Revision Rhinoplasty

If you are seeking a revision rhinoplasty then you are not alone. At least 10% of all patients who have undergone a rhinoplasty undergo a secondary procedure to acheive their desired result.” The best revision rhinoplasty surgery ever performed was the one that was never done” That is to say,it is best to get it right suring the first surgery. Most of the time, when the primary rhinoplasty is performed by an experienced facial plastic surgeon, only minor touch up surgery is needed to further refine your results. However in some cases, major revision nasal surgery is needed as slight changes are just not enough. Furthermore, some patients may have pre-existing breathing difficulties that were not improved by surgery, or that progressively got worse over the years after surgery.  If any of these reasons apply to you, then you have come to the right place. First educate yourself about revision rhinoplasty before undergoing another nasal surgery.

Common reasons for Revision Rhinoplasty:  

•an over-operated, un-natural appearing nose
•overly up-turned nose
•assymetric, twisted, disproportionate nose
•no facial balance
•nasal tip problemsnose remains too wide
•nose too thin
•crooked  nose
•nostril assymmetry
•undesirable scars
•too pinched
•lost of ethnic features
•infected or exposed implant

 Understanding  the basics of rhinoplasty 

In a simplified way, 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. Most changes done in rhinoplasty are made by altering the shape of the underlying nasal cartilages and nasal bone. Occasionally the skin requires some minor alteration. Over time, the nasal skin adapts to the restructured cartilage and bone. Minor changes to the structure of the nose — often measured in millimeters — can make a large difference in how your nose looks.   It can take up to one year for your final result to show. The nasal cartilages and bones provide structural support to the nose preventing nasal collapse during breathing. Thus, overzealous violation of these structural elements without compensatory techniques often results in a bad nose job that requires revision.

 

The nasal skin can be thin or thick. Thin skin adapts quicker and better to  alterations made to the underlying nasal bone and cartilages. Individuals with thin nasal skin will see their final results quicker as swelling and adaptation occurs faster. One disadvantage with the thin nasal skin is that any irregularities in the nasal structure is also obvious and difficult to hide. Patients with thicker skin have slower healing and skin adaptation but they hide any irregularies better. Thicker skin needs more structural support therefore overzealous alteration of the cartilages without compensatory measures will eventually lead to an amorphous nose that just does not work well. It is not too uncommon to have people tell us that their rhinoplasty looked great for 6 months then things begun to change. To avoid these predictible changes of wound healing  and the need for major rhinoplasty revisions, we carefully evalaute each patient to determine their nasal skin type, nasal bone structure and strength of their nasal cartilage.  We have found that creating highlights and shawdow points on the nose by reshaping the nasal cartilage and bones and actually adding more structure provides an natural looking, balanced result that withstands the forces of wound healing.

Timing for revision rhinoplasty

Revision rhinoplasty can be done at any time followiing 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 chnages are being contemplated since the wound healing process may correct these changes making a revision surgery unecessary.Moeover, one does not want to chase after a moving target since significant soft tissuse chnages can ocur after rhinoplasty even after a year, especially in thick skin noses.

Dr. Sofola‘s special interest in rhinoplasty is reflected by his training, experience and results. Set up a consultation today and let his experience work for you.