Revision rhinoplasty, also commonly referred to as secondary rhinoplasty, is any time the nose has surgery performed on it after the first surgery. Revision rhinoplasty is more often than not more difficult to perform than a primary (first time) procedure. The anatomy is no longer pristine, but rather, there will often be an abundance of thick, hard scar tissue from the previous operation.
Reasons for Considering Revisionary Rhinoplasty
Scar tissue obscures the natural tissue planes that separate the various cartilages, bone, and soft tissue within the nose. Precise and careful dissection is often painstakingly necessary to separate the scar tissue from normal structures of the nose.
It takes more time to complete, will often require materials gained from other parts of the body, and requires more knowledge, experience, and technical skills on the surgeon’s side.
The rhinoplasty procedure lasts from one to three hours.
To begin the surgery, tiny incisions are made which allow the surgeon to access the underlying nasal structure. Once the skin is opened, the cartilage and bone are reshaped to form the basis for the new look. Two basic methods are utilized for performing nose surgery. These methods are referred to as the ‘open’ and the ‘closed’ techniques. The open technique allows for maximum visibility and control over the procedure. The incision used in the open technique is placed in-between the nostrils on the columella (the medial nostril strip). In the closed technique, the incisions are internal and heal faster; however, there is less surgical control over the outcome.
At the outset at any rhinoplasty, one has to devise a plan together with the patient that aims to achieve the ideal outcome through one, first, and final, procedure. This is highly individualised and can be particularly difficult for revision rhinoplasty. Dr Goh will discuss the best technique for you during your initial consultation.
Generally, post-operative instructions call for plenty of rest and limited movement in order to speed up the healing process and to reduce the recovery time. Some swelling may be noticed; however, any swelling will disappear within a few weeks. A splint, bandages, and/or gauze are applied immediately following surgery to aid in the healing process and to minimize movement of the nose. Patients must refrain from smoking for several weeks before and after the surgery. In addition, any corrective glasses that are worn must be taped up and off the nose. Patients sometimes report minor pain associated with the surgery, which can be effectively treated with oral medication and/or cold compresses. While complications are rare, you can minimize the risk of potential problems by carefully following the post-surgical directions given by Dr Goh.