When is it appropriate to do a touch up after original rhinoplasty? My doctor is considering doing rasping of the bone on one side of my nose and adding dermal fat graft to the side/bridge of my nose. Is 3-4 months after original rhinoplasty too soon to perform this sort of a touch up? My surgeon stated that I am healing quickly but he will re-evaluate my nose again in 6 weeks to see if that time is appropriate to touch up my nose or make me wait longer.
Doctor Answers (9)
If they are issues which are not going change in any way over time then they can be addressed soon after your initial surgery. For instance, if your surgeon feels that it is bone and not swelling which is causing the deformity then this will not change with time and can be rasped soon after your initial surgery. If, however, swelling is causing or contributing to your deformity then it is best to wait until all the swelling has resolved. Your surgeon would be able to make these assessments during your follow-up visits.
I would wait at least a year unless the circumstances are appropriate. It's important that you nose is stable enough to undergo the procedure so soon, so I suggest meeting with several different facial plastic surgeons who can give you their expert opinion.
When is a good time for revision rhinoplasty?
Although I will defer judgement to the surgeon who is familiar with your case, it is always wise to wait approximately on year after rhinoplasty before undergoing a revision. This will allow satisfactory time for all swelling to resolve. It will also allow satisfactory time for the "shrink wrap effect" of scar tissue formation to fully mature. At one year postop you will have a very good idea what the final appearance of your nose will look like. At that time, you can plan a revision procedure which will accurately target the "problem areas" of your nose.
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Timing of a a rhinoplasty revision
It can be difficult to determine when is the right time for a revision of a rhinoplasty. You certainly need some time for the soft tissue to soften up prior to a revision. Revision rhinoplasty can be a difficult operation and doing it too soon can make things worse.
Rhinoplasty Revision at 3 to 4 months?
Revision after a year's time is conventional wisdom, but I would trust the judgement of your plastic surgeon. Your plastic surgeon knows how you looked preoperatively, what was done during the surgery, and observes you at the followup visits. He or she would be better to assess when a revision is appropriate.
It is often best to wait at least a year after rhinoplasty to have any sort of revision. There will usually be significant swelling up until that point.
In my practice I generally recommend waiting a full year before considering revision surgery. In some situations miner imperfections resolve over the one year period of healing. At one year you typically will have a good sense of the final result and can tackle any issue at that time. Finally at one year the skin and soft tissue envelope of the nose is usually well healed allowing the surgeon best conditions to perform a revision procedure.
Surely rasping and a cartilage grafts can be done 4 months after surgery. There is no harm in waiting if you like to some more months.
Rhinoplasty Touch Up
So it is usual and customary to wait one year before revising a nose. This is for a few reasons. One, it takes about one year for all of the surgical swelling to reduce. Second, scars mature for one year. That has been shown in the medical literature over and over again. For this reason I wait almost a year for any significant revisions. The type of revisions you are looking at I would make you wait one year if you were my patient. So much changes over the months visually as well. You are so early out from surgery that I personally would not entertain any type of revision. However, I tend to be conservative.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.