Revision rhinoplasty – also known as a secondary rhinoplasty – is a surgical procedure to correct and repair a nose that has previously been operated on. While it may seem like a simple matter to restore a damaged nose, on the contrary, the surgical and artistic challenges are significant.
Essentially patients need to find a qualified and experienced surgeon because revision rhinoplasty is by far a more complex and challenging procedure than the initial rhinoplasty. It is for this reason revision rhinoplasty is more expensive than primary rhinoplasty.
The procedure is much longer than primary rhinoplasty. Revision cases can take more than 1-2 hours to perform because of the obstacles posed by scar tissue and the complexity of surgery. However, this depends on the extent of the revision - the more complex, the longer the length of the surgery.
On a more positive note, revision rhinoplasty tends to involve less pain and bruising than primary rhinoplasty. The splint and sutures are generally removed within 6-7 days. Bruising and swelling will occur and this tends to fade away around 10 days. Patients usually resume work after 7-10 days whilst strenuous activity is usually avoided for up to 3 weeks.
Why is revision rhinoplasty challenging?
Restoration of an unsuccessful rhinoplasty is regarded as the most challenging of all cosmetic surgeries. Unlike primary rhinoplasty where the operative nasal site is soft and skin is supple, a revision procedure usually deals with dense scar tissue which can be challenging to operate.
Then there is also a requirement for a second surgical site to harvest cartilage to aid in the reconstruction of the nose. As can be expected, a second site surgery means more discomfort and more time to heal.
While the outer nasal structure must be attractive and harmoniously proportioned to fit the surrounding face, the surgeon must also take into account the air passages; after surgical revision they must continue to be functional to enable comfortable nasal airflow.
What are the indicators for revision rhinoplasty?
Issues following primary rhinoplasty include an overturned nose, pinched deformity in the nose, nasal hump, twisted nose, over slope in nasal profile, asymmetrical nostrils, unnatural looking nasal tip and breathing difficulties (resulting from an overaggressive rhinoplasty).
Initial consultation is important
The quality of communication and rapport with the surgeon is important. Make sure your surgeon is someone who listens and takes your concerns seriously.
Initial consultation prior to revision rhinoplasty is vital so that your surgeon can assess the nasal bones in the upper area of the nose, the structure of the cartilage in the middle section of the nose, the tip of the nose, the nostrils, etc.
An experienced revision rhinoplasty specialist is one who is focused and experienced in this procedure and has performed many revision cases with a solid track record. A surgeon that performs this procedure frequently should have many before and after photos to share with the patient. While this could reflect only the ‘best results’, at least these are evidence of the type of change the surgeon is capable of producing.
Revision rhinoplasty is not an easy technique which is why cosmetic surgeons specialize in them. And for this type of specialized work, it is expected that you have to pay thousands for it. However for those looking for much less than that, chances are, you will come away, less than satisfied with the result. In essence, have a realistic grasp about the outcome. Manage your expectations and be considerate of the time it takes for your body’s natural ability to heal.