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.
Rhinoplasty before & after photos
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Nose surgery archived questions and answers
Q1: What is the ideal age for a rhinoplasty (nose surgery)?
Generally speaking, the ideal age for undergoing a rhinoplasty (nose surgery) is 17 for men and 15 for women. The bony and soft tissue structure of the face, when reaching this age, is fully matured so the later teens would be a great starting time to do such surgeries. On the other hand, nasal septum is developed fully during facial growth in this age which allows the proper growth of the midface and nasal structures.
The Rhinoplasty surgery is best performed once an individual has hit puberty and also should not be performed before a major growth spurt.
Q2: How long should I stay in Iran for a rhinoplasty?
After checking in the clinic and visiting the doctor, the next day you will get ready to undergo the surgery. six or seven days after the surgery, your plaster (nose splint) will be removed and after a short break you can return to your country with no worries.
Q3: Is exercising OK after a rhinoplasty?
After the rhinoplasty surgery, the most common problem you might experience is a slight nose bleeding and also some swelling. For reducing this problem you should avoid heavy exercises such as weight lifting, jogging, running , body building , diving, etc for at least a month to reduce the post-surgical problems.
Q4: Should I have an open or closed rhinoplasty? Which one is better?
Basically, both methods are used for both primary and secondary rhinoplasties but generally surgeons’ preference is to use the open approach in primary and revision rhinoplasty if tip of the nose needs reconstruction wholly . The open approach allows surgeons to visualize the tip (lower lateral) cartilages directly and in a undistorted way while working on it. But If the patient desires the removal of a hump or get another alteration on the upper part of the nose, then a closed rhinoplasty surgery is preferable.
To sum it up, you should let your surgeon decide what kind of surgery is the proper one for you. Each surgeon’s experience and medical background is different and therefore the method being used will be different.
Q5: Do I have to pay for a revision rhinoplasty if the primary one was a botched one?
Basically, less than 1 percent of our patients need the secondary rhinoplasty because of a medical malfunction (either doctor or clinic). This is because of the highly skilled and most experienced doctors in Iran. Still, in case of a need for a revision, the secondary (revision) rhinoplasty will be free of charge.
Q6: When to re-start skin care after rhinoplasty? Should patients typically wait longer so the cast comes off?
Generally, it is better to talk with your surgeon and discuss the issue with them about your current skin care. They will inform you what to do and what not to do. Just try to avoid strong exfoliants on your nose for 2-3 weeks and be careful with harsh rubbing of your nose .
Q7: How long after rhinoplasty should I wait to get a revision?
As The nasal tip resolves slowly, the average time to do a revision surgery will be 6 up to 8 months after the previous one (at least). this allows the swelling to go down and the tissues soften. As the secondary Rhinoplasty is more difficult, it requires an experienced plastic surgeon to fix it. So a highly skilled doctor is an important factor.