Revision rhinoplasty is performed to correct problems that develop or continue after a previous rhinoplasty. Also known as Tertiary or Secondary Rhinoplasty, this procedure is to correct a prior unsuccessful surgery of the nose.
Nationally, approximately 5-12% of patients that have rhinoplasty need a revision of some kind, whether it is major or minor. Even in the hands of the best rhinoplasty surgeons across the country, the need for revision will sometime occur. Without a doubt, revision rhinoplasty surgery is the one of the most challenging procedures performed.
Patients for revision rhinoplasty may use the same surgeon as the original procedure, but in most cases revision rhinoplasty procedures are performed by a different surgeon. As in the original rhinoplasty there are limits to what can be done. The surgeon performing the revision rhinoplasty can often give a variety of options, depending on what the patient expects the revision rhinoplasty to accomplish. Dips can be filled out using implants and bumps can be filed down. Breathing problems coming from conditions like a deviated septum and sinusitis can be addressed at the same time.
Revision rhinoplasty can also correct noses that are thick or thin, and remove scar tissue. Because revision rhinoplasty requires a certain set of skills and is often more delicate than the first procedure, a revision rhinoplasty is a specialty in its own right, with some plastic surgeons’ reputations being built on revision rhinoplasty alone.
Sometimes the problems are minor and easily corrected, but if they are major a revision rhinoplasty is always more difficult and requires more expertise than the first surgery. This is due to the fact that the normal nose is no longer intact and the tissue before the first surgery is now filled with scar tissue. This makes it difficult to separate and reposition the remaining bones and cartilage. Usually a revision rhinoplasty will give significant improvement and sometimes dramatic results can be achieved for revision rhinoplasty patients.
Damage from your prior rhinoplasty may not just be cosmetic but functional as well. Breathing can be hindered and an array of complications can ensue. Also be aware that depression and revision surgery is an issue that should not be ignored.
Since most secondary rhinoplasty patients have an operated and unnatural looking nose that does not function properly, the surgical goal is to produce a nose that appears natural, functions properly, and is in balance with other facial features. The patient’s wishes in regard to the type of nose desired are always considered, but there are limiting factors. To accomplish the goal it is necessary to reconstruct and reshape the supporting framework of cartilage and bone. This will allow the overlying skin to redrape over the reconstructed framework giving the nose its new shape. Skin texture and thickness, the amount of scar tissue from the previous surgery and the facial proportions and contour play an important role in what can be achieved.