Revision Rhinoplasty

Revision Nose Aesthetic Procedures

Various revision rhinoplasty operation techniques are available for the surgical treatment of noses with functional or aesthetic problems that occur in patients who have had a previous rhinoplasty operation. Rhinoplasty performed for the second time is called secondary rhinoplasty, and rhinoplasty performed for the third time is called tertiary rhinoplasty. Apart from open and closed technical revision rhinoplasty operations, there are revision rhinoplasty operations that include sub-techniques that vary according to the tools used in bone shaping.

Challenges of Revision Rhinoplasty Operation

Unlike primary rhinoplasty, revision rhinoplasty operations are more difficult, more personalized and risky operations. The risk of circulatory and healing problems, tissue dissection difficulties, the presence of healing tissue and suture reactions in the previously operated area make the planned procedure difficult. In addition, the need for additional cartilage or camouflage material (temporalis fascia) may cause the operation to be more difficult and complicated, since the cartilage tissue to be used for changing the shape of the nose is not sufficient. Sometimes, the risk of skin injury may arise, since it is very difficult to lift the nose skin by elevating it. In some patients, since there is a large amount of roughness on the nose, it may be necessary to use fascia or similar membranes to provide camouflage under the skin.

Who Is Revision Nose Aesthetics Suitable For?

Anyone who has had rhinoplasty before but has various problems in terms of both shape and function can have revision rhinoplasty. However, in order for this surgical operation to be performed, a minimum of 6-9 months must have passed since the first operation. In fact, if the patient does not have a serious problem such as respiratory distress, it would be much more correct to wait 1 year after the first surgery. Those who seem to have a swollen nose after rhinoplasty, and those who have problems such as the appearance of the nostrils due to excessive lifting of the tip of the nose can benefit from revision rhinoplasty.

Revision rhinoplasty can also be preferred in cases such as the reduction of the nose more or less than it should be, the distortion of the shape gained due to a blow to the nose after the first surgery, a disproportion between the nose and the face area, and an asymmetrical appearance in the nose.

How Long Does Revision Nose Aesthetics Take?

One of the most frequently asked questions by patients is how long revision rhinoplasty surgery takes. However, as we mentioned before, these plastic surgeries can be performed for many different purposes. Therefore, it would be misleading to talk about a precise duration. In some patients, even the removal of the skin over the cartilage structure may take more than 40 minutes. The duration of the surgery can be much longer when cartilage tissue is required to be removed from the back of the ear and cartilage grafts are required to be taken from the rib cartilage. However, in some patients, only a 20-minute operation may be sufficient to achieve the goal.

Various factors such as the shape formed after the first surgery in the nose area and what kind of intervention will be performed bring about the change in the duration of the surgery. After the clinical examination by your doctor before the operation, you will be informed about how long the revision rhinoplasty surgery will take. Of course, unexpected situations may develop during surgery. Therefore, surgical intervention may take a little longer than the specified time.

What is the Recovery Process After Revision Nose Aesthetics?

While noting that the recovery process after the operation does not force the patients too much, let's underline that some factors should be paid attention to at the maximum level. First of all, revision rhinoplasty surgery usually does not require clinical rest. Usually, only 1 day of clinical rest is required. After the surgery, it may be necessary to apply a cold compress for about 1-3 days. Therefore, the patient is not discharged immediately after the operation. Cold face mask is a preferred method to reduce edema and bruising. If an operation was performed on the auricle or rib to remove additional cartilage tissue, the patient's pain may be a little more.

What to Do After Revision Nose Aesthetics

During the healing process, a lot of attention needs to be paid to hygiene. Patients may have the feeling of constantly touching their noses with their hands, but this is not recommended. Especially after the bandage is opened, the nose should not be touched for a few days, except for necessities such as massage. However, care should be taken not to get any blows to the nose area after revision rhinoplasty. It is recommended to sleep with 2 pillows to keep the head area up for 1 week after the surgery. In this way, the swelling will be less.

If silicone splints with a perforated structure are used after revision rhinoplasty, they are removed after 7 days. If a plastic or silicone splint is used, this splint is also removed after approximately 7 days. How long the bandage will remain on the nose varies depending on both the intervention and the speed of recovery of the patient. We can usually state that this period does not last more than 1 week. In some patients, nasal packing and nasal splint may not be used, and it may be sufficient to stick a few plasters on the nose.

It is possible to take a shower 2 days after the revision rhinoplasty, provided that the nose area is not wet. If the inside of the nose has been treated, it is appropriate not to contact the city mains water inside the nose for about 3 weeks while taking a bath. However, you should not enter the pool, sea, sauna or Turkish bath for 1 month. At the same time, you should take a break from exercise and sports activities that force the body during this period. Patients can usually return to their work life after a few days. There may even be patients who are able to work the day after the operation. You do not need to take a long break from your business life for this operation.

