Revision Rhinoplasty Procedure
Revision Rhinoplasty Surgery - Beverly Hills & Los Angeles
Revision rhinoplasty represents a different approach to the nose from a primary rhinoplasty. Revision rhinoplasty simply refers to a second, or some cases a third or fourth, surgery to correct previous imperfections. There are many issues that may lead a patient to undergo a revision rhinoplasty, but they essentially fall into two major categories: aesthetic and functional.
The aesthetic reason is the more common reason to have a revision rhinoplasty. Patients frequently say that their nose is too pinched, may still be crooked, the hump is still present, the nose is upturned too much or too little. Healing forces and surgical technique can be to blame for most of these issues, so they must be addressed again at the time of revision. During the revision rhinoplasty, we focus on building the nose back up. We replace cartilage that is missing, and give the nose more support so that it not only looks better, but patients can breathe more freely.
When we refer to the functional portion of the nose, we are referring to the way it works. First and foremost, a patient must be able to breathe in and out of their nose. When patients undergo a rhinoplasty, they may heal in such a way that they are unable to breathe through their nose post-operatively. In the past, most rhinoplasties performed, were essentially reductive rhinoplasties. Surgeons would remove the hump, most of the cartilage and patients would be left with a more narrow nasal passage. Additionally, trauma to the nose can cause a septal deviation to occur, further leading to breathing problems.
Use of cartilage to re-inforce the nose and correct asymmetries
If the nose is too pinched after surgery, cartilage grafting may be required to open the nasal passage for easier breathing. The advantage of this is that it will also help make the nose look less pinched after revision rhinoplasty surgery. At the same time, if there is a deviated septum present, this can also be addressed at the time of surgery.
Given the fact that cartilage is utilized, especially in revision rhinoplasty, there are several sources to harvest the cartilage. If a patient has not had a previous septoplasty (which is removal of a portion of the cartilage that separates the two sides of the nose), then septal cartilage will be used. If this is unavailable, or there is not enough cartilage, ear or rib cartilage can be used as well. I prefer to use the ear cartilage first before needing rib cartilage.
The initial healing time after revision rhinoplasty is usually 7-14 days depending on bruising and swelling. There is no uncomfortable nasal packing after surgery, just a cast that rests on the bridge of the nose to protect it during the first week. The healing following the initial period after b can be longer than after the primary rhinoplasty. There is more scar tissue present, the channels through which the swelling drains are not as efficient. As a general rule, it takes about six months for the final result to become apparent after primary rhinoplasty. Revision rhinoplasty results may take up to a year to be final. Therefore, it is important to be patient during the healing phase, as small amounts of swelling tend to resolve with time.
YOUR CONSULTATION FOR REVISION RHINOPLASTY:
Our office is dedicated to providing you with the best service and support. Initially, pictures will be taken of you, and some paperwork filled out going over your medical history. If you can obtain reports from your primary rhinoplasty, those are also beneficial. You will meet with Dr. Shemirani and his staff where he can listen to your concerns and examine you. Following this, computer imaging can be done to set a plan of what your nose could look like after surgery. We want to be sure that we are on the same page as our patients when setting out to perform another surgery. If you have any questions, they will all be answered at the time of your consultation, and if any concerns come up, we are always available for you. We will explain the plan without using medical jargon so that it will be as effortless as possible.
Facial Plastic Surgeons
As a facial plastic surgeon, I deal exclusively with the face so that I am able to concentrate my knowledge in one specific part of the body. Additionally, my training included five years of head and neck surgery where we dealt primarily with nasal breathing issues. This knowledge is essential in treating the nose in both the aesthetic and functional aspects. There are several areas that are commonly responsible for nasal airway obstruction. I have written a peer-reviewed, nationally published article on the diagnosis and treatment of nasal obstruction. Rhinoplasty is a passion of mine and I treat each patient individually based on the look and the function of the nose. I want to be sure that you are fully satisfied with your rhinoplasty.