Revision Rhinoplasty in Beverly Hills
Revision rhinoplasty is a surgical procedure designed to repair both form and function of a nose that has previously been operated on. Many people have difficult breathing from their nose or are dissatisfied with the cosmetic appearance of their nose as a result of prior nasal surgery. In fact, many patients have had several unsuccessful nasal surgeries, even as many as six or seven prior procedures. Because rhinoplasty is one of the most difficult of all plastic surgery procedures, there is a large need for secondary surgeries. Further, this procedure tends to be an even more complicated procedure than primary rhinoplasty, making it essential that patients find a sufficiently qualified and experienced surgeon. Good candidates include physically healthy men and women who are realistic in their expectations and are unhappy with the results of a prior rhinoplasty procedure.
Revision rhinoplasty can range from a simple procedure to remove some residual excess bone or cartilage in the nasal bridge to a very complicated complete overhaul of the nose. Revision rhinoplasty is performed on an individual who has had the misfortune of having too much tissue removed and has severe residual deformity; these patients are generally considered the most difficult type of rhinoplasty. Such surgeries are usually long and complicated affairs that require the use of tissue grafts harvested from the ear, rib or temple region to restore the necessary cartilage, bone and fascia that may be necessary. In addition the skin and soft tissue envelope is often a significant limitation on the outcome due to scarring, resistance to expansion and surface irregularities. In major revision rhinoplasty cases, one needs to be realistic about the result that can ultimately be achieved.
Rhinoplasty surgery is performed in a state of the art, AAAHC accredited surgical center within the Lasky Clinic. Primary noses can take between one and a half and three and half hours to complete depending on their complexity. Twilight sedation with the patient unconscious but breathing on their own is the usual choice for anesthesia but occasionally simple local injections or general anesthetic are utilized. Incisions may be confined to the inside of the nose (closed rhinoplasty) or may involve an additional small incision under the tip of the nose (open rhinoplasty). There are times when open rhinoplasty is preferred because it can offer better exposure and an overall better results. Other times, however, closed rhinoplasty is sufficient.
The Revision Rhinoplasty Procedure
Once the incisions are made, the skin of the nose is separated from the underlying bone and cartilage. What occurs next will depend upon the particular case. Cartilage may be repositioned or missing structures may be replaced. When the desired result is achieved, the skin is then redraped over the new framework and the incisions are closed. Revision rhinoplasty procedure tend to involve less pain and bruising than primary rhinoplasty. Any discomfort that patients do experience can be controlled with pain medication. The splint and stitches are typically removed within six to seven days. Bruising and swelling will occur and, though much of the bruising will have faded by about the tenth day, it can take up to a year for all of the swelling to fully fade. Most patients are able to return to work in about a week, though more strenuous activities will need to be avoided for two to three weeks and patients should avoid bumping or jarring the nose or getting a sunburn for eight weeks.
As with all types of surgery, there are potential complications associated with revision rhinoplasty. These may include adverse anesthesia reactions, incomplete improvement, infection, bleeding, infection, congestion, runny nose and the need for additional surgery.