Homemade rhinoplasty can cause infection and death, warn doctors

Home rhinoplasty techniques propagated on the internet can lead to infection, bleeding, anatomical and structural lesions in the nose, respiratory disorders, generalized infection and, in the last degree, cause death, warn experts.

The practice of “operating” on the nose at home has gained repercussion in recent days, after a young man sought care at the UPA (Emergency Care Unit) in Campo Limpo, in the south of São Paulo. At the time, he said he performed the procedure based on posts on the internet and revealed that he used instant glue to make the suture. Last Friday (5), there was still a video on YouTube teaching how to tune and upturn your nose with bare wire and hot glue.

According to SMS (Municipal Health Department), the patient was referred to the Dr. Fernando Mauro Pires da Rocha and welcomed by the mental health team. Then, he underwent care with the oral and maxillofacial team, which cleaned the wound, bandaged it and provided guidance on the necessary care. The boy was discharged on the same day and was referred for return and for care at the psychology service.

YouTube says that all content on the platform must follow Community Guidelines and that it does not allow material that encourages dangerous activities that risk serious injury or death. “We rely on a combination of intelligent systems, human reviewers, and user reports to identify suspicious content and remove anything that violates our policies once found.” The video indicated by the report is now restricted to people over 18 years of age.

“Ignorance makes people brave. If they are not aware of the risk they run, especially young women, they become brave to venture into this type of procedure”, says doctor Carlos Inácio Coelho de Almeida, a member of the SBCP (Brazilian Society of Plastic Surgery).

Among the risks listed by Almeida and by José Roberto Parisi Jurado, vice president of ABORL-CCF (Brazilian Association of Otorhinolaryngology and Cervico-Facial Surgery), are irreversible deformities, bleeding and infections. “The nose is a region very prone to infection, so much so that in surgeries, in addition to the use of sterilized material, we prepare the patient with antiseptic before and after and prescribe antibiotics for the postoperative period”, says the otolaryngologist.

There is also a chance of complications when there is no cut and the procedure is done with the placement of flexible modelers like those advertised on buying and selling sites. The object can sink into the nose, requiring medical help to remove it, or cause a buildup of secretions.

“A person who does this kind of thing may be afraid to seek medical attention and the infection can evolve. The germ that is only in the nose, when untreated, can reach the bloodstream and turn into a generalized infection, or septicemia”, says Jurado.

In 2020 alone, 87,879 rhinoplasty procedures were performed in Brazil, according to ISAPS (International Society of Aesthetic Plastic Surgery). The number is equivalent to 6.7% of all cosmetic surgeries performed in the head region in Brazil and 10.3% of all rhinoplasties performed in the world. It is the fourth most sought after cosmetic surgery by men (209,087 procedures) and fifth among women (643,468 procedures).

“The nose is an important organ for facial harmony and people who seek rhinoplasty are looking for this harmony”, says Almeida.

Jurado adds that the central portion of the face is the one that most calls our attention. When a person sees himself in a selfie or in a video, he mostly observes this area and the nose, as it is the central structure, is what most incites the desire to improve the aesthetic aspect, following a pattern established over the years.

“Models, actors, people considered beautiful in the world usually have a nose in the delicate pattern. It’s rare for someone to have a rounded nose, a ‘ball’ nose, and be considered beautiful. This was created through television, newspapers , magazines, movies and the person feels like having a pattern similar to what they see in these media”.

The issue is that the patient does not always have realistic expectations, something that is discussed in preoperative consultations with the plastic surgeon. It is up to the professional to analyze all the elements of the nose, the reference points of the face and talk about what is achievable.

Another factor lies in the availability of the procedure. The SUS (Unified Health System) covers repair operations and rhinoplasty is cosmetic surgery. “When the patient has a nose with functional problems, with deviations and needs a rhinoseptolasty, he has coverage. But that nose surgery for an aesthetic desire, which does not involve any pathology, the SUS does not cover”, says Almeida.

With this, there are two options: seek hospitals and trained doctors in the private network or seek care in educational institutions. Some medical schools, in order to offer training to residents in plastic surgery and otolaryngology, serve patients through the SUS in their hospitals or, in the case of private educational institutions, they charge below market rates.