The Revision Rhinoplasty
Article by Michael Elam, MD
Orange County Facial Plastic Surgeon
Dr. Elam has thirty-five years of experience in revision rhinoplasty surgery. Like most Cosmetic Surgery procedures revision rhinoplasty is both a science and an art. Success in revision rhinoplasty requires years of accumulated knowledge and lots of experience and expertise. Revision rhinoplasty is typically performed for one of two reasons either the result is aesthetically undesirable to the patient or the patient has diminished nasal function.
While some revisions are relatively minor in some cases the revision surgery can be more extensive then the original surgery. The revising surgeon is often dealing with tissue planes that have possibly been over resected, or asymmetrically resected and weakened cartilages. A careful analysis must be done of the patients existing condition so that proper surgical alterations may be made to improve or correct these undesirable results.
When patients are considering revision rhinoplasty it is critical to allow the nose to heal from its primary surgery before correction. Dr. Elam’s general rule of thumb is typically one year from the original surgery. Rhinoplasty surgery takes time to heal and while the majority of the swelling is typically dissipated in the first three to four months the final swelling, approximately thirty percent takes an entire year to fully resolve. This may be even longer depending on each patient’s personal anatomy.
In some revision procedures a patient may require actual reconstruction of the nose and may require augmentation grafting. Often times these patients have undergone septoplasty and have limited amounts of septal cartilage available for structural grafting. When this is the case then the surgeon must decide upon the type of material that will be used for grafting. With thirty-five years of experience and expertise it is my preference to use autogenous material vs. manufactured materials. Autogenous material such as auricular cartilage (ear cartilage) has long-term survival characteristics; it is resistant to reabsorption, infection and has great flexibility.
Whether the consulting patient is in need of a minor revision procedure or a complete reconstruction Dr. Elam is able to achieve high levels of satisfaction from his patients. Revision rhinoplasty surgery is a very rewarding procedure for both surgeon and patient alike.