New York, NY | Revision Rhinoplasty | Lee Ann M. Klausner, MD, FACS
A revision rhinoplasty is an operation performed to reshape the nose and a patient who has had at least one prior operation performed to reshape the nose and generally, patients who consider revision rhinoplasty are patients who are dissatisfied with their previous operation, perhaps because not enough was done in the first operation. In some cases, too much was taken away in the first operation, and in other cases, there is nasal dysfunction as a result of the prior operation. The greatest challenge with revision rhinoplasty has to do with the fact that because of the prior surgery there are scar tissues and there are layers in the nose and this becomes more difficult to identify the layers in your surgical dissection and open the nose. There’s the greatest risk of traumatizing the layers because of the presence of scar tissue. The other feature that makes revision rhinoplasty more challenging has to do with what might’ve been done in a prior operation. Maybe the cartilage and the natural curves on the cartilage and other structures in the nose have been altered with the prior operation and being able to recreate those nice, natural-looking contours can be more challenging the second time around. The general rule of thumb is to allow about a year following the previous surgery to pass and the reason for that is to give the nose an opportunity to heal, to give the scar tissue an opportunity to remodel and mature, and to allow for a lot of the swelling to go away. Operations, minor revisions to nasal surgery, if they occur earlier than that, the tissue is a lot tougher and more difficult to dissect. A revision rhinoplasty can take longer to heal. The presence of scar tissue can also impede the resolution of the swelling. So, a nose that has had more than one operation, and in some cases multiple operations uh can hold on to the swelling for much longer.