What is Revision Rhinoplasty?
Unfortunately, not every rhinoplasty creates the desired results. During the first surgery, existing problems may go unnoticed, complications may occur, a new cosmetic or functional problem may occur, or an overly ambitious surgeon may leave the patient with unsatisfactory results.
If you had nasal surgery that produced undesirable results or breathing problems, it is understandable to be fearful and frustrated. The only way to fix the problem is through corrective surgery. Dr. Gerarchi is a secondary rhinoplasty specialist who helps patients who have already gone through a failed nasal procedure to correct the appearance and function of the nose.
Also known as a secondary rhinoplasty, revision rhinoplasty is intended to repair or further improve the results from a primary nasal operation. Patients may have several problems from an initial procedure that require correction, such as a saddle nose deformity, polly beak deformity, hanging columella, a pinched nose, a misaligned nasal bridge, a bump on the nose or a nose that is not proportional to the face. Surgery can also result in functional problems, including breathing difficulties or chronic nasal obstruction. Both cosmetic and functional problems may be addressed through revision surgery.
Dr. Gerarchi recommends patients wait at least one year after their first nasal surgery before seeking corrective surgery. Nasal surgery results in swelling that can take up to one year to resolve, and the scar tissue needs time to soften. By waiting at least one year, the nose will achieve its final appearance for a full evaluation and the results of the revision procedure will be much more predictable.
Revision nasal surgery is very technically complicated. It is by far one of the most complex cosmetic surgery procedures performed. This is why it is very important to seek out the best facial plastic surgeon available who has extensive experience performing revision procedures with innovative techniques that result in the best possible cosmetic and functional outcome.
Revision Rhinoplasty Surgery
Revision surgery may be performed as a day procedure or as an overnight procedure. This decision depends on the complexity of the procedure and what must be corrected. Surgery typically takes one to four hours to complete using general anaesthesia for the patient’s comfort.
While Dr. Gerarchi may use the closed technique with incisions completely within the nostrils, this technique limits what may be corrected. In most cases, the open technique will be used to give Dr. Gerarchi greater access to the structure of the nose and a greater ability to correct cosmetic and functional issues.
This procedure will begin with a very small incision between the nostrils at the base of the nose. The skin will then be pulled back for full access to the structure of the nose. Depending on the nature of the problem(s) that must be corrected, nasal cartilage may be sculpted, excess tissue and skin may be removed, and reconstructive cartilage grafts or implants may be added. After repair work is complete, Dr. Gerarchi will reposition the skin and use small sutures and a cast to hold the nose structure in place.
Are you a Candidate?
The ideal candidate is a man or women in good physical health that has experienced unsatisfactory results from an initial nasal surgery. It is very important to have realistic expectations about this procedure and understand that there are limits. Patients should be non-smokers, or able to quit smoking for two weeks before and six weeks after surgery, as smoking impedes the healing process and can lead to complications and unsatisfactory results. Dr. Gerarchi will help you determine if you are a candidate for this surgery during your initial consultation.
If you are unhappy with the results of a previous surgery, secondary nasal surgery is effective and safe with the ability to improve the function and appearance of your nose. A good way to get started is researching the procedure online to learn about the advantages and drawbacks of surgery, how the surgery is performed and what you can expect during recovery. It is also important to review before and after photos to understand what to expect, and to carefully research surgeons. Look for a facial plastic surgeon who has extensive experience performing this procedure with satisfying results for patients.
When you are ready to get started, contact The Face Institute with any questions and to set up a consultation with Dr. Gerarchi.
The first step toward achieving your surgical goals is the consultation. During this appointment, you will have the opportunity to get to know your surgeon. This is also a time for excellent doctor-patient communication so Dr. Gerarchi can understand your goals and what you hope to achieve during the surgery.
Dr. Gerarchi will review any medications and supplements you are taking, review your surgical history and conduct a thorough examination of your nasal structure before explaining the procedure and any risks. Using computer imaging software, Dr. Gerarchi will create a personalised surgical plan and guide you to what is likely to be able to be achieved during surgery. During the consultation, the cost of your surgery will be broken down and Dr. Gerarchi’s staff will explain all payment options to you.
