Revision Rhinoplasty

All patients go into plastic surgery expecting wonderful things, and rightfully so; after all, the primary goal of cosmetic procedures is to help patients feel better about their appearance. In addition, procedures require a significant financial and time investment, so they should provide good results to be worth the commitment. Unfortunately, things do not always work out ideally, particularly when it comes to rhinoplasty (nose job). In instances where the patient is unhappy with the results, whether due to unrealistic expectations or failure by the surgeon to perform the operation according to good standards, revision rhinoplasty may be necessary. This secondary cosmetic surgery is designed to achieve the goals that primary rhinoplasty did not accomplish.

How is Revision Rhinoplasty Different from Primary Rhinoplasty?

Revision(secondary) rhinoplasty is a cosmetic surgery that is performed when the outcome of the original rhinoplasty does not satisfy the need of the patient. Patients may be unhappy with the appearance of their nose, or may experience functional difficulty following surgery. Traumatic injury following rhinoplasty is another reason why individuals may opt for corrective surgery. Revision rhinoplasty is similar to primary rhinoplasty in that it can be performed as an “open” or “closed’ procedure. In closed rhinoplasty, the surgical incisions are made inside the nose, to eliminate the appearance of scarring. With open rhinoplasty, an additional incision is made across the columella. While this leaves a small scar, it gives the surgeon more access to the nasal tissue and bone. The goals of your rhinoplasty revision will dictate the type of surgery you receive.

Secondary rhinoplasty differs from the primary procedure in that it may require cartilage or bone grafting. In the event that too much tissue or bone was removed in the first surgery, your plastic surgeon will need to replace this in order to achieve the desired look. Often times, cartilage is taken from the ear or other areas of the nose. In rare cases, it is harvested from the rib, in what is known as a costal cartilage graft. Secondary rhinoplasty procedures may also be more difficult to perform than traditional rhinoplasty surgery because the septum may have been altered or partly removed during the first surgery. The septum forms the framework of the nose, and its presence is necessary for the shaping of the new nose. If this cartilage and bone has been removed or scarred; if the skin is now thicker and more difficult to work with; or if the patient’s airway has been impeded, the secondary/revision nose job may be more complex.

Candidacy

Patients who are unhappy with their previous nose job results are candidates for revision nose job surgery. Whether the nose is deemed too small, too large, or shaped improperly, a skilled surgeon may be able to correct the problem. Patients who experience breathing difficulty following rhinoplasty may also opt to undergo a second procedure. Factors influencing your candidacy for revision rhinoplasty include how many rhinoplasty procedures you have had before, what you hope to accomplish with a revision nose job, and the amount of nasal tissue currently in your nose. Patients who have significant scar tissue left behind from previous surgeries may not be ideal for revision rhinoplasty. A personal consultation, which is offered for free by many cosmetic surgeons, is the best way to determine if you are a good candidate for the procedure. During this time you and your surgeon will discuss your previous procedures, as well as your aesthetic and functional goals for revision rhinoplasty.

Risks and Benefits: What You Should Know about Secondary Nose Reshaping

The main benefit of revision rhinoplasty is that it can help patients finally receive the outcome they desire. This secondary surgery enhances both the appearance and functionality of the nose. Just as with primary rhinoplasty, it can successfully alter the size and shape of the nose to bring balance to the facial features. Revision rhinoplasty has the same risks as first-time rhinoplasty, including bleeding, infection, scarring, nerve damage, and bursting of the blood vessels. Patients also run the risk of again being unhappy with the results of the surgery. Communicating with your surgeon is the best way to ensure that you will be happy with the results of your surgery. Choosing a certified, well-recommended plastic surgeon is also vital. As a patient, it is essential that you choose a rhinoplasty surgeon who understands your aesthetic goals and stay realistic about what revision nose job can achieve.

Visit the DocShop gallery to view rhinoplasty before and after photos.

Photo credit: Minas Constantinides, MD, FACS, PC

Many Patients Want to Know …

How Long Should I Wait Before Undergoing Revision Surgery?

When considering revision rhinoplasty, it is recommended to wait at least one year following your initial surgery. This is because the full results of rhinoplasty can take anywhere from 8-12 months to develop. It can also take up to a year for scar tissue to soften. Prematurely altering the outcome of your original rhinoplasty surgery can negatively affect the appearance and functionality of the nose. Your plastic surgeon can provide more guidance on your specific procedure, including the kind of results you can expect.

Contact a Surgeon

Contact a local plastic surgeon to find out if you are a good candidate for rhinoplasty.