REVISION RHINOPLASTY

 

If you are seeking revision rhinoplasty,you are not alone. At least 10% of all patients who undergo  rhinoplasty require a secondary procedure to achieve their desired result. Even in the best and most experienced hands, minor touch up surgery may be needed  to further refine your results. However in some cases, major revision surgery is needed and minor changes are just not enough. If this is your case, then you have come to the right place. Learn more about revision rhinoplasty before undergoing another nasal surgery.

  • an over-operated, unnatural  looking nose

  • breathing difficulty

  • overly up-turned nose

  • asymmetric, twisted, disproportionate nose

  • no facial balance 

  • nasal tip problems

  • nose remains too wide

  • nose too thin

  • crooked  nose

  • nostril assymmetry

  • undesirable scars

  • too pinched

  • lost of ethnic features

  • infected or exposed implant

  

 

The nose is made up of an internal mucosal lining, a supporting structure of cartilage and bone and an outer lining of skin and muscle. During rhinoplasty, the  nasal cartilages and nasal bones are reshaped.  The nasal skin conforms to the restructured cartilage and bones to reveal a refined nose. Minor changes  made to the structure of the nose — often measured in millimeters — can make a large difference in how the nose looks.  It can take up to one year or even longer for your final result to show. The length of time largely depends on the thickness of the skin. 

 

The nasal cartilages and bones provide structural support to the nose giving it shape and  preventing collapse during breathing. Therefore, overzealous violation of these structural elements without compensatory techniques often results in a bad nose job that requires revision. 

 

The nasal skin can  vary in thickness from very thin or  very thick. Thin skin conforms quicker to  alterations made to the  nasal bone and cartilages while thick skin takes much longer. Individuals with thin nasal skin will see their final results sooner than this with thick nasal skin. Thicker skin needs more structural support therefore overzealous alteration of the cartilages without compensatory measures will eventually loose its shape.  To avoid these predictable changes of wound healing  and the need for major rhinoplasty revisions, we carefully evaluate each patient to determine their nasal skin type, nasal bone structure and strength of their nasal cartilage.  We have found that creating highlights and shadow points on the nose by reshaping the nasal cartilage and bones and actually adding more structure provides a natural looking, balanced result that withstands the forces of wound healing. 

 

 

 

 

 

Revision rhinoplasty can be done at any time following the primary surgery  but the timing should be selected to optimize the result. When major structural changes are needed, waiting too long before undergoing a revision may not be helpful as contraction and scarring of the skin and nasal lining may make the revision surgery more difficult. On the other hand, it is best to wait at least 6 months when minor changes are being contemplated since the wound healing process may correct these changes making a revision surgery unnecessary. Moreover, one does not want to chase after a moving target since significant soft tissue changes can occur after rhinoplasty even after a year, especially in thick skin noses.

Revision rhinoplasty showing more refined bridge and tip. The flat bridge in now slightly raised to reflect light making the nose more photogenic. The tip has also been slightly rotated up .

 Revision rhinoplasty after previous rhinoplasty with implant placed for dorsal projection left the nose looking harsh and operated.After the implant was removed, dorsal definition was achieved with contoured rib cartilage graft. The tip was refined and nostrils reshped. The dorsal profile now starts higher but looks natural and soft.

 Revision rhinoplasty  to correct over rotated  tip.Notice lengthening of the short nose and de-rotation of the tip in to a more balance position.

Revision rhinoplasty to correct dorsal irregularities and collapse creating a refined bridge and tip.

Rhinoplasty for a severely contracted nose, scarred skin, over-rotated tip , no bridge and saddle deformity.

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