Revision Rhinoplasty

Rhinoplasty (nasal surgery) is one of the most difficult procedures performed by plastic surgeons. To most people it seems simple, whittle off some parts and it will look better. The problem is you don't just remove parts you have to reshape multiple parts and do it in such a way that the whole works together to give a pleasing shape that is functional (meaning you can breathe in and out of it). In addition you are dealing with a variable amount of scarring depending upon the persons genetics. I often joke that "I guarantee the work if you guarantee the parts".

Revision rhinoplasty is even harder because you are dealing with scarring and often loss of parts that you, as the primary surgeon, may not have taken off. In these situations it is usually best to remove as much scar as possible and see what you have left. You then reshape the nose to accomplish your goals. This reshaping may involve re-breaking the bones to realign them as well as harvesting cartilage from the septum (the "wall" in the middle between the nostrils) to use to rebuild those cartilaginous parts that are deficient or misshapen.

Revisions can be straightforward or highly complicated. Most are somewhere in between. They usually take a little longer than the original surgery and may take longer for the postoperative swelling to go down as well. When cartilage grafts have been used, the final results may take several months to reveal itself.

It is key in these situations to have a clear understanding with your surgeon about what you desire and what realistically can be accomplished. Although difficult, these cases can be very rewarding for both the patient and the surgeon.

Dean Jabs, MD