Revision rhinoplasty is a surgical procedure to change the bony and cartilaginous skeleton of the nose which can be performed for either functional (breathing concerns), aesthetic concerns or both functional and aesthetic purposes following the initial (primary) rhinoplasty.
A full reconstructive revision rhinoplasty can go for as long as 6 hours, compared to an initial rhinoplasty which on average goes for between 2 and 3 hours. Revision rhinoplasty surgery is very challenging surgery as the surgeon may have very little to work with after the initial operation. It is important to understand that there are limitations to what can be realistically achieved in any rhinoplasty, be it primary surgery or revision.
How many rhinoplasties can one person have?
It is extremely important to get the initial rhinoplasty surgery right, however, 5 to 10 percent of rhinoplasty patients worldwide require revision surgery. Some revision rhinoplasty surgeries may require just small changes, whereas other cases may require full reconstruction of the nose to improve the breathing functionality as well as the overall aesthetics. In general, revision rhinoplasty is more extensive and requires a lot more time and skill to achieve a good outcome. With each subsequent rhinoplasty, it is more difficult to get the desired outcome (this is because the nose of a person undergoing a revision rhinoplasty will usually have less cartilage available to rebuild the structure of the nose from the inside). It is more likely that a graft from a distal site such as rib will be needed in a revision case. Mr Patrick Walsh sees many rhinoplasty revision patients and generally finds that although each nose needs to be assessed on its own merits, the chances of improving the nose significantly decrease after the third rhinoplasty.
What is a graft in revision rhinoplasty?
With less tissue and cartilage available to work with in a revision rhinoplasty, a rib cartilage graft may be required to substitute lost or severely deformed cartilage. This involves a small incision in the crease under the breast and this is essential to be able to restore the structure to allow for a nose that breathes well and looks good. A rib graft can be quite painful and extend the initial recovery period. Special arrangements for pain relief at the rib graft site such as a local anaesthetic infusion are employed. Fascia grafts may also be required and are often taken from above the ear in the hairline to pad the soft tissues of the nose under the skin. This gives the nose a smooth appearance, particularly in thin-skinned people. Rarely, ear cartilage is used for specific grafts in the septum and tip of the nose.
Considering having revision rhinoplasty?
Mr Walsh has performed many revision rhinoplasties and many have been extensive. If you have had a previous rhinoplasty in the past and have issues with breathing or the appearance of your nose then a consultation may help you decide whether or not this is something that you would like to proceed with. Mr Walsh uses the latest 3D imaging technology during the consultation which allows you to see the sort of result he believes could be achieved for you surgically.