Empty Nose Syndrome case history · United States
John Malamos (1967–2010): Empty Nose Syndrome After Revision Rhinoplasty and Inferior Turbinate Reduction
Based on interview notes with John’s brother Thomas, this page documents a life that changed dramatically after revision cosmetic nasal surgery was combined with inferior turbinate reduction.
John Malamos lived in Illinois and, according to his brother’s account, enjoyed a full and active life before two cosmetic nasal operations. The first procedure did not produce the expected result, leading to revision surgery. During that second operation, the surgeon also reduced John’s inferior turbinates. His brother says John had not expected that additional procedure and had not been meaningfully informed about its risks.
John Malamos before nasal surgery
Thomas described John as a warm, social and energetic person. He loved riding motorcycles and traveling through the western United States with friends. He had a steady relationship, a close circle of friends, family nearby and a satisfying career as an assistant manager at Costco.
His brother’s account emphasizes that John had no comparable history of severe breathing distress, insomnia or major emotional problems before the nasal procedures.
Revision rhinoplasty and an unexpected inferior turbinate reduction
According to Thomas, John first underwent cosmetic nasal surgery without major pre-existing breathing problems. Because the cosmetic result was unsatisfactory, he later returned for revision surgery.
Thomas says that during the revision, the surgeon also reduced John’s inferior turbinates. The family’s central concern is that this additional procedure was not the reason John entered surgery and that the risks were not adequately explained beforehand.
Thomas shared John’s story as a warning to patients to ask exactly which procedures may be performed and to explicitly discuss whether turbinate surgery is being considered.
Severe symptoms after turbinate reduction
After the turbinate procedure, Thomas described a dramatic change. John developed insomnia, dryness, nasal pain, a persistent suffocating sensation, anxiety and deep emotional distress.
The family believed these symptoms represented Empty Nose Syndrome. John reportedly struggled to understand why his nose could feel unable to breathe despite being physically open.
How friends and colleagues remembered John
The strongest contrast in the family material is between John’s life before surgery and the period after ENS symptoms emerged. His obituary received numerous comments from coworkers and friends who remembered his warmth, generosity and ability to support others.
“John was one of a kind. The most compassionate and dear friend and boss.”
Kristin Harbke · October 10, 2010“He always greeted me with an infectious smile and we never failed to share a laugh together.”
Patrick Hayes · October 28, 2010“I would not be where I am today without John.”
Jeff Wilkalis · August 7, 2011“We all still miss you so much and remember you by sharing memories of you.”
Ruth Reynolds · July 10, 2023Thomas said hundreds of coworkers attended John’s funeral, underscoring the strong impression he had made on the people around him.
Searching for answers: Cleveland Clinic, Mayo Clinic and ENS diagnosis
As John’s symptoms worsened, he and his father traveled long distances seeking specialist help. The family account says he was evaluated at major institutions including the Cleveland Clinic and Mayo Clinic.
According to Thomas, John eventually received an Empty Nose Syndrome diagnosis. The family was devastated to learn that no effective treatment or local referral was offered that could meaningfully restore his former quality of life.
John was employed, riding motorcycles, traveling and maintaining close relationships.
Thomas says the turbinate procedure was not something John expected when he entered surgery.
Insomnia, dryness, pain, suffocating sensations and emotional deterioration followed.
John sought care at major institutions and, according to the family, was eventually diagnosed with Empty Nose Syndrome.
His family later shared his story to raise awareness of the consequences they associated with the turbinate procedure.
Thomas Malamos’ message about informed consent and ENS awareness
Thomas now shares John’s story to encourage patients to ask detailed questions before nasal surgery. His main message is not to assume that a surgeon will perform only the procedure discussed in broad terms.
He believes John would not have agreed to inferior turbinate reduction if the risks had been clearly explained and if John had been given a meaningful role in the decision.
Thomas also questions why the turbinates were treated during a cosmetic revision at all. Those questions remain part of the family’s interpretation of the case and are presented here as such.
Sources and supporting documentation
The supporting PDF and John’s obituary are linked below so readers can review the underlying material directly.
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