Also known as secondary rhinoplasty, revision rhinoplasty is a surgical procedure which corrects nasal problems of an aesthetic or functional nature resulting from a previous rhinoplasty surgery. Revision rhinoplasty is by far one of the most challenging plastic surgery procedures, requiring an experienced surgeon with particular skill in reconstructing the cartilages and bony framework of the nose.
Revision rhinoplasty may correct or improve a number of issues which have resulted from prior surgery including nasal obstructions and other functional problems which may inhibit breathing, depressions, bumps, collapsed or pinched tips, and excessive scarring. In some cases, cartilage grafts or implants may be necessary to replace missing structures. Candidates for revision rhinoplasty include men and women who are looking to improve aesthetic or functional problems of the nose which have resulted from prior surgery. It is particularly important that patients have realistic expectations as there may be limitations to what can be achieved. An initial consultation with Dr. Kapoor in his Beverly Hills office will help to determine if revision rhinoplasty is right for you and what improvements can be achieved.
Dr. Kapoor may perform the revision rhinoplasty surgery onsite at the Beverly Hills Wellness Surgery Center, a state-of-the-art AAAHC-certified facility. Revision rhinoplasty procedures generally average two or more hours in length and may be performed with either local anesthesia combined with intravenous sedation or with general anesthesia. An “open” approach, in which a small incision is made across the columella, or the strip of skin located between the nostrils, is often required as it allows for a better view of and access to the inside of the nose. Less complicated cases may involve a “closed” or “invisible” approach in which all incisions are confined to the inside of the nose.
Once the incisions have been made, Dr. Kapoor will carefully separate the skin of the nose from the underlying framework of bone and cartilage. The doctor may then reposition cartilage or replace missing structures. If cartilage grafts are needed, cartilage may be taken from the septum, ear or rib. Once the necessary changes have been made, Dr. Kapoor will re-drape the skin over the new framework and suture it into place. A splint will be applied to the outside of the nose and, if necessary, cotton or soft plastic splints may be placed in the nostrils.
The recovery after revision rhinoplasty is often less extensive than after a primary procedure. Though the face may look and feel puffy right after surgery, there is generally less bruising and swelling encountered. The bruising should subside within about ten days, while the swelling may take several months to disappear. Patients often experience less pain, and discomfort can be controlled with prescribed medication. Nasal packing, if used, may be removed within a few days after surgery, while the splint and external sutures are removed within about six to seven days.
Work or school may be resumed within about one week after the revision rhinoplasty procedure. Strenuous activities which increase the blood pressure will need to be avoided for a longer period of time. It’s also important that patients avoid sunburn to the nose or rubbing or hitting the nose for at least eight weeks.
Q. Who can benefit from revision rhinoplasty?
Men and women who would like a better-looking or better-functioning nose due to problems caused by a previous rhinoplasty surgery. Candidates should also realize that there may be limitations to what the surgery can achieve and must be realistic in their expectations.
Q. What are the risks?
Because revision rhinoplasty is one of the most challenging plastic surgery procedures, it requires a highly skilled aesthetic surgeon, such as Dr. Kapoor. Nevertheless, there is still risk as with any surgery, and potential complications are similar to primary rhinoplasty surgery. These may include infection, nosebleed, a reaction to the anesthesia, and small burst blood vessels appearing as tiny red spots on the skin’s surface.
Q. What's the first step?
The first step in the revision rhinoplasty procedure is an initial consultation with Dr. Kapoor in his Beverly Hills office. The doctor will review your medical records and history and listen carefully to your desires. He will perform a detailed physical exam of your nose. Dr. Kapoor will also discuss the possibilities through surgery, the cost of the procedure, information about health insurance, and the specifics of the procedure. Any questions or concerns that you may have will be addressed at this time.