Why do patients consider a revision rhinoplasty?
Patients who tend to have a revision rhinoplasty can be categorized in two groups. The first one include people who focus mainly on the beauty of the nose and are looking for certain types of nasal correction, especially after a failed rhinoplasty. The other group includes people who seek getting a revision nose job to improve the shape of the nose while fixing health problems caused by their primary rhinoplasty or not fixed by it. These problems include breathing issues, over-rotated tip, nasal valve collapse, asymmetric nostrils, wide nose, crooked nose, long nose, birth defects, Polly beak, deviated septum, nose bumps, collapsed bridge, sinus problems, nasal collapse and/or deformity, sleep apnea and/or snoring.
What does revision rhinoplasty involve?
Revision rhinoplasty is more complex than primary rhinoplasty, as repairing a damage caused by a previous surgery is always challenging. The surgical procedure is performed under general anesthesia; however, in rare cases, the procedure can be performed under sedation and local anesthesia. Before preforming the surgical procedure, an open or closed approach will be chosen based on the unique case. In most cases, the surgery will be performed as an open procedure, which starts by making a small incision between the nostrils so that the skin can be lifted allowing the surgeon to access the delicate tissues, cartilage and bones responsible for the appearance of the nose and to reshape the required sections along the nasal bridge, tip, and nostrils. Afterwards, the surgeon corrects any obstructions in the airway before sealing the wound with several stitches.
In simpler procedures, the surgeon may only have to remove excess tissue or cartilage that may have been missed in the original surgery. Furthermore, where necessary, the bone may be fractured in a controlled way, in order to straighten out a crooked nasal bridge.
Success rate of revision rhinoplasty in Iran
Most patients achieve amazing results, and it all depends on the patients’ expectations in the first place. However, the fact remains that revision nose job is a complex procedure that requires master knowledge of the anatomical structure of the nose as well as high practical skills.
Is revision rhinoplasty dangerous?
There are some risks and complications that the patients should be aware of before undergoing the surgery, such as:
- Bleeding is one of the most common risks of rhinoplasty or a revision rhinoplasty, since blood vessels may be damaged during each surgery. Blood loss is common while undergoing any surgery and only very few patients may experience significant post-surgery blood loss.
- Reactions to anesthesia, which can be avoided by choosing a highly qualified anesthesiologist to administer general anesthesia. That is why a physical exam prior to the surgery is necessary.
- Nasal blockage or a similar sensation can occasionally occur. As the nasal contours are reshaped, changes may need to be made to the septum and, in some cases, the overall size of your nose may need to be reduced.
- Infection is a rare risk that can be avoided by choosing an experienced surgeon. To help prevent problems due to infection, patients are instructed to watch for symptoms, such as excessive swelling, fever, odorous nasal discharge or pain, and contact their surgeon right away if any of these symptoms is observed.
How long does it take to recover after a revision rhinoplasty?
There is a certain timeline for recovery after revision nose job, as the patient is required to reduce their physical activity for six weeks after the surgery. Moreover, a splint might remain in place for a few days after surgery, and there will be some degree of nasal congestion and swelling afterwards, which will take about 2 weeks to start subsiding. However, it may take a complete year for the healing process to complete and for the final shape of the nose to show up.
How long does it take for swelling to go down after revision rhinoplasty?
Swelling and bruising are common after a revision rhinoplasty, and most of the swelling resolves in about two weeks, with the remaining swelling resolving in a matter of months.
What is grafting and what materials are used for grafting in revision rhinoplasty?
Grafting refers to a surgical procedure that involves moving tissues from one site to another from the same body, or from another individual.
One of the main goals in revision nose job is to restore the structural support of the nose and to replace lost tissues. In order to achieve this, the surgeon must rely on grafts mainly. Many grafting materials are available in revision rhinoplasty, and each type has its own unique physical, chemical, and biological properties. Surgeons believe that grafting materials must be resistant to trauma, easy to sculpt, resistant to infections and extrusion, and stable.
The most common types of grafts are known as autogenous grafts, which are taken from the body of same patient during the surgery and placed in its intended place in the nose after appropriate handling. These grafts are the most favorable due to their long-term clinical outcome and their low possibility to be rejected or become infected. Autogenous grafts are known as non-synthetic grafts, and they include cartilage, bone and subcutaneous tissue.
Why rib grafts are preferable?
While a cartilage graft can be harvested from the nasal septum, there often is not enough of the material available in that region to harvest and use as grafting material in revision rhinoplasty. In these cases, cartilages can be harvested from other parts of the body such as ribs as cartilage can be obtained from the ribs in larger quantities when required. Furthermore, cartilage can be used in multiple ways while being reshaped, and it is less likely to be rejected or become infected as it comes from the patient’s own body.
What to do before considering a revision rhinoplasty?
1. Make sure your nose if fully healed from the previous surgery
First and most importantly, take all the time you need for your nose to fully recover after your previous nose job before undergoing a revision nose job. Generally, it is recommended to wait for one year before undergoing a revision rhinoplasty since nose job surgery takes a full year to heal.
2. Consult an expert before considering a revision rhinoplasty
Undergoing a revision rhinoplasty mainly depends on the:
- Dissatisfaction caused by the first rhinoplasty
- Amount of the nasal septum removed during initial procedure
- The quality of the nasal airway, and the skin of the patient.
3. Choose your surgeon carefully
A revision rhinoplasty is more delicate than the primary rhinoplasty, as many additional issues should be taken into consideration, which requires a highly experienced plastic surgeon or ENT surgeon.
What to do to speed up the recovery process?
1. Follow the doctor’s instructions
Listen carefully to what the plastic surgeon has to say, as you will receive specific instructions on what medications to take, and how to take care of the wound in order to avoid infection.
2. Don’t hesitate to ask for professional assistance
If something does not feel right during the recovery period, or you are experiencing any type of unwanted symptoms, discuss it with your doctor right away.
3. Sleep only on your back and keep your head elevated at all times
Sleeping on your side after having a revision rhinoplasty can cause more swelling and bruising. It might also displace your nose in rare cases. To avoid this, you will need to keep your head elevated at night for 6 weeks after the surgery.
4. Apply cold compresses
Using cold compresses can significantly reduce the swelling in the first 72 hours after the surgery, as long as it is being applied carefully to the swollen area.
5. Get plenty of rest
Rest is a vital part of the recovery process, as the body needs energy to heal itself.
6. Maintain a healthy diet
Make sure your body gets all the nutrition needed for the healing process, whether by eating fruits and vegetables or by using supplements.
7. Avoid touching your nose or wearing glasses
After surgery, you are going to have to resist the urge to blow your nose, as the experienced nasal congestion is caused by the swollen nasal tissues. Instead, contact your doctor and ask him/her about using a saline nasal spray to moisturize your nasal passages until the swelling goes away. It is also advised to switch to contact lenses instead of wearing glasses, as glasses are known to put pressure on the nose, which might cause additional bruising or swelling. If you cannot use contacts, consult with your surgeon to decide on a suitable type of glasses that is specifically designed to be used after rhinoplasty.
8. Allow your body to take all the time needed to heal
Don’t rush things, be patient and have faith. Your nose will heal eventually, and you will have the expected results in the right time.