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Secondary (Revision) Rhinoplasty

Rhinoplasty commonly referred to as a nose job or nose reshaping is a plastic surgery technique for correcting and reshaping the form, fixing the functional problems, and aesthetically enhancing the nose by resolving nasal trauma.

secondary rhinoplasty, also known as revision rhinoplasty or revision nose surgery, is corrective nasal surgery that helps to change the shape and/or function of the nose after a previous unsuccessful rhinoplasty. Secondary aesthetic and reconstructive nasal re-shaping is specified for aesthetic or functional defects not correctly treated or made worse from the previous operation. Revision rhinoplasty can be performed a few times when it’s needed.

Revision rate is much higher than other aesthetic operations because millimetric mistakes during the rhinoplasty surgery may cause aesthetic and functional defects.

Secondary (revision) rhinoplasty is significantly more complicated and challenging surgery than primary rhinoplasty. It needs much more experience, skills, knowledge, and patience.

Secondary (Revision) Rhinoplasty Procedure

Generally, secondary (revision) rhinoplasty surgeries take from 2 to 4 hours but if the surgery includes the use of rib graft it may take up to 6 hours.

The patient will receive general anesthesia or deep sedation.

In some cases, revision surgery includes only minor repairing of current structures to achieve the desired appearance.

However, most revision rhinoplasty cases are much more complicated and generally needed an open method. In most cases, the surgeon may need to use additional grafts to repair and rebuild a structural defected nose.

Most likely the septum (middle wall of the nose) is used for grafting material in primary surgeries, but in general, patients, who will have revision surgery, do not have enough septum because of the primary surgery. Therefore, revision rhinoplasty usually includes harvesting cartilage from behind the ear for grafting.

When it is done successfully, the ear will look exactly the same as before because incisions will be hidden behind the ear and by the time they will disappear.

Recovery Period After Secondary (Revision) Rhinoplasty

  • The recovery after the revision surgery is like primary surgery.
  • After secondary (revision) rhinoplasty surgery patients should stay overnight in the hospital.
  • The splint and bandaging around your nose will be removed in about seven days.
  • The area around the patient’s eyes and nose will be bruised and swollen for a few days.
  • Cold compresses can help minimize the swelling and reduce pain. The surgeon may also recommend painkillers.
  • It takes about 2 weeks before most of the swelling and bruising improves.
  • It may take several weeks before the patient can return to daily activities.
  • The new shape of the nose can be seen after a month but thoroughly recovery can take 6-12 months.
  • During the secondary (revision) rhinoplasty recovery it is important to protect the nose from any damage.

Frequently Asked Questions About Secondary (Revision) Rhinoplasty

Some patients from other surgeons visit us for a rhinoplasty revision because they were truly unhappy with how their nose looked more than a year after their previous surgery. Revision is possible if you are not satisfied with your new nose or if you are having health issues such as breathing. In other cases, bringing your facial features into harmony could create the appearance you’re going for. This could mean combining nose surgery with another procedure like facial implants and dermal fillers. 

If you are in good health and have realistic expectations for your revision rhinoplasty outcome, you’re likely to be a good candidate for successful secondary rhinoplasty.

Some of the more common mistakes or issues in primary rhinoplasty include:

  • Improper diagnosis of nasal problems, physical and/or functional
  • Poor listening skills or misunderstanding how the patient wants his or her nose to look
  • Unexpected issues with healing.
  • Poor surgical technique and/or inadequate experience as a rhinoplasty surgeon

Revision rhinoplasty can solve most of the problems from your primary rhinoplasty, such as:

  • The nose is too small
  • The nose is too large
  • The roof is too low
  • The nose looks flat in profile
  • The nasal roof is too curved
  • The roof is too wide
  • The nose is too narrow
  • The nose is too long
  • The nose is too short
  • Nostrils show too much
  • Tip of nose droops
  • The tip is creased at the center
  • Nasal tip is too upturned
  • Nasal tip is too sharp or pinched
  • Nasal tip is rounded 
  • Sides of nose collapse inward when breathing, making breathing difficult
  • The nose looks the same as before primary rhinoplasty – issues not corrected
  • The nose has a bump

Most likely the septum (middle wall of the nose) is used for grafting material in primary surgeries, but in general, patients, who will have revision surgery, do not have enough septum because of the primary surgery. Therefore, revision rhinoplasty usually includes harvesting cartilage from behind the ear for grafting.

When it is done successfully, the ear will look exactly the same as before because incisions will be hidden behind the ear and by the time they will disappear.

Secondary (revision) rhinoplasty is significantly more complicated and challenging surgery than primary rhinoplasty. It needs much more experience, skills, knowledge, and patience. Most revision rhinoplasty patients need grafting from other parts of the body. Therefore, revision rhinoplasty prices are higher than primary rhinoplasty.

If your first rhinoplasty went well but there were unexpected complications, it would be the best choice for you to continue with the same doctor. Because your own doctor knows all the details about the first rhinoplasty so it will be easier for him to do the revision surgery.

But, if you think that the problems occurred during the first rhinoplasty were because of the doctor or you have lost confidence in your doctor, it is better to find another doctor for secondary rhinoplasty.

After the first operation, the nose should be completely healed and the shape should be fully settled. The recommended minimum period to complete this process is 1 year. The success rate of the secondary rhinoplasty before the complete healing of the first rhinoplasty is very low.

It is more difficult to lower a raised nose than to lift a low nose. Secondary rhinoplasty lower the raised nose by adding or removing cartilage to the required site.

You can plan your nose height again by talking to your doctor. This problem can be solved easily with the necessary supports.

Each surgery has different risks and complications, Patients should be informed about these risks and complications before surgery. The possibility of having a revision rhinoplasty after primary rhinoplasty is 5%. But the possibility of having a revision surgery after successful primary rhinoplasty is 20% for patients who are not satisfied with the result of the primary rhinoplasty.

all the cartilage inside the nose may be used during a previously performed nose surgeries so in case more cartilage is needed and there is no cartilage left in the nose, cartilage taken from the ears or rids is used in the surgery.

The difficulty or ease of secondary rhinoplasty surgery is related to the size of the second procedure. Severe bone deformities in the first surgery increase the difficulty of revision operations. Also, interventions made on Nasal bone increase postoperative pain rate. However, revision operations performed in case of small deformities do not cause abnormal pain and this period can be overcome in a short time.

The healing of lividities and swellings in the secondary rhinoplasty takes 1-2 days more than the first rhinoplasty, The extension of healing period depends on the interventions made to the cartilages and tissues in the secondary rhinoplasty.

The duration of stay in the hospital in regard to secondary rhinoplasty operations is mostly related to the type of anesthesia used in the operation. In general anesthesia, the patient must stay in the hospital for 1 night. On the other hand, the patient can be discharged on the same day of the operation in case the operation performed under the local anesthesia.

the type of anesthesia used in secondary rhinoplasty operations may vary depending on the size of intervention will be performed which means that small interventions can be performed under local anesthesia according to the patient’s request.

Secondary rhinoplasty operations are more difficult and complicated than the first operations. Therefore the duration of the operation may be longer than the first operation and it might take about 2-3 hours.

İt has the same risks of any surgical operation that occur because of surgery and anesthesia with a small possibility to have bleeding, infection problems etc…

Since there is more interventions in the nose in secondary rhinoplasty surgeries, it may takes longer to get the final shape of the nose than what did it take in the first rhinoplasty. Generally, it takes about 8 – 12 months.

In case of making small interventions in the secondary rhinoplasty there will be no need to place any splint or tampon, but in case of making interventions to bones and cartilages splint and tampon will be placed as in the first rhinoplasty.