Revision Rhinoplasty

Revision rhinoplasty is a secondary correctional surgical procedure which is performed after a primary rhinoplasty or the first procedure performed elsewhere by a different surgeon. Revision rhinoplasty may even be carried out a second time in order to improve the appearance and function of the nose. Revision rhinoplasty can correct both aesthetic deformities and functional disturbances. Revision rhinoplasty is one of the most complex procedures performed at Centre for Surgery and many surgeons elsewhere often avoid performing the procedure.

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Most types of revision rhinoplasty require reconstructive surgery to provide adequate structural support for the nasal tip and all the nasal dorsum or bridge of the nose. This is often provided in the form of cartilage. In many revision rhinoplasty procedures, they will already be a lack of cartilage available in the nasal septum to be used for reconstruction and your surgeon may need to harvest cartilage from another part of the body as an alternative approach. Other common sites include the removal of cartilage from the ear and sometimes from the ribs. Patients who have abnormalities affecting the nasal tip or bridge of the nose may require harvesting soft tissue from other parts of the body. The hairline is also a source of fascia which is a tough connective tissue layer occasionally used by some rhinoplasty surgeons. Often the internal architecture of the nose has been distorted by scar tissue from previous surgery and skin grafts or soft tissue flaps will be required to correct abnormalities of airway patency which may result in breathing difficulties. Ideal candidates for a revision rhinoplasty at Centre for Surgery are fit and healthy patients over the age of eighteen with realistic expectations of what a revision rhinoplasty procedure can achieve.

Choosing Centre for Surgery for your procedure means you will be seen and assessed by specialist rhinoplasty surgeons who are dedicated sub-specialists in rhinoplasty surgery. They do very few other types of surgery and so have become experts in all aspects of rhinoplasty surgery. Patients who choose us for revision rhinoplasty do not do so on the basis of price. They do so on the basis of their skill, compassion and professionalism as experienced medical professionals. You can expect our surgeons to expertly assess you and provide accurate unbiased medical advice along with a number of treatment options, one of which is to do nothing. A decision to undertake rhinoplasty surgery, especially revision surgery, should not be taken lightly. Our surgeons will take the time to explain all the risks and benefits and what you can expect to achieve. This may be aided by computerised 3D imaging, which may be used at your consultation to give you a rough idea of how you could look after revision rhinoplasty surgery.

Patients often decide to have a revision rhinoplasty to address the poor results from a previous nose job procedure often performed by another surgeon. Patients often express dissatisfaction with their rhinoplasty results for several reasons. They may feel the overall facial features are no longer balanced, they may believe the nose is still too big for their face, or they may now have problems breathing through their nose due to the previous rhinoplasty. Even in the most skilled rhinoplasty surgeon’s hands, revision rhinoplasty surgery has a higher revision rate than primary rhinoplasty. On average, about 15 to 20% of all patients who have a primary rhinoplasty will require a corrective procedure of some type to address anaesthetic or functional concerns they may have.

It is important to be aware that no surgeon can guarantee the outcome of any type of surgery, especially a highly complex revision rhinoplasty surgery where many factors will be beyond the surgeon’s control, including the healing process, with significant variation in this area between patients.

If you would like to consider having a revision rhinoplasty, you should wait until you are fully healed from your first rhinoplasty procedure. At Centre for Surgery, we would recommend waiting at least 12 months from the first procedure before even having a revision rhinoplasty consultation. Having surgery sooner than this may result in further structural damage to the nose, which may prove difficult, if not impossible, to correct adequately. We would advise all patients considering revision rhinoplasty to undertake detailed research and to have a very clear idea of what the procedure can achieve with realistic expectations established from the very beginning.

Revision rhinoplasty is one of the most difficult surgical procedures to undertake for many reasons. Often previous rhinoplasty surgery results in the formation of dense scar tissue. This makes it challenging to perform revision rhinoplasty surgery as the common identifying features of the nose may be distorted by scar tissue. This can compromise the final results as excessive scar tissue may recur even after well-performed revision rhinoplasty. Many noses after primary rhinoplasty may have damaged cartilage or lack cartilage, which is often required as part of a secondary rhinoplasty procedure to adequately reconstruct the nose.

Patients who choose to have a revision rhinoplasty in London need to understand that even a corrective rhinoplasty procedure may not be entirely successful in repairing cosmetic abnormalities which were not adequately addressed in the first procedure or have resulted from having a primary rhinoplasty. The success or failure of a nose job procedure can often be difficult to objectively measure, as even successful revision rhinoplasty surgery may be viewed as unsuccessful by the patient. The likelihood of developing dissatisfaction after revision rhinoplasty is higher for patients who are already unhappy with the results of the first procedure.

Patients must be aware of all the potential risks and complications of revision rhinoplasty surgery, including an unsatisfactory outcome. They must have realistic expectations of what the procedure can achieve before being accepted for a revision rhinoplasty at Centre for Surgery.

