Revision Rhinoplasty

Getting it Right

Rhinoplasty, commonly known as nose surgery, is one of the most complicated cosmetic surgery procedures. That may explain why Dr. Aydin sees many patients who have had nose surgery elsewhere but now need that failed surgery to be carefully revised. The term for these procedures is revision rhinoplasty.

Revision rhinoplasty can be needed for simple breathing, as the previous surgery has somehow occluded the nasal passages. It may be for cosmetic reasons such as the bridge sagging. Some people may have had as many as five or six prior surgeries.

Revision rhinoplasty demands precision and special care because it can be even more complicated than the original procedure. Tissue and cartilage grafts can be required to provide the required mass needed for the procedure. Sometimes the nose needs to, in effect, be rebuilt.

The procedure

Cases of revision rhinoplasty can be simple, where the patient simply wants some additional bone or cartilage removed from the nasal bridge. Maybe the tip remained more bulbous than they were hoping. These revisions can be very straightforward.

Or they can involve a complete rebuilding of the nose. In these cases, the previous surgeon removed too much tissue, cartilage, or bone, leaving the patient disfigured. Revising these prior mistakes can require surgeries lasting up to four hours. These surgeries may require tissue grafts harvested from the ear, ribs, or temple regions to restore the necessary amount of cartilage, bone, and fascia. In these types of revisions, the skin and soft tissue can be a limitation due to previous scarring and a developed resistance to expansion. In these cases, realism with the possible outcome is paramount.

In many revision rhinoplasties, the open method is preferred because it allows better access to the structures that may need grafting or rebuilding. Open rhinoplasty is done through an incision on the skin under the nose between the nostrils. If that sort of access isn’t needed, Dr. Aydin will use the closed method where all incisions are made inside the nose.

Recovery

Because the entire area has already been through one or more surgeries, revision rhinoplasty tends to be less painful than the original procedure. Bruising is less, as well. As with any rhinoplasty, patients will have a splint on their nose for the first week, and stitches are removed at the end of that week. There will be bruising and swelling. Much of it will have passed by the tenth day following your revision surgery, but it can take up to a full year for your swelling to totally subside. Sometimes swelling will show itself in the morning, and fade through the day. Most revision patients can return to work in about a week, but strenuous activities will need to be avoided for up to one month.

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