Rhinoplasty is a cosmetic procedure performed to address nasal shape and function issues . It involves permanent changes to the bone and cartilage within the nose, improving its shape and function. Literature indicates that one in four patients undergoing rhinoplasty develops various problems and requires revision surgery.

Revision rhinoplasty may be performed for patients who, despite rhinoplasty, have persistent problems or believe their problems persist. Patients may experience discomfort with the new nose shape or breathing difficulties. Some patients may request some changes upon seeing their new nose shape. Rhinoplasty is a personalized procedure. The success of the surgery depends on the patient’s satisfaction. People don’t often worry about congenital problems to this degree.

However, they often exacerbate the problems that arise as a result of plastic surgery by their own volition. Revision rhinoplasty is more challenging for both the patient and the surgeon than the initial surgery . Despite this, the rhinoplasty surgeon must reassure the patient, provide the necessary information to ensure confidence is maintained, and ensure that any problems are resolved with the revision.

When should revision rhinoplasty be performed?

In patients who undergo rhinoplasty, the newly formed nose shape may not be immediately visible. Initial swelling and bruising on the nose and face may prevent this from happening. Patients must wait a certain period of time for these effects to subside. They should not rush to make a decision due to potential issues with the new nose shape.

If there is dissatisfaction with the new nose shape due to edema, a minimum of 6 months or 1 year should be waited.

Therefore, revision surgery should be performed after complete healing and the nasal shape should be evaluated accordingly. Second surgeries performed before this time will have a lower success rate. The decision to perform revision surgery should be made after the nose has settled. The revision process should be managed through close communication with the patient.

However, if the new nose exhibits any deformities such as deviation or droopiness, a revision rhinoplasty surgery can be performed after a 3-month period to correct these deformities.

Which doctor should perform revision rhinoplasty?

When a revision is needed, it’s best to have the same surgeon perform the rhinoplasty. If the tissue healing was successful during the initial surgery, it’s best to have the surgeon perform the procedure. This is because your surgeon knows what they did inside and outside the nose during the initial surgery. Therefore, any changes made during the revision surgery are more likely to be successful.

However, if there is a loss of trust, lack of communication, or a lack of empathy between the patient and doctor, the patient may be referred to a more qualified doctor. The new doctor should be familiar with the exact procedure and its notes, review previous nasal photographs, identify any defective areas, and discuss in detail with the patient how the reconstruction will be performed.

How are tissue needs met in revision rhinoplasty surgery?

Revision Rhinoplasty

Revision surgeries allow for corrections to be made to previously performed rhinoplasty. This means the nose will be reshaped. Therefore, depending on the procedures performed during the surgery, cartilage may be required in almost all cases. Since the initial surgery uses cartilage from within the nose, cartilage may need to be taken from other areas of the body. In this case, this would be the case with cartilage from the pinna or ribs. Cartilage harvested from the ears does not cause any problems. After the cartilage harvest, the ears only need to be bandaged for one day. If sufficient cartilage cannot be harvested from the ears, rib cartilage can be used to provide the necessary replacement.

If patients do not want cartilage tissue taken from their bodies, cartilage can be obtained from cadavers or some synthetic products.

However, this option can lead to complications such as infection, the body’s rejection of the tissue, and volume depletion. Therefore, specialists always consider the patient’s own tissue to be the safest option. In certain circumstances, other procedures may also be appropriate.

What are the possible reasons for revision rhinoplasty?

A second surgery may be requested due to breathing difficulties or undesirable nasal shape. Because patient satisfaction is paramount in rhinoplasty, every possible change is accommodated in revision rhinoplasty.

What happens in revision rhinoplasty if the patient desires a lower nose?

This problem can arise if the patient’s initial surgery didn’t remove enough nasal tissue. This is a common problem in rhinoplasty performed according to the planned procedure. Revision surgery removes excess nasal tissue, easily fulfilling the patient’s needs.

What happens in revision rhinoplasty if the patient desires a more upturned nose?

If the patient requests such a procedure, revision rhinoplasty surgery involves more complex procedures. Lifting a drooping nose is more challenging than lowering a tipped nose. This requires harvesting cartilage from another area of the body.

The removed cartilage tissue is placed inside the nose, and the patient’s desire for a raised nose is fulfilled.

What happens during revision rhinoplasty if the patient states that the nasal dorsum is too small?

If a patient who has had rhinoplasty still hasn’t corrected the arched shape of their new nose, a second operation may be necessary. This correction is also easily accomplished.

The excess bone and cartilage tissue inside the nose is filed down and the arched structure of the nose is eliminated.

If the patient’s nasal dorsum has been removed too much, what is done in revision rhinoplasty?

In this case, the excess tissue removed from the nasal dorsum during rhinoplasty results in an unsightly, sunken appearance at the nasal dorsum. This needs to be revised.

Since cartilage tissue will be added to the back of the nose, tissue taken from other areas is added to the back of the nose.

If nasal congestion occurs after rhinoplasty, is revision necessary?

The changes made during rhinoplasty surgery should prevent the patient from experiencing nasal congestion. The surgery should address existing breathing problems, and the changes should not cause nasal congestion.

If the patient experiences nasal congestion despite having a recovery period after surgery, revision rhinoplasty surgery becomes inevitable.

The nasal physiology should be fully established and a decision can be made after the 6th month.

Is a new surgery planned for revision rhinoplasty?

For the second operation to be successful, the rhinoplasty surgeon must develop a thorough surgical plan. The specific procedures to be performed on the nose must be determined, the tissue requirements for the procedures must be determined, and the source of this tissue must be determined. In most cases, a definitive assessment cannot be made without first opening the nose; therefore, the surgeon must be prepared for any eventuality and obtain the patient’s consent before proceeding with the surgery.

Can the nose be reshaped in revision rhinoplasty surgery?

Reshaping the nose completely is not possible with revision surgery. Therefore, an experienced rhinoplasty surgeon should be involved during the initial surgery, ensuring the best surgical plan and ensuring patient satisfaction. Revision rhinoplasty can only correct the shape achieved during the initial surgery. With this in mind, the value of the initial surgery should be recognized.

Revision surgeries are always more difficult than the first surgeries and the chance of success is lower than the first surgery, but it should not be forgotten that much more satisfactory results can be achieved in competent hands.

In experienced, competent and communicative hands, satisfactory results can be achieved.