What is Revision Rhinoplasty?
Revision rhinoplasty is a cosmetic nose surgery performed when the desired result from a previous nose surgery has not been achieved, or when the surgical procedure has caused a different complication in the nose. The terms "secondary rhinoplasty" or "correction surgery" are also used instead of revision rhinoplasty. According to some terminologies, revision rhinoplasty refers to the second surgery performed by the same surgeon to correct the negative results of their own operation, while a correction surgery performed by another surgeon is referred to as secondary rhinoplasty.
Why is Revision Rhinoplasty Necessary?
Aesthetic nose surgery is a delicate process. After these surgeries, there can be a need for correction in about 8-15% of cases. This necessity for re-surgery can stem from various factors. It is important to note that the experience of the surgeon who performed the initial aesthetic nose surgery plays a significant role. A major factor can be the failure of the surgeon to fully understand what the patient wants during the initial consultation. A plan that satisfies both the physician and the patient from functional and aesthetic perspectives must be created. The surgeon should clearly explain to the patient what reasonable requests can be accommodated and what cannot, along with the reasons. The most suitable technique and correction plan should be designed based on the patient's anatomy and skin type.
What Are the Reasons for Revision Rhinoplasty?
The occurrence of aesthetic and functional complications after the primary rhinoplasty surgery forms the basis for the necessity of revision rhinoplasty. Generally, the following reasons can play a role in the decision to pursue revision rhinoplasty:
- Asymmetry in the nostrils
- Elevation of the nasal bridge
- Irregularities in the nasal dorsum
- Collapse in the nasal sidewalls
- Deviation of the nose
- Development of excessive scar tissue inside or outside the nose
- Hanging or overly shortened or upturned (pig-like) appearance
- Difficulty in breathing
How is the Decision for Revision Rhinoplasty Made?
The quality and care taken in the initial surgery closely influence the revision surgery. Whether a minor revision (a small procedure) or a comprehensive surgery to resolve major issues is needed also depends on the prior surgery and its outcomes. Post-operative inflammatory or bleeding complications can lead to long-term alterations in the shape of the nose, necessitating further surgery.
When is the Decision for Revision Rhinoplasty Made?
Timing is important; it is more appropriate to plan revision rhinoplasty at least six months after the initial rhinoplasty, once the nose has fully settled. If a decision is made before the swelling has subsided, additional issues that may become apparent after the swelling can remain hidden. Thus, performing revision surgery too early can lead to incomplete corrections. It is crucial to avoid being hasty or premature.
What Materials Are Used for Revision Rhinoplasty?
To perform these corrections, cartilage tissues are primarily required. If only a small amount is needed, cartilage can be harvested from the ear; if a larger quantity is required, cartilage transfer from the rib may be planned. Skin incisions aim to be placed along the ear folds or the skin creases below the breast to minimize visibility.
As surgeons performing nasal surgery, our main goal is to achieve the desired result in one attempt. Otherwise, issues such as costs for the patient and the stress of a second surgery, as well as low patient satisfaction for us doctors, can arise. However, it should not be forgotten that these issues are included in the probabilities associated with all surgical procedures.
