I had rhinoplasty on my nose five years ago, after this procedure I had breathing difficulties.I then had septoplasty and my turbinates operated on to fix this two years ago. I want to have a second rhinoplast as the results from my first one were minimal, I was told that I may need grafts. Please can you tell me the risks of this second rhinoplasty and the affects it can have on the results or what can or can't be achieved with my history.
I Had Rhinoplasty, Followed by a Setoplasty. I Want a Second Rhinoplasty. What Are the Risks?
Doctor Answers (7)
Revision with grafts
Your situation is not unique - many patients revision patients require grafts. Just make sure you choose a surgeon with experience in ear and rib grafts
Revision rhinoplasty and risks
Revision rhinoplasty is always much more difficult than the primary rhinoplasty. There is a 10 to 15% chance of requiring a touchup procedure after this one. Complexity will depend upon how many grafts, where they are placed, whether they are placed in the tip, bridge, or in the mid third of the nose. The healing process also is very important as some patients heal with more scar tissue in their nose.
Revision nasal surgery
As in the saying goes " first chance is your best chance" So all your nasal problems both cosmetic and functional should have been addressed during your first surgery. The nasal septem is a key part of the nose and all surgeons doing rhinoplasty should be capable of handling it well. It appears that two defferenr surgeons worked on your nose a Plastic sugeon and an ENT surgeon. I understand that it is a common practice in UK under NHS. Any way, now you need to consult a surgeon well versed in nasal reconstructive surgery to restore your nose to good appearanse and function. Good Luck
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It is well known that this type of revision rhinoplasty is usually more challenging than a primary procedure but the risks are similar. It is impossible to give advice regarding what can be achieved without seeing pictures of your nose. Discuss your dilemma with your surgeon, but also get a second opinion from a surgeon who does a lot of revision work. Good luck.
Secondary rhinoplasty is always a bit more difficult than a primary. The graft matterial normally used may not be available.
Risk of revision rhinoplasty (secondary nose job)
There are risks to crossing the street or flying in an airplane and, of course, there are risks to any surgical procedure. These risks can occur regardless of surgeon or technique. These include but are not limited to: infection, bleeding (epsitaxis), hematoma, discomfort, wound breakdown, hypertrophic scar formation, asymmetry, unfavorable healing, aspiration, difficulty with nasal breathing, septal fistula, synechiae, alteration in voice, implant/graft infection, donor site problems, exposure, palpability, visibility, changes with aging, need for secondary surgical revisions, and inability to guarantee a specific cosmetic and/or functional result.
Possible Graft Options for Revision Rhinoplasty
There are a variety of different options for graft harvesting. You could have enough reamaining cartilage that can be harvested from the septum.
Other options include ear cartilage and rib cartilage. Depending on your surgeon's philosophy, other alternatives such as radiated rib graft exist that can provide you with good results.
Careful examination of inside of your nose along with a detailed discussion of different options can provide you with an accurate estimate of the success of surgery and risks associated with it.
There are few of us around the states that enjoy doing revision rhinoplasty. Even though this operation can be challenging, with appropriate planning, you could have a good result.
You can post your picture or send confidentially for better evaluation and recommendation.
Please see the two attachement below that was recently published in Plastic Surgery Journal for addtional details.
Hope this was helpful.
Current Status of Grafts and Implants in Rhinoplasty: Part I. Autologous Grafts
Sajjadian, Ali; Rubinstein, Roee; Naghshineh, Nima
Plastic & Reconstructive Surgery. 125(2):40e-49e, February 2010.
Current Status of Grafts and Implants in Rhinoplasty: Part II. Homologous Grafts and Allogenic Implants
Sajjadian, Ali; Naghshineh, Nima; Rubinstein, Roee
Plastic & Reconstructive Surgery. 125(3):99e-109e, March 2010.
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