Complications in Rhinoplasty: A Literature Review and Comparison with a Survey of Consent Forms.

Importance: Informed consent in rhinoplasty is a challenging process due to the technically demanding surgery with a wide array of potential complications. Objective: To underscore the significance of informed consent in rhinoplasty, its complications, and identify gaps in the consent process. Design, Setting, and Participants: Dual search and comparison. First a review of the literature for rhinoplasty articles was carried out between January 2000 and November 2017 with at least 100 patients to identify complications and their incidences. Then a comprehensive online search for rhinoplasty consent forms was carried out to identify consent form topics and their incidences. Main Outcomes and Measures: Consent form topics and complication rates from the literature review were reported and directly compared. Results: A total of 117 articles were included, with 36 different complications reported. Twenty-four consent forms were evaluated, yielding 80 different topics. Common complications within the literature included skin problems such as acne (18.3%), numbness (16.7%), hospital revisit (6.5%), primary source revision rate (5.3%), and dissatisfaction (5.0%). The most commonly covered consent topics included infection (100%), bleeding (95.8%), and scarring (95.8%). Unsatisfactory results and need for revision were only covered in 83.3% and 75.0% of consent forms, respectively, despite both being in the top 5 complications cited in the literature. Conclusions and Relevance: Rhinoplasty consent forms generally cover a wide range of topics, with varying incidences of complications cited within the literature. Certain complications such as dissatisfaction and revision surgery should be included in every consent process. These data help provide a contextual framework as well as valuable information in preoperative counseling for patients and physicians regarding rhinoplasty and its potential complications Level of Evidence: NA.