What to Do Before Surgery
It is very common to feel anxious, nervous and stressed ahead of your surgery, but there are steps you can take to ensure a smooth surgery and problem-free recovery process.
- Arrange for someone to drive you home from the surgical centre if your procedure is performed as an outpatient day surgery.
- Remember to fill prescriptions ahead of your procedure. Do not wait until you need medication to go to the pharmacy.
- Plan to take2 weeks away from work and normal activities to heal.
- Think about what you want to tell friends, family members and co-workers about your surgery.
- It will help if a friend or family member can help you during the first few days of your recovery, as you will still feel tired and sore.
- Review post-surgical instructions and ask any questions you have before your surgery.
- Gather a list of important phone numbers and contact information to keep close if you need it.
- Schedule follow-up appointments with Dr. Gerarchi and be prepared to make these appointments.
- Discontinue use of aspirin, ibuprofen and herbal supplements a minimum of two weeks ahead of your procedure. Dr. Gerarchi will review your medications ahead of the procedure so you know what should be discontinued.
- Quit smoking at least two weeks before your procedure and be prepared to quit for at least six weeks afterward. Smoking affects circulation and can increase complications and slow healing.
Your Revision Rhinoplasty Recovery
The recovery from this surgery usually takes one to two weeks. Some swelling, bruising and some bleeding are common. Most patients feel and look well enough to go out in public and return to work after two weeks. For most patients, revision surgery has an easier recovery than the initial procedure.
To control swelling, keep your head elevated and use cool compresses around the eyes. While most swelling resolves within two weeks, residual swelling takes close to 12 months to resolve completely. Mild to moderate discomfort is to be expected, but this is well controlled through pain medication Dr. Gerarchi prescribes.
For an easier and faster recovery, avoid alcoholic beverages and smoking, as well as strenuous activity for the first six weeks. The nose should be protected while it heals, which means bumping, rubbing or touching the nose should be avoided. Do not blow your nose or sniff your nose excessively for the first three weeks. If you need to sneeze, do so through your mouth and do not try to hold it in.
Keep your head elevated with pillows during rest for the first two or three weeks. This will improve circulation and help reduce swelling. Direct sunlight should also be avoided to avoid permanent marks on the nose. You may wear contacts after surgery, but do not wear glasses for the first month.
How soon after my first rhinoplasty can I get revision surgery?
Dr. Gerarchi recommends waiting about one year for all swelling to resolve. After nasal surgery, residual swelling remains for up to one year, and performing the revision surgery before this period increases the risk of unsatisfactory results.
How old must I be for this procedure?
Nasal surgery may be performed at any time, but it is best to wait until growth is complete around the age of 16.
How will the procedure be performed?
The exact techniques used for your procedure depend on the issues that must be corrected. For minor corrections, the closed technique may be used, in which all incisions are made inside of the nostrils. In most cases of revision surgery, the open technique is used that results in a very fine, well-hidden incision at the base of the nose.
Will I have scars after my surgery?
If the closed technique is used, there will be no visible scarring. With the open technique, a very fine incision will be made on the skin between the nostrils at the base of the nose. This will result in a fine scar that is well concealed and fades with time.
Is revision rhinoplasty recovery similar to primary surgery?
It really depends on how much reconstruction is required. Most patients experience a less extensive recovery following revision surgery, but complex procedures may result in more bruising, swelling and discomfort. Most patients resume work and most normal activities within 2 weeks.
The before and after photographs shown are of Dr Gerarchi’s patients and the surgery has been performed by Dr Gerarchi. They are for illustrative purposes only. They show the results achieved by individual patients and are no guarantee of the outcome to be expected by any particular individual considering surgery. Surgeons of good reputation do not guarantee outcomes. Unexpected events and individual healing characteristics can affect the outcome of any surgery.
Please feel free free to call us on (02) 9412 4599 or email if you would like any additional information about this procedure.