Revision Rhinoplasty: Q&A
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For What Scenarios Does a Nose Revision Pose More Risks Than the First Procedure?
Why is revision rhinoplasty a longer surgery than the original? What are the most common complications to the bone, cartilage and skin?
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anon
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For What Scenarios Does a Nose Revision Pose More Risks Than the First Procedure?
I have perfomed Rhinoplasty and Revision Rhinoplasty for over 20 years and it's the scar tissue within the nasal tissues that makes Revision Rhinoplasty more difficult. The scar tissue increases each time another surgery is performed, on the nose. Then there's the issue of cartilage removal, asymmetry and decreased blood supply to the nasal skin as well as internal mucosal scar formation from previous incisions.
Having said all that, this isn't anreason not to...
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Comparison of Primary and Revision Rhinoplasties
Except for minor revisions, a revision rhinoplasty is always more difficult and challenging because normal anatomy is altered, scarring is present, circulation is compromised, and frequently too much bone and cartilage has been remove necessitating grafting from the ears or ribs. Revision rhinoplasty is a specialty of its own and should be done by a surgeon who is experienced in this work. I feel very strongly about that - when I started doing facial plastic surgery 35 years ago, I did not...
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Revision rhinoplasty takes longer due to scarring and missing parts.
Over the past 35 years of doing revision rhinoplasty I still find it one of the most challenging procedures in plastic surgery. Each is different due to scarring and missing parts removed during prior rhinoplasty. Therefore, the surgeon must know how to diagnose what is missing and make it.
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Why is revision rhinoplasty difficult
Where should we start? First there is the skin. Rhinoplasty is done by separating the skin envelope from the underlying bone and cartilage and then reshaping that structure so the skin can redrape to it. In a primary rhinoplasty with no previous surgery there is a natural plane between the skin and cartilage that allows it to peel right off easily. The second time you go back this plane is gone and it is like trying to separate two pieces of paper that have been glued together without...
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Revision vs. Primary Rhinoplasty
Revision rhinoplasty is one of the most difficult cosmetic plastic surgery procedures. My professor of plastic surgery recommended that surgeons should not attempt revison of other surgeon's rhinoplasty for the first 10 years of their careers.
The first problem is the anatomy of an operated nose is not normal. Rhinoplasty surgery alters and changes the nose's normal anatomy in order to create the new shape. Skin, cartilage, bone and mucosa ( the internal lining of the nose)...
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One word--- scarring
Revision rhinoplasties are almost always much harder than the original surgery! Scar tissue under the skin makes dissection more difficult and the surgeon never knows what will be found. If cartilage was removed at the original surgery, grafting of cartilage is more likely to be necessary. Make sure the surgeon has a lot of experience in revision rhinoplasty. Scarring and swelling tends to be worse after a revision surgery as well.
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Nose
The problem with revision rhinoplasty is that even if the original surgeon is doing it he often can't tell exactly what is going on in there as healing is unpredictable. Also no matter what, your surgeon has to deal with scar tissue
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