Revision Rhinoplasty
Given the complex nature of nasal surgery, it is not uncommon for some discrepancy to occur between the goal and the actual outcome. Even surgery performed by the most skilled and experienced rhinoplasty specialists carries some chance that a secondary procedure will be necessary. Revision rhinoplasty is designed to repair problems with the nasal aesthetics or function that result from a primary rhinoplasty surgery.
A few words about Revision Rhinoplasty
Revision rhinoplasty typically is performed under twilight sedation or general anesthesia. Like primary rhinoplasty, revision can be performed through either a closed (endonasal) approach, during which incisions are made inside the nose, or open (external) rhinoplasty where incisions are made on the strip of skin between the nostrils. The approach depends on that maneuvers need to be accomplished. The skin of the nose will be elevated from the supporting bone and cartilage. Any missing structures removed during the previous surgery can be replaced or repositioned.
External dressings on the nose and sutures are usually removed 1 week post-operatively. These are placed to help control swelling and stabilize the nose. Patients who undergo revision rhinoplasty typically experience less pain, swelling and bruising than with their first procedure. Bruising will fade over the course of about 10 days and swelling will gradually subside too. While swelling will noticeably decrease during the initial weeks after surgery, the last bits of swelling can take several months and up to a year to fully fade.
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Revision Rhinoplasty FAQs
Patients undergo revision rhinoplasty when a previous rhinoplasty procedure has left them with a nose that does not meet their expectations. The prior surgery may also have affected the person’s ability to breathe properly. Common problems that need correction include asymmetry, unsatisfactory structural support, obstruction of the airway, and general dissatisfaction with the appearance.
The best candidates are healthy men and women looking to repair an aesthetic or functional problem with their nose after a previous rhinoplasty surgery. Candidates must have realistic expectations. Even a secondary procedure may not be able to fully correct the problem, though an experienced surgeon can get as close as possible to meeting, and hopefully exceeding, expectations
It is recommended that patients wait to undergo rhinoplasty until the nose has stopped growing. This is typically around 14 or 15 for girls and 16 or 17 for boys (but can vary on an individual basis). Since revision rhinoplasty is performed following a primary procedure, patients will likely be at least this old at the time of their surgery.
Patients generally experience less bruising, swelling, and pain with revision rhinoplasty. However, it can take 1 -2 weeks for any bruising to resolve. The final results of your surgery many not be seen for up to one year since some swelling will take longer to resolve.
Most patients return to work after dressings and sutures have been removed, which is usually one week after surgery. Some patients feel comfortable returning to work with a splint and may return sooner, at around 2 days. Dr. Agarwal, Dr. Maloney, or Dr. Ross may choose to apply supportive brown paper tape to the nose for another 3-4 days after the splint and sutures are removed.
Strenuous activity should be avoided for about 2 to 3 weeks. Walking exercises can resume at around 1 week. Sports and exercise routines that risk trauma to the nose should be put off for 6 to 8 weeks.
Most procedures are performed at our state of the art AAAASF (American Association for Accreditation of Ambulatory Surgery Facilities) certified office surgical center. We maintain an impeccable operating room and suite, with utmost attention to your safety.
It is required that patients have a family member or friend accompany them to their procedure and drive them home afterwards since the effects of anesthesia can inhibit your ability to operate a vehicle. It is also recommended that someone stay with you for the first night post-op.
All surgical procedures have some risk of complication. Risks associated with revision rhinoplasty may include but are not limited to: adverse reactions to anesthesia, small burst blood vessels, excessive scarring, prolonged swelling, asymmetry, bleeding, infection, and the need for additional revision procedures.
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