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RISKS OF RHINOPLASTY
The decision to undergo elective cosmetic surgery is often a decision most people make after lots of research and homework and consultation.  While some people make the decision to undergo elective plastic surgery without much research or thought or hesitation, most people do give their decision lots of thought and consideration. 

Unlike a trauma or cancer patient, elective cosmetic surgery patients do not “need” the surgery they are seeking.  They want and desire the cosmetic surgery instead.  So as Cosmetic Surgeons, we take otherwise healthy patients, put them through surgery with its down time and bruising and swelling and risk of complications in order to improve their image and self confidence a few weeks later.  While a trauma patient who has broken his jaw in a car accident needs the maxillofacial surgery, regardless of surgical risks, in order to repair the broken jaw, to prevent infection and mastication malfunction, a cosmetic Rhinoplasty patient does not require a cosmetic Rhinoplasty unless there can be fairly certain and significant improvements of the nose afterwards to balance the risks of surgery. 

So as a very cautious and conservative surgeon, my rule of thumb is roughly a 20% cut off.  What I mean is that if the goals of improvement are not at least a 20% improvement of the face then elective cosmetic surgery should be avoided.  If the goals are at least a 20% improvement (or hopefully more), then the benefits of elective cosmetic surgery may outweigh the risks of plastic surgery. 

I have patients who come and see me after they have had several nose jobs by other surgeons but they are unhappy with the results.  Some have had very poor results and I offer then Revision Rhinoplasty to correct the errors of the previous surgeons.  Others have very decent noses and I will take time to educate them and discuss the facts of “tissue dynamics and healing” and will try my hardest to talk them out of another surgery.  Of the latter group, some appreciate my honesty and efforts and will walk out of my office with a new appreciation for their noses.  Others leave, falsely thinking that I somehow “did not see” their problem or do not want to help them, etc… 

The fact is that any surgery carries risk.  There is no denying that.  We never sugar coat anything.  I always have my patients sit down and thoroughly read the multi-page surgical consent forms so that they can have an opportunity to ask questions about every single aspect of the stated risks.  I much rather my patients avoid surgery due to fear of risks than to have them blindly dive into a surgery. 
For example, the Rhinoplasty Consent form from the American Society of Plastic Surgery is pasted below.