Nose Jobs and Your Sense of Smell

"A lovely young woman smells freshly picked wild flowers"Most plastic surgery articles list the common side effects of a rhinoplasty, including:

  • Swelling
  • Bleeding
  • Bruising
  • Possible adverse reactions to anesthesia

But some are surprised to find their sense of smell has gone askew.

Writing in an issue of BMC Ear, Nose and Throat Disorders, a professional journal for physicians, Iranian plastic surgeon Hashem Shemshadi, M.D. and three associates rounded up a study group of 40 to 65 male and female patients, all of whom had rhinoplasty via the open method which peels back the nasal skin to show the nasal framework.

(Read more about open and closed rhinoplasty.)

Before surgery, each patient took and passed a smell test which involved sniffing common odors. Then, one week after the rhinoplasty, the surgeons repeated the test with the exact same smells.

Result? 87.5 percent could not identify any odors at all while the remainder reported losing at least a little ability to sniff ordinary things. The good news: the smell loss was not permanent.

About six weeks after surgery, 85 percent of the study group said they were experiencing only a slight to moderate loss in their olfactory abilities.

The third and final test at six months revealed that all the patients’ sniffers were just as sharp as when first tested.  (Read more about the rhinoplasty smell study.)

The Iranian cosmetic plastic surgeons noted that while the study group needed half a year to completely regain their smell, other nose job patients said it took a little longer.

But the larger question for any patient is: why would a rhinoplasty cause a loss of smell, if only for a short while?

The very convoluted, complex nose can sense odors because as you breathe, the air rolls around in eddies within the nose as it passes on to your lungs. Contained within the nose are nerve-rich regions that react to the molecules of various odors. Swelling is a reaction to surgery – and perhaps more so with open rhinoplasty – so scent molecules in that air can’t pass over the correct nerves. When the swelling subsides, so does the loss of smell.

The affect is stronger when a septoplasty on a deviated septum is done in the same surgical session.

Worth noting: the most skilled rhinoplasty surgeons use the closed method in which the surgeon works entirely through the nostrils.

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The patient below had rhinoplasty to improve the appearance of his nose plus septoplasty and  turbinate reduction to improve breathing. (Robert Kotler M.D. photo)

"A young man with a humped nose shows his new look in an after rhinoplasty picture"
Before and after rhinoplasty

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