When performing a revision rhinoplasty, often times a facial plastic surgeon is refining the work of another surgeon who was unsuccessful in producing the intended results for a patient. Dr. Andres Bustillo specializes in revision rhinoplasty surgery and is familiar with the typical complications that are presented with patients requesting a secondary nose surgery. Below are some common issues the doctor may be presented with at his Miami area practice, and how he is able to work around them to deliver optimal results with each revision rhinoplasty he performs.
Missing Tissues as Structural Components of the Nose
Many patients visit a plastic surgeon seeking a rhinoplasty to refine the look of the nose, with a common goal of minimizing the size of the nose. Unfortunately, many surgeons perform what is called a reductive rhinoplasty. In this type of surgery, the surgeon removed a large amount of cartilage and bone to decrease the size of the nose. The result is a small nose with a shape that is not aesthetically pleasing. Apart from a poor cosmetic outcome, there can be nasal airway obstruction, or even suffer a collapse.
- Misshapen Nose – The bridge of the nose suffers what is referred to as a “scoop nose” where the bridge is not straight but concaved toward the face. In such a case, Dr. Bustillo can use autologous cartilage from the patient’s ears, septum, or rib of the body to rebuild the bridge. In some cases, the doctor may opt to implant synthetic materials to sculpt the nose.
Another issue that may be present due to a botched prior nose surgery is a turned-up tip, which can result from an inexperienced surgeon’s work. Bridge construction, such as that described above, may help with the look of the tip; however, this part of the nose may require additional reconstruction. The patient’s own grafted cartilage can be used to rebuild the nasal tip.
- Nasal Breathing Obstructions and Collapsed Tissues – If a prior plastic surgeon removed too much tissue from a dorsal hump or harvested an excessive amount of tissue from the septum, a deviated septum or middle vault collapse may result. A deviated septum occurs when the area of cartilage that separates the two airways infringes upon one of the airways, causing a constricted nasal passage. The uneven anatomy may require a manipulation of existing cartilage, though typically does not require movement or surgery of the nasal bones.
Cartilage grafts may also be necessary to repair the existing cartilage if the structure has been weakened by a previous procedure. Additionally, the Journal of the American Medical Association offers a third solution, writing on their website that “The polydioxanone plate is a safe and reliable absorbable implant that has many different applications in rhinoplasty and septal surgery. It not only acts as a scaffold but also stimulates and guides cartilage regeneration.” This dual-action plate is a great option when repairing existing cartilage or implanting harvested cartilage would not be the best solution to rebuild the septum.
During a patient examination with Dr. Bustillo, which can be scheduled by calling (305) 663-3380, the doctor can view the work of your previous surgeon. If you are not in the South Florida area, you can visit Dr. Andres Bustillo’s site and submit photos that detail the issues of your nose you would like to correct.
