Is is possible to do a revision rhinoplasty, having a good outcome, without previous operative notes? (Photo)

Is it possible to do a revision with good outcome without previous operative notes? I had a primary with 2 small tip revisions. Nothing much changed from the primary other than now I have a droopy tip. The surgeon I guess either lost my records or per the facility he didn't document my surgeries.

Doctor Answers 9

Revision rhinoplasty is possible without previous operative notes

In the majority of revision rhinoplasty that we perform,  the operative reports are unavailable or inaccurate.  Look for an experienced rhinoplasty surgeon  who has dedicated a significant portion of their practice to the discipline of rhinoplasty and revision rhinoplasty.

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews

Prior records in rhinoplasty revision surgery are not usually helpful

After being in practice for 12 years and performing over 1000 rhinoplasty surgeries with 1/3rd of those revision cases I have found that operative notes are not really helpful. Even when we get the notes I find that the description of the previous surgery is often inaccurate and of little help. What matters most in revision surgery is analyzing the nose now to determine what it needs to be improved and then doing a careful exposure to show what is going on under the skin. Tissue can change over time, bones heal, cartilage can weaken and resorb or shift making the nose very different from what was described in an operative note 5, 10, or even 20 years ago. 
Your description of a failed surgery with several minor attempts to correct with tip revisions points to a problem with tip support and projection which is hard to fix without doing a full rhinoplasty surgery. I would advise to seek several opinions from experienced rhinoplasty surgeons. Good luck with your quest.

Ivan Wayne, MD
Oklahoma City Facial Plastic Surgeon
5.0 out of 5 stars 61 reviews

Doing revision rhinoplasty without prior operative notes

It is certainly feasible to do a revision rhinoplasty without having access to the prior operative notes. I find that in the majority of cases the old operative notes are either not available or not very accurate.

Regardless, you would want to be seen by an experienced revision rhinoplasty surgeon. This type of surgery is normally more complex so you want someone well versed in dealing with anything that may come up during surgery.

You can learn more about revision rhinoplasty at my web reference link below.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 21 reviews

Revision rhinoplasty without previous records

I would agree with others, that previous operative notes not always available and do not preclude revision surgery. Preoperative photos, even personal photos to judge the changes can be very helpful, as well as some idea of how much septal cartilage is still present ( was a septoplasty done).  The most important factor is that the surgeon have options for cartilage grafts, as they are usually a part of a revision rhinoplasty. Your photograph, although limited in its information suggests that your nose is still large and bulky, and there is a very good chance that revision rhinoplasty could help.  The previous  experience of the revision surgeon is critical, and so you should be careful in choosing your surgeon..

Thomas A. Mustoe, MD, FACS
Chicago Plastic Surgeon
4.8 out of 5 stars 96 reviews

Revision rhinoplasty

Dear Mkw32,

  • We frequently perform revision rhinoplasty without previous notes
  • Usually, the previous operative reports are only somewhat helpful (sometimes inaccurate)
  • I would visit a revision rhinoplasty specialist when you are ready

Nima Shemirani

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 74 reviews

Nasal Revision Without Previous Operative Records

It can helpful to have previous records; however, over the past 35 years I've found that frequently they are not available. I have a large sampling because almost 2/3rds of my rhinoplasty surgery involves revision work.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 39 reviews

Droopy tip revision

In my mind, the chance of achieving an ideal outcome decreases with each revision surgery. So choose your rhinoplasty surgeon wisely! In saying that, from what is visible on your photo, you should be able to achieve tip rotation and refinement and, more importantly, tip support without to much difficulty. Your previous operation notes would be useful but are not essential to achieve this. Good luck!

Paul G. Gerarchi, MBBS, FRACS
Sydney Facial Plastic Surgeon
4.6 out of 5 stars 25 reviews

Revision Rhinoplasty

After 3 procedures on the nose, it is important to know exactly what was done before any other procedures are considered.  Perhaps your new surgeon will be able to directly communicate with the previous surgeon to gain further insight.  As always, it is important to consult a board-certified Plastic Surgeon who has experience in revision rhinoplasty.

Jarrod Little, MD
Louisville Plastic Surgeon
4.9 out of 5 stars 21 reviews

Rhinoplasty documentation

It is usually extremely helpful to have surgeons note for any kind of revisional work. More importantly, try to get the surgeons preoperative photographs, which will enable some assessment of what change has really been achieved.
One single close range photograph without any preoperative comparison makes it hard to judge.

Alexander Aslani, MD
Spain Plastic Surgeon
4.8 out of 5 stars 312 reviews

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.