Rhinoplasty and The Sense of Smell

When you first inquire about nose surgery, your plastic surgeon will tell you about the various risks of rhinoplasty.

Because the nose is so complicated and because healing highly influences the way your final result appears, rhinoplasty has one of the highest rates of revision, a secondary repair procedure.

So, your success rate is increased by choosing a board-certified plastic surgeon. (Read our previous post about certification in plastic surgery.)

Your surgeon will also tell you about the usual complications of nose surgery. They range from the serious like infections, excessive bleeding and bad reactions from anesthesia to swelling, bleeding and scar tissue formation inside the nose.

One complication you rarely hear much about – loss of smell – was studied by a plastic surgeon in Iran and reported in the March, 2009, issue of BMC Ear, Nose and Throat Disorders, a professional journal for physicians.

Dr. Hashem Shemshadi, M.D. a plastic surgeon and three associates studied a group of 40 men and women rhinoplasty patients who had open rhinoplasty. (See a 3D animation of open nose surgery.)

Before surgery, the researchers gave the patients a smell test with 40 familiar scents; they all passed with flying colors.

Then, one week after surgery, the doctors tested the same 40 odors on the patients again.

Results? 87.5 percent could not smell while the others had at least moderate degrees of smell impairment. But it wasn’t permanent.

At the six week point after surgery, 85 percent of the patients reported only a mild to moderate decline in their ability to smell.
At the six month point, the smell i.d. test was given yet again. The researchers found the subjects’ olfactory function was just as good as before surgery.

While this group needed six months to regain their complete sense of smell, others patients may take a little longer.

Why the loss of smell after rhinoplasty?

The delicate and complicated human nose senses odors because, as you breathe, air swirls around inside the nose in eddies on its way to your lungs. Certain regions of the nose, along with some in the mouth, have nerve endings to detect odors.

Swelling goes hand-in-hand with most nose surgery. So the air that carries scent molecules simply cannot get to the right nerve endings.

When the swelling subsides, the problem is solved.