Given that rhinoplasty is both a common procedure and a complex one, national statistics demonstrate that many patients (15%) go onto have a secondary procedure obtain the results the initially sought. Because of my interest in this area and experience, local surgeons refer to me patients who desire revision rhinoplasty. The process of revision rhinoplasty is involves dealing with the initial defects, changes created in the prior procedure and scar tissue.
Successful revision rhinoplasty involves evaluating the nose to determine the initial aesthetic problems that were left unsolved and the new problems created by the prior procedure. The plan and its execution must address both issues in order to bring about a satisfactory result. These procedures often require strengthening portions of the noses skeletal structure that were weakened with the prior procedure. Cartilage grafts from the ears and/or ribs are often required for this purpose. While “out of the jar” irradiated cadaveric cartilage grafts are available, I prefer to use the patient’s own tissues because it is felt they have improved performance over time. These tissues can be utilized with minimal change in shape, scar, and discomfort in the locations from which they are borrowed.
- Utilizes patients own tissues to re-build the nose
- Additional advanced fellowship training in rhinoplasty
- Published scientific contributions regarding rhinoplasty technique improvement
- Speaking engagements on nasal surgery at major scientific meetings and a nationally ranked medical schools
Rhinoplasty generally requires general anesthesia but is usually performed on an outpatient basis. A small splint is applied on the outside of the nose. Often soft plastic splints are placed inside the nostrils. Packing is not routinely used. The splints, both internal and external, are removed at about one week. Bruising and swelling is generally mild and lasts about 7 days. Patients generally return to school or work at about that time. A mild amount of discomfort will be felt at the ear if cartilage is borrowed from that location. Generally no change in the shape of the ear is noted. If cartilage is borrowed from the ribs there will be some mild soreness on the chest as well.