There may be numbness in the nose area for about 2 to 3 months. This is normal and will go away on its own afterwards. Bruising and edema begin to decrease after 2 days and disappear in a short time. One of the most curious questions is when the result can be seen after revision rhinoplasty. It is possible to see the shape of the nose clearly after 1-2 months if minor interventions are made. This period is longer in patients with excessive deep dissection and cartilage grafting procedures. However, it may take 1 year for the nose to fully take the form gained by surgery. In those with very thick skin features, this period may extend up to 2 and a half years. Recovery time may differ from person to person. During this period, you should take into account the warnings and recommendations made by your doctor. Strictly complying with the warnings and recommendations will allow you to experience a more comfortable recovery process after revision rhinoplasty.

Functional Structure Should Be Preserved in Surgery

The aim of all aesthetic operations should not be only appearance. In rhinoplasty, the functional structure of the nose must be preserved. The nose consists of cartilage and bone roof. During breathing, air passes through the nasal passages. However, the narrowing of the nasal passages or the curvature of the nasal wall cause various problems in breathing. It is very important to protect the valve areas in the nose in rhinoplasty operations or revision rhinoplasty operations. Much more attention should be paid to the preservation of the functional structure, especially in operations performed to correct nasal wall curvatures.

How is Revision Nose Aesthetics Performed?

The surgical procedure may vary depending on the surgical intervention to be performed. For example, a revision rhinoplasty performed only for the purpose of reducing the tip of the nose and a surgical intervention to correct the deformation at the tip of the nose are not the same. However, we can state that revision rhinoplasty is usually performed with the incision and then the transfer, removal or shaping of the desired cartilage tissues. However, a different surgical procedure can be followed in revision rhinoplasty for nasal tip thinning.

Since the operation is performed with local or general anesthesia, it is of course impossible for the patient to feel any pain or ache. Revision surgeries are not required in most of the aesthetic surgeries such as low nose tip lift performed by an experienced doctor. For this reason, it should be noted that the belief that revision surgery may be needed after each rhinoplasty is not true. In order to avoid the need for revision rhinoplasty, you should also consider the warnings made by your doctor after the surgery.

Revision rhinoplasty is like opening a gift surprise box!

The comments of patients who have had rhinoplasty surgery before and who were not satisfied sometimes do not coincide with what we see during the operation. For example, in a patient who said "I think only the cartilage at the tip of my nose has slipped", there was a suture reaction at the tip of the nose during the surgery, or in a patient who said "the cartilages in my nose turned sideways", we saw that the nose turned sideways as a result of the healing process, due to the rather asymmetrical cartilage in the nose. Nose aesthetic surgeries are not a risk-free photo application. Not every revision rhinoplasty surgery is performed only because of the doctor's error. In rhinoplasty surgeries, all aesthetic nose surgeries after the first surgery are more difficult and more complex. It requires knowledge, experience and foresight. During the operation, we generally continue the procedure by seeing the normal anatomical structures, cartilages, connective tissues under the skin and some anatomical details that guide us during the procedure. In patients with revision rhinoplasty, we may have to continue the surgery under the skin as if cutting a cardboard or cardboard, due to the healing tissues.

Is revision rhinoplasty surgery painful?

When the amount of pain that occurs after revision rhinoplasty is compared with the pain after primary rhinoplasty, of course, it is less if a small procedure is performed. However, if it is done as a complete rhinoplasty, the patient will feel as much pain as the pain felt after the previous rhinoplasty surgery. Painless rhinoplasty revision may not be possible under local anesthesia. Only a small filling process or a small asymmetry removal can be done painlessly. In general, I perform all nasal aesthetic applications in the operating rooms of hospitals in order to ensure the comfort and sterilization conditions of my patients.

Sometimes, it may be necessary not to expect perfect results after revision rhinoplasty surgeries!

In rhinoplasty surgeries, it is generally recommended to respect the anatomy of the nose and to perform the procedure without changing the nose anatomy as much as possible. In some of the patients, very serious anatomical changes and irreversible changes in the nasal cartilage and other tissues can be found.

In these patients, sometimes not all deformities can be fully corrected. It should be noted that in case the nasal cartilages are different from each other and in patients who have most of their cartilage removed, the same cartilage is not found in the body, so it is not easy to obtain a similar one, and this is not a photo program application. The patient's expectation of a perfect result after the operation may cause disappointments after the operation. The aim should sometimes be to reduce deformities and to bring nasal breathing in the best possible way.

After the revision rhinoplasty surgeries, the expectation of millimetric full symmetry or a complete recovery in patients may cause disappointment. However, very good results can be obtained in patients whose nasal anatomy has not been changed too much and who has not undergone too many traumatic procedures in the nose.

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Dr. Murat Enöz - MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

Private Office:

Address: İncirli Cad., No:41, Kat:4, Dilek Pastanesi Üstü (Dilek Patisserie Building), Posta kodu: 34147, Bakırköy - İstanbul

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E-mail: muratenoz@gmail.com

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Fax: +90 212 542 74 47

Fax: +90 212 542 74 47