I had rhinoplasty almost a year ago and am not happy with the resuts. It looks EXACTLY the same as before my surgery! So I'm wondering, do I now have to get "revision" rhinoplasty? Or would it not be called that since my nose wasn't botched in the surgery, it just wasn't changed. Do I have to go to someone who specializes in revisions or could I just go anywhere?
Unhappy with Primary Rhinoplasty, Do I Have to Go to a Revision Rhinoplasty Specialist Now?
Doctor Answers (6)
I would recommend a revision rhinoplasty specialist
Depending on what you had performed during your surgery, it is possible you may have some residual swelling and are not seeing the final result. It typically takes around one year before the final result is evident.
The amount of time the swelling lingers may be influenced by the following things:
1) Whether or not tip work was performed
2) The thickness of the patient's skin
3) If the procedure was open or closed
In general, the more rhinoplasties you have performed, the more difficult each successive surgery will be. This is regardless of whether the surgery was "botched," but a revision will be easier to perform if there are not severe issues that are present from an improperly performed initial procedure. The difficulty of revisions is due to the following:
1) Shrink wrappage of the skin
2) Three-dimensional healing
3) Scar tissue
A revision is not out of the question, but I would recommend speaking with your surgeon and get a detailed description of what was performed during your initial surgery and how he or she predicts your nose may change in the months to come. If you were to follow through with another surgery, I would recommend speaking with a qualified specialist. If necessary, 5-Flourouracil mixed with kenalog is a powerful way to help soften and potentially reduce the amount of scar tissue present after a revision rhinoplasty. I have also seen some patients that are diagnosed with scar tissue who actually have think sebaceous skin. In these cases, a light dose of Accutane, a medication that reduces the thickness of sebaceous skin, may help define your nose.
In choosing a surgeon, I always recommend going to a specialist and not to just “anyone”. Thanks and I hope this helps!
A surgeon with revision rhinoplasty experience would be advisable
Despite having no change in your external appearance, there is always scar tissue created during a primary rhinoplasty, making dissection more difficult. A surgeon with expertise in revision rhinoplasty would be able to make important pre-operative and intra-operative decisions based on experience dealing with the challenges inherent to revision rhinoplasty. A revision rhinoplasty surgeon will have plenty of experience with primary rhinoplasty as well.
I think that if you are unhappy with your rhinoplasty, you need to go for an evaluation and specify what bothers you.
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Do I Need a Revision Rhinoplasty Specialist?
Secondary rhinoplasty surgery may be difficult or relatively easy, depending upon what was done to the nose previously and how noticeable the problems are. Some patients are overly perfectionistic and may not even be candidates for a revision procedure. However if indeed your expectations were not met at any level you should definitely see someone who has significant experience and interest in nasal surgery. You will not likely find anyone who only specializes in 'revision' Rhinoplasty so I wouldn't worry about this. However many otherwise talented plastic surgeons have limited experience in nasal surgery. You have to look deeper to find out what their areas of expertise are. If you live in an urban environment you should be able to find someone relatively easily. Best of Luck Dr Harrell
Web reference: http://www.westonsurgery.com
Even if your nose looks the same on the outside after rhinoplasty, the inside is a different story.
Once operated on, the nose undergoes changes in multiple changes, including to the blood supply, skin, and underlying soft tissue. Scar tissue forms. As a result, even if your nose looks EXACTLY the same to you on the outside, because of the changes on the inside, any future operation on your nose will be more difficult than your first. Your best chance of getting a result you will be satisfied with is to find someone who specializes in revision rhinoplasty.
Need for Revision Rhinoplasty
First you will have to decide if you're going back to your original surgeon. If not I suggest you see a surgeon who does a lot of revision work. Don't worry about what your surgery is called; a revision specialist also does a lot of primary rhinoplasty surgery.
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.
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