Empty Nose Syndrome and the Cost of Cosmetic Surgery: The Story of John Malamos (1967–2010)

John Malamos, United States 1967-2010. Based on Interview Notes with John’s Brother

John Malamos resided in Illinois, United States and lived a vibrant and fulfilling life until he had two cosmetic surgeries on his nose. Then his life took a very dark turn that ultimately resulted in his early death at the very young age of 43. The first cosmetic surgery John underwent with no notable breathing issues. Unfortunately, the surgery was not performed correctly and John had to undergo surgery again. During this revision, the surgeon chose to also reduce his nasal inferior turbinates without explaining the risks of this procedure to John. This unnecessary reduction set off a cascade of health problems including insomnia, dryness, pain, suffocation, anxiety, and depression.

 
John’s brother Thomas shared his story to offer a critical reminder to be aware of ALL of the operations that your surgeon may perform and to explicitly communicate that you want to avoid unnecessary “add-on” surgeries such as the reduction of the nasal turbinates. John went into the operating room thinking he was just getting a revision of his cosmetic surgery and left the operating room with both a revision to the cosmetic surgery AND a reduction to his inferior turbinates. That reduction had nothing to do with his cosmetic surgery and it is almost certain John would still be alive today had the surgeon not added this operation and caused John to get the dreaded Empty Nose Syndrome (ENS).

Before his surgery, John lived life to the fullest and hardly had any worries in his life. He was a passionate motorcyclist who loved traveling to the western area of the United States with his motorcycle friends. He had a steady girlfriend, a circle of close friends, family living nearby, and a satisfying career as an assistant manager at Costco. John was a beacon of warmth and joy in his community— a man whose presence was felt deeply by those around him.

Colleagues and customers alike from Costco remember him fondly. They still share stories of his kindness and exceptional management skills over ten years later when his brother visits the store to purchase items. John had a rare talent for making everyone around him feel valued and appreciated. The hundreds of co-workers who attended his funeral and commented on his obituary serve as a testament to the positive impact he had on so many lives. Below is just a few of the many comments left from his co-workers online. (1)  

“John was one of a kind. The most compassionate and dear friend and boss. I will always remember our talks about life and how many times John helped me to get through rough times. I will miss him dearly.”

Kristin Harbke, October 10, 2010

"I met John when joining Costco in 2002. He always greeted me with an infectious smile and we never failed to share a laugh together. More than just a co-worker; John was a great friend. It's rare to encounter someone as outgoing and compassionate as John. I remained in touch with him over the years and I was extremely saddened to hear of his passing. My thoughts and prayers are with the Malamos family during this difficult time."

Patrick Hayes, October 28, 2010

"I would not be where I am today without John. Not only did he give me the opportunity to work at Costco, but he gave me a second chance at life and always made me smile even on the worst days. He made it a point to ask me how I was doing and really make me feel good about myself. I sincerely miss you and thank you for all that you have given me."

Jeff Wilkalis, August 7, 2011

"John, it´s been so long since you´ve been gone but it seems like yesterday. We all still miss you so much and remember you by sharing memories of you. Life is not the same since you´ve been gone.I miss the way you´d make time to talk to us and help solve our problems of life. Such a caring person. You will always live in my heart forever. Say hello to Audrey,I know she´d be looking for you with open arms. May you continue to rest on and be happy forever. Love Ruth"

Ruth Reynolds, July 10, 2023

John Malamos 1967–2010: A Life Cut Short by Rhinoplasty and Turbinate Reduction Surgery

After the surgery on his nasal turbinates, John’s fulfilling and happy life took a very dark turn. In his efforts to understand why he felt like he was suffocating and unable to sleep for days at a time, he sought consultations at renowned institutions such as the Cleveland Clinic and Mayo Clinic. After traveling with his father hundreds of miles for these consultations he was finally able to get a diagnosis – Empty Nose Syndrome – but neither clinic had treatments to offer nor referrals to doctors closer to home. His hopes were dashed to learn there would be no relief from his immense suffering and that his quality of life would continue to be very low for the foreseeable future.

John became very anxious and deeply depressed as a result of ENS. This worried his family as John had no known mental health issues prior to the surgery. He ended up getting treatment and spending time in a mental health care hospital but this just left him feeling even more isolated and hopeless as the root cause of his problems were physical in nature and not mental. 

In his darkest moments, John tried multiple times to end his suffering. He initially attempted suicide using carbon monoxide gas from his car’s tailpipe but backed out at the last moment. A subsequent failed attempt included trying to hang himself. He finally ended up stealing a revolver after visiting a family member’s house and shooting himself the next day. This resulted in his very tragic and early death. Notably, his family was able to demonstrate to their church that his death was the result of a physical condition that had tortured him severely. This was important so that his burial and services could be performed according to the Greek Orthodox tradition.

Thomas Malamos now shares his brother’s story in the hope of raising awareness and preventing future tragedies. He wants people to understand the severe and avoidable impact that ENS can have on a person’s life. Thomas does not believe that his brother would have had his nasal turbinates reduced if he had been explained the risks of the surgery and been allowed to play a role in the decision-making process. Like so many other friends and family members who lost loved ones to ENS, Thomas wonders why the surgeon operated on John’s nasal turbinates. Was it to make more money? Was it because they hadn’t been trained on the importance of the nasal turbinates during medical school? Did the surgeon lack the skill and precision needed to operate on the rest of the nose without touching the turbinates? Knowing the answer to this questions could help others avoid the same fate as his brother. 

As part of honoring John’s memory, John’s brother shared photographs and videos from happier times—moments filled with laughter, adventure, and the joy of living life fully. These images serve as a reminder of the person John was before his illness took over, reflecting a life that was bright and full of promise. This is how Thomas would like his brother to be remembered by others. 

(1) https://www.legacy.com/us/obituaries/chicagotribune/name/john-malamos-obituary?id=2754254

John Malamos' PDF file can be viewed here  (takes a while to load)