potential surgical complications that may influence the long term result from tip rhinoplasty surgery. Even though risks and complications occur infrequently. The risks cited are particularly associated with tip rhinoplasty surgery. Other complications and risks can occur but are even more uncommon. Should complications occur, additional surgery or other treatments may be necessary. The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee or warranty expressed or implied as to the results that may be obtained. Infrequently, it is necessary to perform additional surgery to improve your results.
The cost of surgery involves several charges for the services provided. The total includes fees charged by your doctor, the cost of surgical supplies, anesthesia, laboratory tests, and possible outpatient hospital charges, depending on where the surgery is performed. Depending on whether the cost of surgery is covered by an insurance plan, you will be responsible for necessary co-payments, deductibles, and charges not covered. Additional costs may occur should complications develop from the surgery. Secondary surgery or hospital day surgery charges involved with revisionary surgery would also be your responsibility.
Informed-consent documents are used to communicate information about the proposed surgical treatment of a disease or condition along with disclosure of risks and alternative forms of treatment(s). The informed-consent process attempts to define principles of risk disclosure that should generally meet the needs of most patients in most circumstances.
However, informed consent documents should not be considered all inclusive in defining other methods of care and risks encountered. Your plastic surgeon may provide you with additional or different information which is based on all the facts in your particular case and the state of medical knowledge.
Informed-consent documents are not intended to define or serve as the standard of medical care. Standards of medical care are determined on the basis of all of the facts involved in an individual case and are subject to change as scientific knowledge and technology advance and as practice patterns evolve.