What exactly is a revision rhinoplasty?
Revision rhinoplasty, also known as secondary rhinoplasty is a surgical procedure that aims to correct a previous poor result. As more and more inexperienced plastic surgeons perform rhinoplasties, there are an increasing number of dissatisfied patients with their rhinoplasty results. Dr. Bustillo is a rhinoplasty specialist and is well known for his revision rhinoplasty expertise. He performs a large number of secondary rhinoplasty surgeries. Usually, the goal of a revision rhinoplasty is to return the nose to normalcy. In other words, to bring the nose back to a normal shape, so that it does not attract the attention of the eye. Occasionally, Dr. Bustillo will also perform functional nasal surgery at the same time to help the patient regain breathing.
Who is a good candidate for a revision rhinoplasty?
Healthy teenagers and adults who had an unsuccessful rhinoplasty and would like to have the nose reshaped to more natural and aesthetically pleasing shape. For most secondary nasal surgery, the patient should wait one year after their previous nasal surgery.
At what age can a revision rhinoplasty be performed?
Miami plastic surgeon Dr. Bustillo performs the revision rhinoplasty surgery at about fifteen years of age and older.
How does Dr. Bustillo perform a consultation for revision rhinoplasty?
Dr. Bustillo likes to spend a good amount of time with his revision rhinoplasty patients. He likes to get to know them well and will examine the nose from the inside out. By performing a thorough examination, he will know exactly what the problem areas of the nose are. He will them formulate an individualized surgical plan for the secondary surgery that he will share with you. Pictures will be taken, and a computer generated image will be made of your nose. Dr. Bustillo likes to involve the patient in the decision making process, so that the patient and the doctor are both aligned. He will then review the surgery, the anesthesia, and the recovery. You will the meet with the patient care coordinator, who explains the scheduling procedure.
Where does Dr. Bustillo perform a revision rhinoplasty?
Dr. Bustillo performs the secondary rhinoplasty procedure in an AAAASF certified facility.
What type of anesthesia does Dr. Bustillo use when doing a secondary rhinoplasty?
Dr. Bustillo performs the secondary rhinoplasty using general anesthesia. Because the revision rhinoplasty procedure is generally more complicated than the primary rhinoplasty, many times Dr. Bustillo has to obtain grafts. General anesthesia allows Dr. Bustillo to stay focused on the surgery, while the anesthesiologist provides anesthesia. Dr. Bustillo only works with anesthesiologists that are board certified and are part of the anesthesiology department at Baptist Hospital of Miami, one of the best hospitals in South Florida. Dr. Bustillo does not use nurses to provide anesthesia.
How does Dr. Bustillo perform the revision rhinoplasty?
The revision rhinoplasty surgery can be very technically challenging procedure. Dr. Bustillo always has a surgical plan thought out before he steps into the operating room. In fact, he usually draws out the plan with the patient in the room during the consultation. In the plan, he will have specific note about what the status is of the septal cartilage, the nasal bones, the bridge, and the nasal tip cartilages. He will have notes about where he will obtain cartilage grafts from, either, septum, ear, or any of the other areas. For the most part, Dr. Bustillo will perform the secondary surgery in an open approach, so that he can visualize all of the nasal structures more clearly and reconstruct the nasal framework.
How long does it take Dr. Bustillo to perform a revision rhinoplasty?
Dr. Bustillo takes about two to three hours to perform a revision rhinoplasty surgery.
Where does Dr. Bustillo make the incisions for a revision rhinoplasty?
Because Dr. Bustillo usually performs the secondary rhinoplasty via an open approach, the incision is in the columella of the nose, which that “column” of skin between both nostrils. The incision heals very well and will be imperceptible once the patient heals from the revision rhinoplasty surgery.
What should I expect in terms of pain with my revision rhinoplasty procedure?
For the most part, patients that undergo a revision rhinoplasty do not have much pain. If Dr. Bustillo obtains a cartilage graft from the ear, this may cause some discomfort. The pain medication we give will take care of the minor ear discomfort.
What is it like to recover from a revision rhinoplasty?
