Revision Rhinoplasty is also referred to as Secondary Rhinoplasty. This surgery occurs after a previous Rhinoplasty. This surgery is dedicated to correcting problems that developed or continues since the last surgery. In some cases, the problems are minor and easy to correct.
In the case of a major problem, more expertise is required than a primary surgeon since Secondary Rhinoplasty is always more difficult.
This is due to fact that the original anatomy may no longer be intact and scar tissue now fills the tissue plans which were present before the first Rhinoplasty Surgery.
Repositioning and separating what is left of the bones and cartilage is much more difficult now. The answer to a successful revision Rhinoplasty is using an experienced surgeon with the appropriate techniques.
Dr. Solomon’s goal is to see that his Secondary Rhinoplasty patients receive a natural looking and properly functioning nose that is in harmony with the rest of the patient’s facial features.
To achieve this goal, it is required that Dr. Solomon reshapes and reconstructs the framework that supports the cartilage and bone.
Revision Rhinoplasty can be necessary in cases where the original surgery was unable to achieve the ideal results. Problems with primary surgery can be a result of poor planning, inadequate communication between the surgeon and patient, or technical issues with the surgery or healing. Some problems that can occur from primary rhinoplasty Surgery include polybeak deformity, pinched nasal tip, retracted nostrils- hanging collumella, inverted V deformity, and open roof deformity.
Polybeak deformity refers to a deformity resulting from rhinoplasty surgery where the bridge of the nose becomes shaped like a bird’s beak. Typically this results if too much nasal bone is removed and/or not enough cartilage on the bridge is removed. This deformity can also result in patients with thick nasal skin where the area above the tip develops fullness. Polybeak deformity can generally be improved by the following procedures; removing more scar tissue or cartilage from the supratip region of the nose, adding tissue to over resected nasal bones, and improving nasal tip projection. Each revision rhinoplasty case must be assessed individually.
Pinched nasal tip refers to an unnaturally narrow nasal tip after rhinoplasty surgery.
Pinched nasal tip can be result from over resection of the cartilages that make up the nasal tip. This weakens the side walls of the nose and over time the tip can become pinched. The nasal tip can also become pinched if the surgeon over narrows the cartilage with sutures or with incision into the nasal tip cartilage called dome division technique. Pinched nasal tip can be improved by revision rhinoplasty by reconstructing the cartilages of the nasal tip with grafts either from the nasal septum, ear cartilage or rib cartilage.
Hanging collumella or retracted nostrils refers to the relationship between the middle portion of the nasal tip and the nostrils. Some patients develop this problem after rhinoplasty surgery. This can be corrected with revision rhinoplasty surgery by adding cartilage to the nostrils called alar rim grafting or by removing more tissue from the central collumella region.
Inverted V deformity can occur following rhinoplasty surgery. This problem can occur from rhinoplasty surgery where over time the cartilage in the middle portion of the nasal bridge moves inwards relative to the nasal bones. This gives an upside down V shape to the nose from front on view. Revision rhinoplasty Surgery can improve this problem by placing grafts of cartilage along the nasal bridge called spreader grafts. This type of surgery generally is done by open rhinoplasty technique.
Open roof deformity can occur when the primary surgery did not adequately narrow the nasal bones. Revision Rhinoplasty surgery can improve this by perfoming Osteotomies and narrowing the nasal bones optimally. This generally can be done by closed revision rhinoplasty surgery.