Revision Rhinoplasty, also known as Secondary Rhinoplasty or Complex Rhinoplasty, is usually sought after whenever a previous surgery of the nose did not lead to the expected aesthetic or functional outcome. The experience of a previous surgery which resulted in an undesirable outcome, coupled with the uncertainty of the next surgery providing the long-term desired result can make considering Revision Rhinoplasty a very daunting task.
Based on the nature of how human beings perceive and process noses, we see our nose with a very detail-oriented view. This focus only increases when patients require Revision Rhinoplasty, which subsequently also raises the patient’s expectations. Completely correcting aesthetic concerns that occurred following a primary Rhinoplasty is often a difficult task. Limitations due to scar tissue formation, damaged or deficient cartilage, soft tissue irregularities and other structural damages all have to factored in.
These are the main physiological and psychological reasons why Revision Rhinoplasty is considered to be one of the most challenging procedures, for both the patient and the surgeon. It is therefore pivotal to understand the patient in order to establish a realistic goal.
When is a Revision Rhinoplasty necessary?
A Revision Rhinoplasty becomes necessary when it is needed to address imbalances that persist or are newly created by the first procedure. An unforeseen healing complication or improper healing itself may lead to the need for this second procedure in order to ensure facial balance. This being said, a secondary rhinoplasty is a much more complicated procedure compared to the initial procedure, but with an advanced cosmetic surgeon your secondary procedure can also be very successful.
It is also very important that we work closely with you to manage your expectations. A Revision Rhinoplasty can improve the appearance of the nose and ease of breathing, but it’s important to note that risks and unpredictability cannot be entirely eliminated. Realistic expectations and a grounded acceptance of what your ‘new’ nose may or may not look like is essential before we begin any further cosmetic surgery.
The Procedure
Previous surgery can complicate any further work, which is what makes Revision Rhinoplasty a more complex procedure.
The procedure is usually performed under general anaesthetic, but there is scope for it also to be performed under sedation and local anaesthetic in extenuating circumstances. Almost always, a Revision Rhinoplasty will be performed as an open procedure to allow the surgeon better access to the delicate tissue, cartilage and bones that are responsible for the appearance of the nose. This requires a small incision being made on the outside of the nose so that the skin can be lifted, but it is subtle and can easily be concealed in the contour of the nose postoperatively.
In simpler Revision Rhinoplasties, your surgeon may have to remove excess tissue or cartilage that may have been missed in the original surgery. Where necessary, they may also have to straighten out a crooked nasal bridge by fracturing the bone in a controlled way.
For more complicated procedures, a total overhaul may be necessary. When patients have had too much tissue removed from the nose, a graft using cartilage or bone will have to be used, which can be taken from the ear, temple or ribs.
There is also a chance that scar tissue will have developed as a result of the first procedure, in which case surgery is inadvisable, or the skin in the area may be insufficient.
These circumstances make Revision Rhinoplasty problematic, and should be discussed carefully with us.
For a relatively straightforward procedure, Revision Rhinoplasty will take 1-3 hours. If you require a graft, this may become more.
