Delayed Onset of Dorsal Nasal Artery Pseudoaneurysm Following Primary Rhinoplasty: A Rare Vascular Complication - A Case Report

Pseudoaneurysm formation is an uncommon but serious vascular complication following rhinoplasty. We report a case of a dorsal nasal artery pseudoaneurysm that presented six months after a primary open rhino septoplasty in a 40-year-old male treated for chiromegaly, a dorsal hump, and a ptotic nasal tip. The patient developed a painless, progressively enlarging, and pulsatile mass on the nasal dorsum. CT angiography revealed a sub-centimetric pseudoaneurysm supplied by branches of the dorsal nasal artery. Surgical excision under local anesthesia, including ligation of feeding vessels, was successfully performed. Histopathological analysis confirmed the diagnosis. The patient’s recovery was uneventful, with no recurrence at one-year follow-up. Although rare, pseudoaneurysm should be considered in the differential diagnosis of delayed, pulsatile nasal swellings post-rhinoplasty. Early imaging is vital for diagnosis, and surgical excision remains a definitive treatment when the lesion is accessible. This case emphasizes the importance of meticulous surgical technique and long-term follow-up to detect uncommon vascular complications.