Revision rhinoplasty

Revision rhinoplasty is a secondary correction of a previously operated nose. It may be carried out for improvement in appearance and breathing (function). A significant number of patients who have undergone rhinoplasty present themselves for revision surgery. According to some reports, this is as high as twenty percent.

Why do undergo a secondary rhinoplasty?
The dissatisfaction with appearance could be as a result of unrealized expectations or due to the presence of a new deformity. It could be an unexpected result due to scarring associated with the previous surgery. A rhinoplasty is associated with swelling which can last approximately one year. The final shape of the nose is not apparent up to one year following a rhinoplasty. Because of this, it is prudent to wait for at least one year before carrying out a secondary correction.

Who is a good candidate for secondary rhinoplasty?
A good candidate should have realistic expectations about what can be achieved following a secondary correction. Depending on the existing anatomy there is usually a limit to the amount of improvement that can be achieved with corrective surgery.
Also, patients should be in good health. Smokers have significantly higher complications associated with healing when compared to nonsmokers.

When is a secondary rhinoplasty performed?
Secondary correction is done after allowing sufficient time for the tissues to settle. This usually takes around one year after the first surgery. In the case of corrections undertaken after a second or third surgery, we wait for more than eighteen months.

How is revision rhinoplasty different from the primary rhinoplasty?
Revision rhinoplasty involves manipulation of tissues which have been altered during a previous surgery. There will be scars as a result of the previous surgery. In many cases, some of these scars would be excised and in others, the scars may be left behind or used as a filler material.
Additional support to the nose may be obtained by the use of cartilage grafts from donor sites such as ear or ribs. It is likely that cartilage donor sites within the nose may be exhausted during the primary rhinoplasty.
In general, a secondary correction is more difficult and time-consuming when compared to primary correction.

How is the recovery following revision rhinoplasty?
The recovery following revision rhinoplasty is similar to that of a primary rhinoplasty. A nasal pack may be used for one or two days. Dressings are usually removed after two days. A splint is used in case the bones have been manipulated. Sutures come off within a week.
Patients are usually able to resume light work after a week. Most of the swelling disappears within a month. The nose settles into a final shape by approximately one year following surgery.

What are the benefits of undergoing a secondary rhinoplasty?
An improvement in appearance and function is associated with improvement in self-esteem and confidence. A positive outcome following rhinoplasty is a very rewarding experience for both the patient and the treating surgeon.

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