Secondary or revision Rhinoplasty is mainly done to repair results of previous unsuccessful Rhinoplasty(s).
The most important thing before considering revision Rhinoplasty is that you should wait at least a year after the primary Rhinoplasty. The reason is that it takes at least one year for scar tissues to soften, and at least a year for all swelling to subside. Deciding to have a revision Rhinoplasty too soon, would turn a minor problem into a disaster. So, deciding to undergo revision Rhinoplasty should not be impulsive.
Secondary Rhinoplasty can repair cosmetic issues like a twisted tip or functional issues like difficulty breathing.
To be able to see how your nose may look like after the surgery, some surgeons show you the probable result using 3-D imaging programs.
Your plastic surgeon will consult with you before revision Rhinoplasty and examine your skin, cartilage strength, and bone strength. The surgeon will also assess the available amount of cartilage, as grafting is almost always required. The surgeon will discuss the possibilities with you, and will also explain the factors that can influence the procedure and the result. To recreate symmetry, the surgeon may add back or take away cartilage.
Revision Rhinoplasty takes longer than a primary Rhinoplasty. The procedure sometimes takes up to four hours.
Rhinoplasty is done through two main techniques, the open approach, and the closed approach. Generally, the procedure is done under general anesthesia, and you may need to stay at the hospital overnight.
In the open approach, incisions are made within the nostrils, and the skin of the nose is separated from its supporting framework of bone and cartilage, allowing the surgeon to see the entire structure of the nose. This technique is mainly used in secondary or revision Rhinoplasty.
In the closed approach, incisions are made across the columella, which is the vertical tissue separating the nostrils. One of the advantages of this technique is that there will be no external transcolumellar scar after the surgery.
Depending on the patient’s condition, the surgeon will decide which technique leads to the most desirable result.
The surgeon will then separate the skin of the nose bone and reshape the nose to the desired shape. At the end of the surgery, the surgeon will re-drape the skin over the newly reshaped nose.
After the surgery
Bruising and swelling after nose job is common like any other surgery. It may take one to two weeks for the initial swelling to subside. However, all swelling may subside after several months up to a year. Nasal packing helps reduce swelling, but you cannot breathe through your nose until the packing is removed.
You may feel nauseated after the surgery. To help relieve any pain related to the surgery, your surgeon will prescribe painkillers.
To stop the bleeding during the first few days, which is completely normal, applying a cold compress to your forehead is recommended.
For two or three weeks after the surgery avoid blowing your nose, salty food, and taking showers.
You will also be advised to eat soft food, wear buttoned shirts, sleep with your head elevated, and take baths instead of showers for the first couple of weeks after the surgery.
It is also noted that recovery in revision and primary Rhinoplasty is similar.
Stitches will be removed after three days.