EVALUATING POSTOPERATIVE COMPLICATION IN RHINOPLASTY

Abstract

Background

Rhinoplasty is a commonly performed functional and aesthetic surgical procedure; however, postoperative complications may adversely affect functional outcomes, aesthetic satisfaction, and recovery. This study aimed to evaluate the frequency, spectrum, timing, and associated factors of postoperative complications following rhinoplasty.

Methods

A prospective observational study was conducted among 268 patients undergoing rhinoplasty at the Department of Plastic Surgery and burn unit, Lady Reading Hospital, Peshawar, from June 2024 to June 2025. Patients were followed prospectively for postoperative complications. The primary outcome was the occurrence of at least one clinically significant postoperative complication. Complications were categorized as early (≤30 days) or delayed (>30 days). Demographic, clinical, and operative characteristics were assessed for their association with postoperative complications. Categorical variables were analyzed using the chi-square or Fisher's exact test, while continuous variables were compared using appropriate parametric or non-parametric tests. Multivariable binary logistic regression was performed to identify factors independently associated with postoperative complications.

Results Among 268 patients, 53 (19.8%) developed at least one postoperative complication. Early complications occurred in 37 (13.8%) patients, while delayed complications occurred in 19 (7.1%). Prolonged edema/ecchymosis was the most frequent complication (19, 7.1%), followed by skin/soft-tissue complications and infection (6, 2.2% each). Patients who developed complications had a significantly longer mean operative duration than those without complications (174.12 ± 29.54 vs. 166.28 ± 34.25 minutes; P=0.032). Surgical indication was also significantly associated with complications in the unadjusted analysis (P=0.037). However, after multivariable adjustment, neither operative duration (adjusted OR 1.006, 95% CI 0.998–1.015; P=0.137) nor post-traumatic indication (adjusted OR 2.434, 95% CI 0.991–5.976; P=0.052) remained statistically significant independent predictors. The overall logistic regression model was statistically significant (likelihood-ratio P=0.030). Conclusion

Postoperative complications occurred in approximately one-fifth of patients undergoing rhinoplasty, with most events being early and relatively minor. Prolonged edema/ecchymosis was the predominant complication. Although operative duration and post-traumatic indication were associated with complications in unadjusted analyses, no individual factor remained an independent statistically significant predictor after adjustment. Careful patient assessment, meticulous surgical technique, and appropriate postoperative surveillance remain important for minimizing and detecting complications following rhinoplasty.