Many people who have undergone a rhinoplasty (nose job) by other plastic surgeons may be unhappy with the aesthetic and/or functional results of their procedure, and may seek additional surgery to correct their problem in order to achieve the results they desire. Dr. Bershof is a 5280 Top Doctor Revision Rhinoplasty and many patients are referred to him for this purpose. Unsatisfactory results may occur as a result of a complicated condition, an inexperienced surgeon, or simply due to the patient's healing tendencies. The reported revision rate amongst plastic surgeons, excluding Dr. Bershof is as high as 20% (1 in 5), but this statistic is not true in Dr. Bershof’s practice. He rarely has to re-operate on his rhinoplasties, perhaps less than 1% and these revisions are always minor.
Revision rhinoplasty, also known as secondary rhinoplasty, is a complicated procedure that is most successfully performed by a rhinoplasty specialist to reshape or re-size the nose after an initial procedure.
Dr. Bershof is known for his rhinoplasty skills, an operation considered to be the most difficult of all the cosmetic surgeries. Many plastic surgeons simply do not even perform rhinoplasties. Dr. Bershof often has patients referred to him who have had unsatisfactory results elsewhere, including referrals from other plastic surgeons.
Some of the problems patients complain of after their initial rhinoplasty procedure include:
- Pinched tip
- Pulled up nostrils
- Creases around the nostrils
- Scooped out profile
- Breathing difficulties
- Unnatural appearance/operated look
These problems can range from minor imperfections to severe deformities. Dr. Bershof strives to help patients achieve the highest level of satisfaction from their rhinoplasty and will do his best to produce the results that the patient desires. As difficult as primary rhinoplasties are, secondary or revision rhinoplasties are that much more difficult. It is important to select an experienced rhinoplasty surgeon, such as Dr. Bershof.
Candidates for Revision Rhinoplasty
Anyone who is unhappy with the results of their initial rhinoplasty (nose job) procedure may be a candidate for revision rhinoplasty. Patients should discuss their initial procedure with either their original surgeon or a different surgeon, in order to determine the new goals for revision. It is also important for patients to be both emotionally and financially prepared for additional surgery. What is equally important is for both the patient and the surgeon to set reasonable goals; due to scar tissue from the first rhinoplasty, not all goals might be achievable.
Dr. Bershof will determine whether or not revision surgery is a possibility for you after discussing your goals for surgery, performing an examination and reviewing the previous surgeon's operative dictation.
Revision Rhinoplasty Procedure
The revision rhinoplasty procedure is usually performed on an outpatient basis under general anesthesia to help reduce any potential discomfort. Revision rhinoplasty is usually performed using an open technique, allowing for greater visualization of the underlying nasal structure, because the already-reshaped bone and cartilage may be more difficult to sculpt without direct visualization. An open approach also allows the overlying skin covering to be more freely released from scar tissue so that, as the new underlying anatomy is created, the skin can re-drape in a better fashion.
In cases where reshaping is difficult, a cartilage graft from the nasal septum, ear or rib may be required. Injectable fillers may also be used to correct small defects after the initial procedure, although the use of the patient's own cartilage is preferred. The entire procedure usually takes 3-4 hours to perform.
Recovery from Revision Rhinoplasty
After the revision rhinoplasty procedure, patients will usually experience bruising and swelling for 1-2 weeks, along with some mild pain that can be managed with medication prescribed by Dr. Bershof. Once bruising and swelling has subsided enough, patients can usually return to work and other regular activities. The nose will continue to heal and may change slightly in appearance over the course of a year or more after surgery, when full results will be visible. Revision rhinoplasty results take longer to fully achieve than primary rhinoplasty results.
Initial results of the revision procedure will be noticeable right away, but will continue to improve as swelling subsides and the nose heals. It is important for patients to wait until full results appear before deeming their procedure a success.
Risks and Complications
Revision rhinoplasty carries the same risks associated with the initial rhinoplasty procedure, but also involves additional issues, such as thicker skin, scar tissue and less structural support within the nose. The patient's airway may also have been affected by the initial procedure, which makes revision surgery even that more difficult to perform.
It is important for patients to understand the risks associated with this procedure and to maintain realistic expectations for their revision rhinoplasty. The best results are achieved by choosing a highly skilled and experienced surgeon to perform your revision surgery, and in conjunction with the surgeon, clearly define realistic goals.