Revision rhinoplasty is a procedure in which patients can have their noses reshaped again following a failed nose job. While patient dissatisfaction is understandable, revision rhinoplasty isn’t rare. About 25% of people who undergo rhinoplasty surgery later return to a plastic surgeon to revise results. Reasons for wanting a revision rhinoplasty are varied and depend on the individual patient. Often, however, it comes down to the patient being unhappy with the overall appearance or function of the nose following surgery.
This is a reductive way of looking at it, I believe. There are many reasons why someone would need a revision for a previous rhinoplasty. Read on to find out hints that can help you determine whether revision rhinoplasty surgery is appropriate for you.
Reasons You May Need a Revision Rhinoplasty
The following are types of nose deformities that often occur after an unsuccessful rhinoplasty has taken place. If you have signs of any of these, you may need a revision rhinoplasty.
Nasal Tip Deformity
The nasal tip is composed of cartilaginous and soft tissues. Cartilage has no blood supply so healing occurs through fibrosis, where new scar tissue forms to close off the internal structures. This fibrosis can result in an unaesthetic appearance if too much scar tissue is formed and won’t allow the tissues to move freely over each other. Tip deformities can occur after rhinoplasty if the nasal bones or septum aren’t reduced during surgery.
Nasal Valve Collapse
A nasal valve collapse is a condition where the shape of the nose changes and its function decreases. Nasal valve collapse because of a loss of support due to the weakening or destruction of tiny cartilage structures that help maintain the structure and function of the nose.
Saddle Nose Deformity
A saddle nose deformity is a condition in which the cartilage of the nose has changed its shape, resulting in an undesirable aesthetic appearance. It may resemble a saddle sitting on top of the middle of your face. Saddle nose deformity can arise from previous nasal surgery or trauma to the nose. The saddle shape usually appears in the nasal dorsum (middle of the
nose), which occurs when there is a loss of support to the thin skin covering the thin layer of cartilage.
Hourglass Deformity
An hourglass deformity is a condition where the nasal shape widens from the dorsum down to the tip. This causes a narrowing or a loss of support; a hump appearance or a collapse of the nasal valve is a result. It happens when there is an imbalance between infra-orbital rim width and the dorsal hump height.
Sometimes, All You Need is a Touch-Up
Several patients are looking to give their nose a touch-up after they have healed from the initial surgery. Usually, they want to address the nose tip or the bridge. These two areas are frequently altered with rhinoplasty surgery and sometimes need a little fine-tuning after healing.
Other touch-ups include fixing small bumps or dents in the nose. These can occur during the healing process or by accidental bangs and hits to the nose after surgery. These bumps or dents can be smoothed out by:
- trimming down the cartilage
- repositioning the soft tissue
- using dermal fillers to add a little more volume (also known as non-surgical rhinoplasty)
What to Look For
Feel like you need to change the appearance of your nose after rhinoplasty? Here are some things to look for that are common among revision rhinoplasty patients:
- Slightly upturned or overturned nasal tip
- Crooked nasal bridge
- A nasal bridge that looks a little curved, which can manifest in either a hooked nose or a “ski slope” nose
- Overly rounded or pointed nasal tip
- Minor bumps and dents around the bridge or in the soft tissue
These clues are only a few of the reasons that people seek out revision rhinoplasty. Sometimes, these corrections are needed because of the previous surgery, though other external or internal factors may call for it. When your nose is messed up, the clues are often more apparent.
Repairing Post-Op Damage to the Nose
There are instances where a rhinoplasty patient needs to have their nose surgery entirely redone. Damaging results can range from significant damage through trauma, injury, or botched surgery.
Noses can still be damaged after rhinoplasty surgery if you injure yourself or are the victim of assault. There is a higher chance that a revision surgery won’t be necessary if we reduce the fracture immediately after an injury. For patients who have severely damaged cartilage, their noses have to be rebuilt from the inside out through open rhinoplasty.
Examples of severely damaged noses include:
- Nasal bridge collapse
- Severely crooked or mangled nasal bridge
- Odd growths or bumps on the inside or outside of the nose from poor healing
Botch Job: Rhinoplasty Gone Wrong
A botched surgery can refer to many different problems and most often occurs when patients opt for a less experienced or cheaper surgeon. A lack of experience and insufficient practice makes a rhinoplasty surgeon less qualified than other more experienced doctors.
When a person sees one of these less qualified doctors, they risk receiving a bad nose job. Signs of a botched nose job include the following:
- Nasal bridge collapse
- Migration or rejection of nasal implants
- A severe infection or bacteria growth from poorly inserted implants ● Too big or too small noses
- Severely upturned or downturned nasal tips
- Poor incision placement
- Excessive scarring
If any of these apply to you, seek help from a revision rhinoplasty surgeon immediately. Having a nose this badly damaged can have a very negative effect on your overall health.
Why Choose a Quality Revision Rhinoplasty Surgeon?
Regardless of whether your nose requires a minor fix or major repair, choosing a qualified revision rhinoplasty surgeon could not be more vital.
A plastic surgeon that knows how to perform a rhinoplasty may not know how to revise one successfully. Even though the two procedures are similar, revision rhinoplasty requires a keen understanding of improving an already altered nose.
Revision rhinoplasty is also a demanding procedure because surgeons have to work with, or around, what’s leftover from the previous surgery. Choosing a less-qualified surgeon for your revision rhinoplasty could land you back in a doctor’s office again several months later.
A qualified surgeon needs to have a good portion of their practice dedicated to primary and revision rhinoplasty. A great surgeon will also be board-certified and have specialties in both procedures. When doing your research, look at reviews from former revision rhinoplasty patients. Be sure to view the before and after photos of their revision rhinoplasty work.
Dr. Andres Bustillo is a board-certified facial plastic surgeon who dedicates his entire practice to procedures designed for the face and neck. About half of Dr. Bustillo’s practice involves performing rhinoplasty and revision rhinoplasty on patients. He performs over 300 nose surgeries yearly. During his studies, Dr. Bustillo completed a fellowship in facial and reconstructive surgery and was trained by some of New York’s best plastic surgeons.
To schedule a patient consultation with Dr. Bustillo, contact his office in South Florida at (305) 663-3380 or send your information anytime via the Contact page.