Revision Rhinoplasty (Nose Job)

What is Revision Rhinoplasty?

There are an increasing number of clinics in the UK and around the world that specialize in Revision Rhinoplasty. Put simply, these are surgeons who are specifically skilled in correcting the mistakes of other surgeons who have performed what are often crudely referred to as ‘bad nose jobs’. Revision Rhinoplasty, sometimes referred to as Secondary Rhinoplasty or Rhinoplasty Correction, is an option that some people choose when they are not completely satisfied with the results of their primary procedure. Due to the minute detail required in primary procedures a small percentage of around 10% of patients opt for a secondary operation in order to get their perfect solution.

How is Revision Rhinoplasty performed?

Revision Rhinoplasty is performed in much that same way as a primary procedure using either the ‘Open’ or ‘Closed’ technique, depending on the level of work required. Both of these techniques require the surgeon to make incisions within the nostrils, but the open technique also means that a small incision is made in the area of skin that divides the nostrils. In most cases the open technique is favoured in Revision Rhinoplasty procedures because it allows the surgeon to properly view the problems that have occurred in an unsuccessful primary procedure. As is the case in primary procedures, a Revision Rhinoplasty can be performed under general or local anaesthetic depending on the difficulty level of the procedure. These options will be discussed in any pre-operation consultation a patient will have with their surgeon.

Finding the right surgeon to perform my Revision Rhinoplasty procedure

revision rhinoplasty
For many people a Primary Rhinoplasty is performed for health reasons, mainly relating to breathing problems caused by birth defects or facial trauma following an accident. However, some opt for nasal surgery for purely aesthetic reasons, in the pursuit of what they may refer to as the ‘perfect nose’ to compliment their face. In these cases it is devastating when the results of a primary procedure are not quite as expected. The main way to avoid disappointment is to do very specific research of individual clinics and surgeons to find the very best surgeon you can afford. If you are thinking of having a Revision procedure performed then make sure to pick a surgeon who has a lot of experience in that area. Look at their results on previous patients and try to read testimonials about their work. Of course every case is different, but a good surgeon should be able to give you a clear and precise idea of what they could hope to achieve in a Revision Rhinoplasty.

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Risks and complications

Rhinoplasty has the highest rate of revision surgery, and this can be for a number of reasons.

It could be that there was a mistake made during the initial surgery that warrants correction, or it could be that the patient is not satisfied or comfortable with his or her new nose. It could be that the rhinoplasty did not heal correctly, which can happen when patients do not adhere to the post-operative instructions provided. For example, if you do not keep your head elevated and sleep as normal without support or a cast, the nose can "pull" to one side, resulting in a lop-sided finish. Whatever the reason, if you have to undergo revision rhinoplasty surgery, there are some risks of which you should be aware.

For example, you may experience an adverse reaction to anaesthesia. There is also the chance that blood vessels can burst under the surface of the skin during the surgery, resulting in red spots or general redness developing across the nose. In rare cases, this discoloration is permanent. During open rhinoplasty, there is the risk that there will be permanent visible scars left behind, and there is the risk of these incisions becoming infected during the healing process. There are other functional side effects in addition to aesthetic repercussions; for example, some patients may temporarily lose their sense of smell. Swelling is another common side effect, and your nose can remain swollen for up to a year following the surgery. In some rare cases, scar tissue in the nose may heal in such a way that causes a "whistling" sound as you inhale and exhale. If you have had your nose made smaller, you may encounter a problem with loose skin around the area, especially in cases of a dramatic reduction. This may alleviate itself over time, or may require corrective surgery to heal.

Even if a skilled and experienced surgeon has carried out your surgery, there is still the chance that you will encounter complications or risk associated with undergoing a rhinoplasty. Make sure you speak to your surgeon ahead of your procedure in detail to understand these risks, and ensure you are fully prepared prior to your operation.

Recovering from Revision Rhinoplasty

The process of recovering from a revision rhinoplasty procedure is not dissimilar to recovering from the initial surgery itself.

Your surgeon will insert some sterile packs in order to reduce swelling and the amount of bleeding after surgery, and so you will be unable to breathe through your nose until this is removed. As the anesthetic wears off, it is normal for patients to experience pain and discomfort, and so your surgeon may prescribe painkillers to help you cope. You could also opt for over-the-counter medications if you prefer. Anaesthesia can potentially cause you to feel nauseous, for which you can also be prescribed medication.

It is normal for swelling to occur, and applying a cold compress to your forehead (not directly to the nose) can help to reduce this. You should sleep with your head elevated for at least a week after surgery to avoid any trauma that can impair healing. You should also take great care not to blow your nose for two to three weeks after your revision rhinoplasty, and instead gently wipe as needed. If you have exterior stitches, you will need to return to your surgery between three to seven days so that these can be removed, along with the cast.

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