Revision rhinoplasty is a big undertaking. Patients naturally have many questions before they go through the process all over again. To make things more difficult, there is lots of information – both good and bad – on the internet making it impossible to know what's what. Here are 5 things to consider as you begin your search for a better rhinoplasty outcome:

  1. No two noses are the same

  2. No two surgeons are the same

  3. What are grafts?

  4. Are there any alternatives to surgery?

  5. Follow up

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No Two Noses Are the Same

Problems after rhinoplasty can range from a simple bump on the nose or a crooked nose to complete collapse.  Each revision rhinoplasty patient is unique. Additionally, some problems require minor procedures that can be done in the office, while others require extensive reconstructive surgery best performed in an operating room.  There is no "one size fits all" solution.  A detailed and specific conversation with your surgeon can help you sort through these important issues. 

No Two Surgeons Are the Same

The best plastic surgeons are well trained in a variety of techniques, but no two surgeons are the same.  Some may want to use different types of "grafts" (discussed below) to get the job done, while others propose an entirely different solution. The most important factor in deciding the best rhinoplasty surgeon for you is a clear and honest discussion about your goals and expectations for surgery.

What are grafts?

Your surgeon may use the term "graft" a lot when discussing your surgery.  A graft is simply a piece of tissue that is moved from one part of the body to another.  Common grafts used to reconstruct the nose in revision rhinoplasty are rib cartilage, ear cartilage, soft tissue grafts from the temple region, or even abdominal fat grafts.  Each serves a different purpose and you should ask your surgeon if any of these will be required and what to expect.

Are there any alternatives to surgery?

Yes, but usually surgery is the most definitive solution.  However, in some cases certain less invasive options may be reasonable.  A new device called Spirox Latera is a dissolvable implant that can be placed in a few minutes with just local anesthesia.  It strengthens the side walls of the nose, which are often left weakened after a rhinoplasty.  Another common practice is the use of injectable fillers like Juvederm to correct irregularities after surgery.  However, it is important to be aware that there are very rare but real reports of bad complications from injectable fillers to the nose including skin damage and blindness.  Look for board certified facial plastic surgeons with expertise in rhinoplasty for a consultation on how this can be done safely and effectively. 

Follow up!

One of the most important aspects after your revision rhinoplasty surgery is maintaining good follow up with the surgeon who performed the procedure.  There are differences in healing after revision rhinoplasty that make the postoperative period a critical period.  A surgeon may choose to initiate massage maneuvers, nasal exercises or taping, or perform steroid injections that can help shape the healing process.  Outcomes can be as much as 10-2% better if good follow up is obtained. 



For more information or to request a consult with Dr. Nachlas or Dr. Dibelius, contact Sandy Friedman-Director of Patient Relations at 561-939-0909


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Tagged Nose Surgery, Rhinoplasty, rhinoplasty surgery, Surgery, rhinoplasty surgeon