Take Two: Revision Rhinoplasty

When things don’t go right with a nose job, it can understandably be devastating for the patient.

This is sadly something that happens more frequently than any of us would like.

In fact, almost half of the patients who present to me for rhinoplasty are there because of unsatisfactory outcomes from surgery undertaken elsewhere.

The photo shows the preop above and the immediate intraop postop below. Unfortunately my patient had previous surgery performed elsewhere which left her with a deformed nose and great difficulty with breathing. The preop shows an over resected dorsum with a bulbous drooping tip Structural manoeuvres with the patient’s own rib cartilage were used to create an elegant natural profile and refined defined tip with good support and pleasing nostril shape. This should ensure not only an aesthetically appealing shape but also an excellent functional outcome.

Rhinoplasty is a complex surgical procedure, and revision rhinoplasty, even more so.

A revision rhinoplasty procedure, as the name suggests, is undertaken to ‘revise’ or attempt to fix an unsuccessful primary rhinoplasty.

The photo shows the preop above and the immediate intraop postop below. Unfortunately my patient had previous surgery performed elsewhere which left her with a deformed nose and great difficulty with breathing. The preop shows an over resected dorsum with a bulbous drooping tip Structural manoeuvres with the patient’s own rib cartilage were used to create an elegant natural profile and refined defined tip with good support and pleasing nostril shape. This should ensure not only an aesthetically appealing shape but also an excellent functional outcome.

Patients who have had an unsatisfactory rhinoplasty elsewhere most commonly present to me with breathing difficulties and aesthetic concerns. In many cases, the bridge of the nose has even collapsed due to an insufficient or weakened structure resulting.

The decision to undergo surgery for any area of the face is a big one with a person’s time, money and emotional energy invested. Ideally, rhinoplasty is a procedure that will only need to be performed once and by an appropriately trained and experienced surgeon.

Primary Rhinoplasty: Female patient with moderate bump, bulbous droopy tip and excessive nostril view. Preservation and Structural manoeuvres were used to create an elegant feminine nose with a natural profile and subtle supratip break. The tip is rotated refined and defined and the nostrils are neat.

Fixing problems is not always straightforward; it is far preferable to invest in getting thing done properly the first time. However, while it is a highly specialised area it is often possible to improve results for patients. Some of my happiest patients are those who have undergone successful revision with me. Some even describe it as ‘life changing’.

Sharing Expertise

I regularly speak about rhinoplasty and other facial surgery procedures and was honoured to most recently be invited to speak (via the internet!) at prestigious meetings in St. Petersburg and Seoul:

• Intensive Course: Preservation Rhinoplasty, St Petersburg, 9-10 April
• ASAN Rhinoplasty Symposium, Seoul, 8 May 2021

The aim of attending and presenting at multidisciplinary meetings worldwide with other ENT, Head and Neck, Facial Plastic Surgeons and Plastic Surgeons is to advance the field, ultimately to improve outcomes, with patient safety at the forefront. My presentation at both of these meetings was specifically on the topic of Revision Rhinoplasty.

Showcasing Results

 You can see many images of patients before and after rhinoplasty procedures here.

• Outcomes experienced by one person do not necessarily reflect what another person may experience. Any surgical or invasive procedure carries risks which you should discuss in detail with your surgeon.

For more information or to make an appointment, contact us.

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