Looking at the calendar, you realise it’s been just over 18 months since you had primary rhinoplasty surgery. After years of disliking the way your nose looked, you decided to do something about.
The detailed consultation with your Cosmetic Surgeon gave you insights into the risks, complications and the possibility of the surgery not working.
You remember sitting in the consulting room discussing the way you wanted your nose to look. Remove the large bump in the middle, straighten the shape and reduce the nose tip size. And while the surgery went well and you recovered quickly, there still seemed to be a bump in the middle.
At the 6-monthly check up your Cosmetic Surgeon advised it could take up to 12 months or longer for the final result to be seen. Patiently, you’ve been waiting for the ‘end result’ to be pleasing, but it hasn’t happened
Don’t worry though; you’re not the only person who has had primary rhinoplasty surgery and been unhappy or disappointed with the results. Revision rhinoplasty surgery can be performed to improve the primary rhinoplasty results.
What is revision rhinoplasty?
Revision rhinoplasty surgery refers to any rhinoplasty that is performed to revise or improve a previous rhinoplasty. This surgical procedure is undertaken to correct breathing problems and/or cosmetic deficiencies that arose from the previous rhinoplasty surgery.
It is important to note that every Cosmetic Surgeon who performs rhinoplasty surgery has patients who request revision. Cosmetic Surgeon’s with substantial experience in rhinoplasty would experience very few occasions where their patient’s didn’t like the rhinoplasty result.
Who gets revision rhinoplasty surgery?
Patients who get revision rhinoplasty surgery have had primary rhinoplasty surgery and not been happy with the results. This can happen because of inferior surgical techniques, unpredictable healing patterns or unclear expectations.
Common reasons revision rhinoplasty is performed include:
- It is difficult to breathe – while it is normal for swelling after primary rhinoplasty to cause congestion and blockages for a few weeks, any long-term symptoms may suggest a need for revision rhinoplasty.
- The overall shape and/or size of the nose are not meeting patient expectations. This may include a bump on the nose not being properly corrected or the nose tip being too upturned.
- Over the years since the primary rhinoplasty, visible defects or irregularities have become visible.
- The nose is crooked, or has visible asymmetries that weren’t there before, haven’t been corrected or are new.
It is generally recommended that patients wait 1 to 2 years after the initial rhinoplasty surgery because the problems patients see in the first few months can resolve by themselves.
Not all patients who are dissatisfied with the results of their prior rhinoplasty are suitable candidates for revision rhinoplasty. Some patient’s noses may be as good as they can get and another surgery with the most experienced Cosmetic Surgeon may not improve it.
What happens during revision rhinoplasty surgery?
Revision rhinoplasty surgery is performed under a general anaesthetic and will be either open rhinoplasty or closed rhinoplasty. Read more about the difference between open and closed rhinoplasty here.
Some revision rhinoplasty surgery may require skin grafting. These tissue grafts help restore nasal cartilage, bone or fascia and can be harvested from your ear, ribs or your temple region. If extra cartilage is needed for strength, to build up an area or fill out and soften an area it can be taken from the bowl of your ear (conchal cartilage) or from your rib.
Like primary rhinoplasty surgery, some or all of the following may occur:
- Dorsal reduction
- Infracture
- Tip plasty
- Septoplasty
- Alar base resection
- Cartilage harvest (from the septum)
- Cartilage harvest (from the ears or rib, or both)
- Dermis graft harvest
- Bone graft harvest
- Cartilage grafting – spreader grafts, tip grafts, dorsal grafts, columellar grafts, rim grafts, batten grafts.
- Septal reconstruction
Once all the surgical tasks are done to alter the nose shape to the agreed plan, the incisions are closed and the operation is complete. Revision rhinoplasty surgery usually takes from two to three hours. If the surgery is complex, it can take up to 4 or 5 hours. Find out about the risks and complications of revision rhinoplasty surgery here.
What is recovery like after revision rhinoplasty surgery?
After the revision rhinoplasty surgery, you will have a small, external splint on your nose for 5 to 7 days. Gauze is used to absorb the small amounts of fluid draining from the nose and medication is given to limit any pain and nausea.
Some patients return home on the day of surgery, while others choose to stay in hospital overnight. Discomfort is to be expected but it is generally not severe and decreases quickly. Facial bruising is normal after rhinoplasty with most patient’s bruises fading within 14 days.
Following revision rhinoplasty surgery, it is recommended that you avoid heavy exercise for 3 weeks. Bending, stooping or heavy lifting may cause postoperative bleeding. It is quite common to see some long-term reddening of the nasal skin, with visible broken veins.
What will I look like after having revision rhinoplasty surgery?
It is important to note that while the surgical plan can usually be carried out, not all aspects of revision rhinoplasty are predictable. The success of your revision rhinoplasty surgery depends on a number of factors.
Complications can include:
- Excessive scar formation resulting in nose shape problems. The cartilage can warp leading to asymmetry, which may require improvement, and
- Small bumps or irregularities upon healing.
To achieve the best possible result, a proportion of revision rhinoplasty surgeries require further revision, or a second small operation.
Where can I find the best revision rhinoplasty Cosmetic Surgeons in Australia?
Before you have revision rhinoplasty, it’s important to consult with your Cosmetic Surgeon and to seek second opinions. We suggest that you consult with Cosmetic Surgeons who are experienced and expert rhinoplasty surgeons. You can find the best revision rhinoplasty Cosmetic Surgeons in Australia here.
It is also important that you have realistic about goals and expectations. Some rhinoplasty patients have two, or even three of four rhinoplasty surgeries and discover that it becomes more and more difficult for them to achieve the result they may be seeking.
Before you have surgery, it is vital that you and your Cosmetic Surgeon understand and agree upon the aims of the revision rhinoplasty operation.
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