Revision Rhinoplasty

Rhinoplasty corrects the bone and cartilage structures inside the nose permanently, reshaping the nose and altering its functions. The risks of the surgery are not many and the procedure is quite safe. One of the main objectives of the surgery is to reshape the nose in proportion to the face without causing any breathing problems. However, in some cases, a repeat operation called revision nasal aesthetics may be necessary.

Revision Rhinoplasty

Patients may need a revision rhinoplasty when they complain of persisting problems after a previous rhinoplasty. Some patients may not like the new shape of the nose or some may experience breathing problems after the surgery. Some patients may like the new shape of the nose but they may wish to have revisions.

Revision rhinoplasty can be challenging both for the patient and the surgeon compared to an ordinary rhinoplasty. Because the anatomy of a previously operated nose has already been changed. Furthermore, the patient may have higher expectations. For this reason, we inform our patients appropriately in detail and we realistically discuss the expectations from the surgery.

Our patients are highly satisfied with the results of revision rhinoplasty both by the appearance and function of their noses.

Can Isler, MD.
Aesthetic and Plastic Surgery
General Surgery

About Operation

Expected duration of stay in Istanbul: 6-7 days
Anesthesia: General anesthesia
Expected operation duration: 2-3 hours
Expected duration of stay in the hospital: 1 night
Pain: Occasionally, simple analgesics are needed.
Swelling and bruises: Usually
Dressing: Day 4 and 6
Stitches: No need to take stitches that melt on their own.
Expected return to normal life: 3 days
Sports: Light exercises after 1 week

Before the surgery…

To achieve success with the revision rhinoplasty, all procedures performed in the previous rhinoplasty are repeated. Therefore, the plastic surgeon and the patient should re-evaluate the condition and plan the surgery in collaboration. They must decide what will be changed in the structure of the nose and determine the needs for revision. If tissue grafts are needed, they should decide where to harvest them in advance before the operation.

The operation

Opting for a low nose: Patients may not be satisfied unless an appropriate tissue quantity is removed from the nose in the first rhinoplasty. This is the most common problem after the rhinoplasty. Revision surgery is easily performed to correct this problem. Excess tissue is removed from the nose to meet the needs of the patient.
Asking for an upturned nose: If this the reason of the revision surgery, the procedure will be complex because a tissue graft will be needed. Creating an upturned nose out of a low one is harder compared to doing the reverse. Tissue graft should be harvested from another part of the body. Tissue transplantation helps reshape the nose as the patient opts for.
Less tissue removal from the dorsum of the nose: Revision rhinoplasty can be performed if the bridge of the nose have not been lowered enough as the patient wishes. During the repeat surgery, the bones and cartilage in the nose are reduced using special surgical burrs and rasps to meet the requests of the patient.
If the removed tissue from the dorsum of the nose is too much: Because the tissue on the dorsum of the nose was removed more than required in the first surgery, a repeat operation may be needed. Because in this case, the dorsum of the nose will have a lowered appearance. Tissue grafts harvested from other parts of the body are transferred to the nasal dorsum during the revision surgery, correcting the defects.
If there is a breathing problem in the nose: All corrections should be made appropriately in the first rhinoplasty so that the functions of the nose can be maintained. It will be an adverse consequence if the patient develops breathing problems due to reshaping because rhinoplasty is supposed to eliminate the deformities in the nose, rather than creating any issues with breathing. Measures should be taken against the existing and potential breathing problems. If breathing problems occur after the rhinoplasty, revision rhinoplasty will be inevitable.

The operation

Intranasal tamponades are removed after 2-4 days following the surgery; the sutures at the tip of the nose and the cast over the nose are removed on the seventh day, and the bandages on the dorsum of the nose are removed on the fourteenth day after the surgery.

Finally, nothing will remain other than the nose of the patient after two weeks following the surgery. The patient can take a bath after all the materials over the nose have been removed. However, no contact with water should be allowed when there are bandages on the nose. The patient is allowed to wash his/her hair by leaning the head back at the hairdresser’s.

Transient bruising and swelling may occur around the nose and eyes in patients, who underwent surgery outside the nose. Although these findings are variable among patients, they are temporary and resolve within two to three weeks.

In order to reduce the severity of potential bruising and swelling, ice packs can be applied around the nose for the first three days after the surgery. The patient may return to work and social life after 3-4 weeks following the nasal surgery. However, complete recovery takes a year at the tissue level. Although rare, a second intervention may be required due to untoward recovery outcomes after surgery and this repeat surgery should be performed after one year.

Eyeglasses should not be used for three months after the surgery and exposure to the sun should be avoided. More importantly, any impact such as knocking and bumping on the nose should be avoided for a year.

Frequently Asked Questions

Does revision rhinoplasty allow re-sculpting the nose?

The nose cannot be restructured during the revision surgery. Therefore, it is critical to undergo rhinoplasty in the hands of an experienced surgeon. The revision surgery allows making corrections solely.

I’ve undergone rhinoplasty before but I am not satisfied with the result. Can I undergo repeat surgery?

Yes, you can undergo a repeat operation; revision rhinoplasty is mostly performed due to this complaint.

My nose became too small after the first rhinoplasty, can it be augmented?

Of course, it can be augmented by transferring cartilage grafts.

What is the ideal age to undergo revision rhinoplasty?

There is no ideal age, you can undergo the surgery at any age as long as you are older than 18 years old.

When does the nose gets the final shape?

The targeted shape will be final in 6-12 months.

Can revision rhinoplasty be performed to eliminate breathing problems?

Of course, yes. The inner nasal structures can be corrected while maintaining the shape of the nose.

Does the nose shape change over the years?

No, the surgery provides a permanent appearance.

Will there be any marks left due to excision of cartilage tissue?

Cartilage grafts can be harvested from the nose, ear, and ribs to be used in the revision rhinoplasty. There may be a some scar marks left but they will not be remarkable. Over time, they fade away.

Are allergic reactions likely after the surgery?

Allergic reactions are unlikely when synthetic material is not used.

Does any bruising develop on the lips?

Only mild bruising may occur on the upper lip.

When can one wear contact lenses?

You can start wearing your contact lenses after 3 days.

Does the architecture of the skin affect the success of the surgery?

No, it can only change the speed of recovery.

How many days of resting is required?

An inpatient stay of 1 or 2 days is usually sufficient.

When can I return to work?

Depending on the type of intervention, you can get back to work after 1 week at most.

How many days should pass before starting to wear makeup?

Makeup is allowed after about 10 days.

What are the other types of operations that can be performed in combination with revision rhinoplasty in the same session?

Revision rhinoplasty can be performed in combination with face lift surgery in the same session.

When can the patient engage in workouts or sports activities?

It will take about 3 weeks to start sports activities.

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