Revision rhinoplasty, commonly termed as a secondary rhinoplasty procedure, signifies resizing or reshaping an individual’s nose following his/her prior attempted nose surgery. Contracted nose rhinoplasty is often performed to fix cosmetic irregularities along with correcting breathing difficulties, which may develop from a suboptimal surgical procedure.
Revision rhinoplasty is considered as one of the most difficult nose correction surgeries performed by the top rhinoplasty surgeons to attain consistent results. The difference between an undesirable or optimal outcome is often measured in millimeters.
Most cases of the contracted nose surgery involve disproportionate reduction of a person’s nasal bridge, poorly grafted implant materials, and asymmetry, irregularities of the nasal tip, and infection or extrusion of the implant, causing extensive scarring both on and under the skin, resulting in a thick, non elastic skin. Over the years, the scarring can tighten, further causing the tip to rotate upwards, giving an unsightly “snoutlike” appearance. Correction often involves rib harvest and sometimes even skin manipulation.
The best plastic surgery clinic in Korea encompasses surgeons with a complete knowledge and understanding of the desired anatomical transformation of a patient to repair or revise his/her original nose job.
A lot of patients pursue this revision rhinoplasty as they are not happy with the results of their previous surgery. Some of the common complaints are:
It is further observed that the patients who opted for Septoplasty to correct their deviated septum may need additional surgery to completely alleviate their nose deformities.
A revision surgery of a contracted nose frequently presents a greater level of precision required to attain the best outcomes. Depending upon the specific requirements of a person and the complexity of the procedure, your surgeon may decide on the Open and Closed Rhinoplasty. The procedure is selected by carefully assessing the technique that would best fit the person to impart the desired results.
Since the closed rhinoplasty approach limits a direct visualization of a person’s nasal anatomy, it offers compromising results. And so, an open or external rhinoplasty is mainly used for intricate cases, such as correcting the contracted nose, tip alternation, or bridge augmentation. Besides, a revisional nose job for a contracted nose may also require various tissue grafts. Only an expert with an in-depth knowledge of grafting techniques, tissue transplantation, and tissue rearrangement are uniquely equipped to deal with such challenges.
Being an outpatient procedure, the patients can usually resume their work within a week after the surgery. However, it is recommended to avoid strenuous physical activities and exercises for approximately two weeks post the surgery.
Dermal fillers are a popular “quick fix”. However they are not without risks, especially permanent fillers. It is always advisable to choose non permanent fillers if you desire to have filler augmentation. After multiple filler injections, the skin can sometimes be thinned out very significantly that rhinoplasty can be very risky for skin necrosis. Post filler noses undergoing rhinoplasty are always at higher risk than normal noses. Other complications of fillers (especially permanent ones) include skin colour changes and formation of unsightly lumpy skin that can be very difficult to undo.
Infection rates are much higher when using alloplastic implants such as silicone and goretex. That is the reason why autologous (from your own body) materials are so much better and safer. Once there is implant infection, the soft tissue injury and scarring will frequently lead to formation of a contracted nose. In essence, infection leads to destruction of soft tissue and cartilage alike, and the subsequent scarring can cause significant deformity.
Whether because of infection or malposition of the implant, or simply dissatisfaction with the implant, implants can be removed.
Previous nose jobs gone wrong may cause frustration in patients due to following reasons:
In addition, the patient’s cartilage structures may be evidently visible through the nose skin, thereby giving the person witch-like appearance.
Therefore, bad nose jobs may cause subtle changes in an individual’s nose structure, which can drastically increase their stress levels. And so, it becomes imperative to consult a well-experienced rhinoplasty surgeon to address this problem through a nose job revision rhinoplasty surgery. It is a highly advanced procedure that requires a deep understanding of the delicate parts of the nose. It is unarguably one of the most demanding cosmetic procedures that also play a pivotal role in the mechanics of functional breathing.
Since the previous septoplasty for breathing problems may often cause the removal of your precious septal cartilage (ideal for rhinoplasty). Thus, the previous rhinoplasty would also similarly mean that these cartilages may be used up. The take home messages are:
1) It is very important to inform your surgeon truthfully of any previous nasal surgery, as the lack of available materials can sometimes mean needing a rib harvest. Failure to restore proper support because consent was not taken for a rib harvest can mean a collapsed or contracted nose needing further surgeries.
2) If you are considering septoplasty for breathing problems, also consider if you want any augmentation at the same time. It is better to have them done at the same time or there is a chance you may need a rib harvest should you want cosmetic improvements in future.
It is advisable to go for a revision rhinoplasty only after a gap of six months, post the first nasal surgery. Patients with improperly done rhinoplasty are suggested to wait for a couple of months to enable sufficient recovery time for the nose tissues to get soft and stable again. Nevertheless, in the following cases re-surgery can be performed without waiting extensively for a longer duration:
Dr. Tan Kar Su has performed a number of complex revision rhinoplasty surgeries by using advanced approaches to repair the patient’s cosmetic and functional abilities.