The recovery for a revision rhinoplasty performed by Dr. Bustillo is never as bad as patients actually expect. The patient can sometimes have a mild pressure-like sensation over the nose. Pain in the nose is very rare. Occasionally, if a graft was taken from the ear, the patient may have some mild pain in the area. This is usually relieved with the pain medication that is given. Dr. Bustillo will see the patient in his office the day after surgery to make sure everything is fine. On the fifth day after the secondary surgery, the patient’s cast is removed. Most of the swelling around the eyes subsides by this time. Most patients are able to return to work on the sixth post-operative day. About two thirds of the swelling resolves by the third week. By the sixth month mark, about 90% of the nasal swelling has resolved. About 99% of the swelling will resolve by the one year mark. If the patient has thick nasal skin, it may take about 12-18 months for all of the swelling and edema to resolve.
How long before I can return to work after having a revision rhinoplasty?
The majority of patients can return to work or school about six days after their secondary rhinoplasty. It is interesting that, when a revision rhinoplasty is performed well and the nose is reshaped in a natural fashion, most people will not notice that the surgery was performed.
When can I exercise after having a revision rhinoplasty?
It is important not to exercise for three weeks after your secondary nasal surgery. Exercising during the immediate recovery phase will cause your nose to swell excessively and prolong your recovery period.
When are the stitches removed after the revision rhinoplasty?
The columellar stitches will be removed on the fifth post-operative day. Dr. Bustillo uses very small stitches that are trimmed, not pulled, because they are absorbable. This means that they will not be “pulled” and so this will not cause any pain.
Are there risks or complications that can occur with a revision rhinoplasty?
All surgeries carry certain risks. For the revision rhinoplasty surgery, the main risks are bleeding, infection, and having a cosmetic imperfection. Bleeding is rare, and occurs less than 1% of the time. If this occurs, the patient should call Dr. Bustillo, who will then see the patient immediately in the office. Usually a small cotton is placed in the nose to stop the bleeding. Dr. Bustillo’s patients are given antibiotics through an IV before surgery and are then given oral antibiotics for several days after.
The main complication that can arise from a revision rhinoplasty is a cosmetic imperfection. Because revision rhinoplasty is an extremely difficult procedure, the surgeon may sometimes have to perform a small revision under local anesthesia in the office to correct any small areas of concern. Dr. Bustillo will do these minor corrections without any charging any fees.
Will insurance help to pay a revision rhinoplasty?
Many times patients that come to Dr. Bustillo for a secondary rhinoplasty will have nasal obstruction. These patients many times have had much of their nasal tips removed in order to thin the nose. Insurance may cover part of the surgery that is performed to improve the function of the nose.
What is the cost of a revision rhinoplasty?
The fees charged by surgeons for a revision rhinoplasty varies a great amount. It is important that patients understand that nasal specialist may charge more for a revision because they are also doing more. Rhinoplasty specialists recreate and rebuild the nasal skeleton using different techniques. Dr. Bustillo’s cost for a revision rhinoplasty range from $ 7,700.00 to $18,000.00 depending on the level of difficulty. The surgeon’s fees along with the anesthesia and operating room costs range from $7,700.00 to $18,000.00.
What else do I need to know before having my revision rhinoplasty?
Most patients that undergo a revision rhinoplasty procedure with Dr. Bustillo commonly say that they would have had the surgery sooner if they only knew how easy the recovery was and how great the results were. Although secondary rhinoplasty is a very difficult and complicated procedure requiring a thorough knowledge of the structure of the nose, Dr. Bustillo is an expert nasal surgeon with many years of experience. He will reshape and create a beautiful and natural nose using the most advanced and up to date techniques available in nasal reconstruction.
Do patients travel to have revision rhinoplasty surgery with Dr. Bustillo?
Many patients today find that they have to travel out of their city, state, or country to find a revision rhinoplasty expert. Dr. Bustillo is one of those nasal experts who excels in secondary nasal surgery. For this reason, a large part of Dr. Bustillo’s patients come to Miami to have their revision rhinoplasty. Some patients come to have surgery with Dr. Bustillo because they do not have qualified revision rhinoplasty surgeons. Others come to have revision surgery with Dr. Bustillo because the costs for revision rhinoplasty in their cities, such New York City, are extremely high.