This is not possible. No surgeon can ever guarantee successful results from any surgical procedure. Every surgery carries potential risks and complications, even if they are very rare. Revision rhinoplasty is one of the most complex procedures undertaken at Centre for Surgery and indeed many experienced rhinoplasty surgeons in other parts of the UK may not perform this procedure due to its high risk of patient dissatisfaction.

All patients should have realistic expectations of what sort of results can be achieved after revision rhinoplasty. The final outcome will depend on several factors, including the current structural configuration of the nose and how much damage has already been caused by previous surgery. This will be determined by the type of rhinoplasty undertaken. It is often useful for the revision rhinoplasty surgeon to review the operation record from your first procedure so they can be fully familiar with what was carried out.

Many of our surgeons at Centre for Surgery perform 3-D imaging to give you a rough idea of how you could look after your revision rhinoplasty. Although the technology can be useful, it is important to avoid fixating on the 3-D images as these are merely approximations of the final result and may not reflect the actual results.

A facial plastic surgeon is trained to undertake aesthetic surgical procedures in the facial region. They are dedicated sub-specialists. Compared with general plastic surgeons, facial plastic surgeons are inherently better trained to perform delicate facial procedures. The extra years of surgical training by facial specialists focused on the facial region results in an exceptionally high degree of skill. All our surgeons are on the GMC specialist register for plastic surgery. The Royal College of Surgeons of England has an excellent information resource on cosmetic surgery.

Our plastic surgeons are rhinoplasty specialists and are highly experienced in performing all types of revision rhinoplasty, from minor corrections to complex reconstructive procedures involving rib grafting. Revision rhinoplasty surgery is performed at our specialist day surgery facilities at Baker Street in central London. Revision rhinoplasty surgery takes longer to perform than primary rhinoplasty surgery and 3-4 hours of operating time are typical under TIVA general anaesthesia.

Most revision rhinoplasty surgery is performed via the open approach, where the incisions are made on the inside of the nose and the columella, which is the area of skin between the nostrils. A few revision rhinoplasty procedures are performed using the closed or endonasal approach. In this technique, all incisions are made within the nose. After the surgeon has carefully exposed the bony and cartilaginous framework, the cartilage may be repositioned or augmented with bone grafts taken from several potential sites. After the procedure is complete, the incisions that were used to access the internal framework of the nose are closed, and a metal-backed splint is applied to the nose.

After secondary rhinoplasty, bruising and swelling are more extensive than in primary rhinoplasty. Patients generally will experience very little discomfort. Most bruising will settle within 10-14 days. Swelling may take much longer to settle – often anything from several months to 18 months post-op. The external sutures are removed about five days later. Most patients can return to light work activities within one week. Strenuous activities should be postponed until after four weeks.

Revision rhinoplasty is also known as secondary rhinoplasty. Revision rhinoplasty is performed as a corrective procedure for surgery that was previously performed by another surgeon. The procedure addresses both aesthetic and functional aspects. Suitable candidates for revision rhinoplasty must be in good health, be over the age of 18 years and have realistic expectations for what can be achieved.

Principles of revision rhinoplasty

The key to rhinoplasty is in getting it right the first time. In a small number of cases, our surgeons do perform secondary treatments to achieve the ideal result as everyone heals differently and healing is impossible to predict with perfect accuracy every time. Sadly the adage, ‘buy cheap, pay twice’ very much applies to rhinoplasty surgery where expertise and experience really matter. Poor planning leads to poor execution. Our rhinoplasty surgeons make use of 3D imaging to map as accurately as possible all aspects of your nose to optimise outcomes as much as possible.

Centre for Surgery is one of the top UK centres for London revision rhinoplasty with some of the very best nose job surgeons in the country practising from our facilities in central London. Our state of the art Baker Street clinic is located in Marylebone and is easily accessible for patients from London and further afield. When you come to Centre for Surgery, you can be assured of receiving the very highest standards of medical care from highly experienced and qualified revision rhinoplasty specialists.

Our surgeons perform hundreds of rhinoplasty procedures annually and are regularly called upon to deliver keynote speeches at some of the top national and international rhinoplasty conferences. They have received sub-specialist training in all types of rhinoplasty in the UK and overseas to deliver the best possible outcomes and revision rhinoplasty results.

Before any planned surgery, it is important to have a clear idea of the potential risks and complications associated with revision rhinoplasty and what to expect during recovery. Getting the best results means following your surgeon’s post-operative instructions in full.

If you have been thinking about having a revision rhinoplasty in the UK, give us a call today and speak to one of our expert patient coordinators to book an initial consultation with one of our rhinoplasty surgeons in London. The cost of revision rhinoplasty surgery can significantly exceed the cost of a primary rhinoplasty due to its increased complexity and higher potential for risks and complications. Once you have had a face-to-face consultation with a rhinoplasty specialist, you will receive a full quotation from your dedicated patient coordinator.