How soon can I get revision after an open rhinoplasty?

Question

I had an open (revision) rhinoplasty around 5 months ago only to improve the tip, because my first surgery went badly with the Dorsum area (which was a closed rhinoplasty and initially what I wanted done), but now I want to do some work on my bridge. Now I understand that the tip takes time to heal but would there be ANY way I could only do the bridge without affecting the tip? And if not would I be able to do something with both?

Samir Undavia, MD · Answer

It's important that you schedule a consultation with a board certified plastic surgeon to fully address all of your needs when it comes to a revision rhinoplasty. Typically patients should wait a full year after their rhinoplasty before considering revision rhinoplasty.  I hope my video helps you understand more what is involved with a revision rhinoplasty.

Jay Calvert, MD, FACS · Answer

The answer for this is of course: it depends.  If the nose needs intervention sooner rather than later, then the rules about waiting 1 year do not apply.  However, I have found that waiting for the one year mark is best when the patient can accommodate the fact that they are not happy with their result.

Robert Kotler, MD, FACS · Answer

Dear Jaygirl;

I
understand that you are not happy with the nose five months after surgery. But
the fact is, whether or not the tip and other parts they operated on, any type
of work on the nose should be deferred until nine months because it is too
difficult to operate when the tissue is still thick, healing, and temporarily
tightly affixed.

It
does take time to heal, plus the tip of the nose takes more time than any
part. So I would advise you to be
patient.It's best to wait and see
because, in fact, the nose may improve in the next four months, and you may be
less enthusiastic about having a revision.

It is
very important for you to have consultation. If you do arrange one, be sure take all the records and photos from the original surgery.But first, please take some time to do some cosmetic surgery homework. Finding a good cosmetic plastic surgeon starts with a computer
search of surgeons in your (or distant) areas. Best results come from
super-specialists (a medical, not an advertising term) who do the
procedure you want at least weekly and have done it for at least a decade.

Once you narrow in on the website of a surgeon who looks good to
you, focus on the before and after pictures, looking for patients who have had
the procedure you want. There should be dozens and dozens of such photos.

Many good, plain language cosmetic plastic surgery books are
on Amazon.com or Barnes&Noble.com.
As you read, write down questions that can be asked later in
consultation with a surgeon. Many books about cosmetic plastic surgery
are designed to help with all the nuts and bolts of cosmetic surgery
consultations and provide questions about both the before
and after surgery experiences.The person you want performing your surgery would be a cosmetic surgeon super-specialist. Here's what that means:In modern medicine, knowledge about a particular specialty doubles
every 18 months. No surgeon can master all the
135-plus
plastic surgery procedures. In cosmetic facial surgery (a subdivision of
plastic surgery) a menu of just a half-dozen procedures is
considered proper. Such a narrow practice is the manner of the
cosmetic surgery super-specialist, where the surgeon’s practice is
more of a boutique than a department store. Such cosmetic facial surgeons have generally served
an
additional training period -- beyond board
certification -- known as fellowship training. That surgeon, once he
or she became a specialist, has worked at the side of one or more Master Surgeons
for a year, studying and performing only several procedures.

Fellowship is the highest caliber
credential available. Look for those who are fellowship-trained
and board
certified.One more item will serve you well: Computer Imaging. Here’s how it works: photos are taken
of you as you are and uploaded onto a special computer system
that can
morph your present appearance into an anticipated
after picture. (The technology is also known as Computer Morphing.).
Such
imaging is an incomparable learning tool because it provides a forum for doctor-patient
agreement on the after-surgery result
that would satisfy you and is a result the doctor can deliver. After
all, cosmetic surgery is 100% visual. It's about appearance, but without
visuals, everything is left to the imagination.To anticipate a successful outcome, there must
be a meeting of the minds between surgeon and patient. Why waste your time on a
consultation in which the surgeon can’t demonstrate what he envisions as
the outcome? Would you buy a painting without seeing it? In my opinion, a consultation
without computer imaging is nearly worthless.Best wishes,
Robert
Kotler, MD, FACS

R. Stephen Mulholland, MD (retired) · Answer

Dear
Jaygirl,

In
general, the nasal tip takes many, many months to resolve and enhancement
surgery should be considered any time after 12 months.  The bridge itself can usually be manipulated
sooner than 12 months, either further reduction dorsal rhinoplasty or I have
found that, while waiting for the nasal tip to improve, injection rhinoplasty,
or five-minute nose jobs can provide a nice, stable improvement to the while
waiting for the tip and performing open revision rhinoplasty on both after one
year.

Having
trained in both plastic surgery and E/N/T-head/neck oncology and facial trauma,
I have had over 20 years of cosmetic rhinoplasty experience, as well as
injection five-minute nose job treatments.

I
hope this information has been of some assistance.  For more information, please review the link below.

Sincerely,

R.
Stephen Mulholland, M.D.

Certified
Plastic Surgeon

Yorkville,
Toronto

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