Revision rhinoplasty, compared to other surgeries in the ENT department, faces a host of unique challenges. Firstly, it’s generally a more demanding surgery which requires a longer downtime as the nose has already been altered prior through plastic surgery. Thus, most ENT specialists see revision rhinoplasty more as a reconstructive procedure to improve the patient’s nasal aesthetics and preserve normal breathing functions at the same time. Of course, end results must also meet the patient’s goals and personal preferences.
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Revision rhinoplasty is essentially a procedure to improve on or correct the structure of your nose post nose job. Maybe it didn’t turn out like what you expected, or maybe the surgeon made a mistake, which can happen sometimes. In fact, medical literature suggests that the revision rate of rhinoplasty or nose jobs can be as high as 15 percent due to the complex nature of the surgery. Hence, with this said, I strongly encourage patients who are considering a rhinoplasty to do thorough research of their surgeon’s qualifications to prevent the need for revision rhinoplasty.
Apart from dissatisfaction from the previous rhinoplasty, another reason for revision rhinoplasty is from the side effects of a medical implant, such as silicone. Some patients might not react well to silicone and experience skin redness or thinness post rhinoplasty.
As a rhinoplasty changes the original nose of the shape and deforms the cartilage, breathing complications among some patients may occur too.
I won’t go so far as to say that revision rhinoplasty will solve whatever dissatisfaction and complications you face from a rhinoplasty. While there is no hard rule on how many times a patient can go under the knife, it should be noted that each surgery leads to a buildup of scar tissue, which can significantly impact healing as well as how your nose looks.
Further, revision rhinoplasty often requires additional cartilage. Graft tissue collected from the nasal septum is believed to achieve a stable nasal framework, however, some patients have theirs used up entirely during the primary rhinoplasty, which can make revision rhinoplasty a bit more challenging. In such instances, extra cartilage has to be taken from other body parts like the ear or ribs.
Before the surgery, a specialist will study your case and medical records to assess your eligibility for revision rhinoplasty.
During the surgery, incisions are made from the inside and sometimes outside of the nose. Most surgeons prefer to use natural cartilage from the rest of the body or nose instead of foreign implants. This is to prevent side effects and further tissue scarring. The surgeon then carefully reshapes the bone and cartilage to not just make a beautiful nose but most importantly protect the airways for breathing.
Revision rhinoplasty is done under general anaesthesia and lasts about 1-3 hours depending on the complexity of the patient’s case.
Revision rhinoplasty is recommended for patients dissatisfied with the results of their previous nose surgery, experience complications from the previous nose surgery or have a deviated or pinched nose.
Patients considering revision rhinoplasty should wait at least a year from their previous surgery. Swelling from primary rhinoplasty takes about a year to subside, and the nose will only take its final shape once the swelling subsides. Scar tissue also takes time to soften; deep scars can make it hard for the surgeon to operate on. Thus, it’s good to wait for the tissues to heal completely before undergoing revision rhinoplasty.
In cases where revision rhinoplasty is being considered to correct deformities caused by trauma, revision rhinoplasty may or may not be able to help depending on the severity of the deformities.
Yes, results from revision rhinoplasty are permanent and long term.
I always emphasise to patients to be realistic with their expectations and aim for near-perfection instead of absolute perfection. Know when to stop doing repeated surgeries and obsessively chase something that might not even be feasible in the first place! On that note, it is also important for patients to note that there is a limit to how many corrections they can do without risking permanent damage to the nose. The nose is a vital organ and hence, patient-doctor communication is extremely important.