Revision rhinoplasty is a surgery on a patient’s nose or septum that has already undergone one or more operations. A patient may need or desire revision rhinoplasty if the first surgery (or surgeries) did not achieve their desired appearance or if they are experiencing unresolved or new breathing difficulties. All rhinoplasty surgeons will have a certain number of patients who desire a revision despite their best efforts to meet the patient’s expectations. It is key that the surgeon make every effort to communicate with the patient, agree on realistic goals before any operation, and preserve the normal anatomy should a second operation ever be necessary. Through detailed preoperative evaluation and preservation of normal anatomy, Dr. Marotta insures that the need for any revision is relatively uncommon. If that need does arise, a minor secondary operation may be performed to obtain complete satisfaction.
More often you will be seeing Dr. Marotta for revision rhinoplasty if you have had one or more surgeries on the nose or septum by another surgeon. A detailed history and evaluation including looking at old preoperative (before surgery) photographs, reviewing prior operative reports, and imaging analysis will help determine what can be done to help you achieve your desired result. The revision surgery may involve relatively minor changes. Unfortunately, sometimes scar tissue, lack of normal structure, and changes in the skin, make the revision rhinoplasty one of the most difficult operations to perform. Dr. Marotta’s advanced knowledge of nasal anatomy and nasal reconstruction gives him particular expertise in dealing with this difficult challenge.
Reasons for having revision nose surgery
- You are dissatisfied with the result of a prior nasal surgery.
- Your dissatisfaction can be linked to an identifiable, correctable problem.
- Your nasal breathing has not improved, or has worsened, after nasal surgery.
Procedure
Dr. Marotta performs all nasal surgery under deep sedation. Revision rhinoplasty typically takes longer than an initial septal or nasal surgery. It may take only 2 hours in length but the most difficult operations may even take up to 5 hours depending on the preservation of original structure and the amount of scar tissue. Ideally, your existing septal cartilage will be used to reconstruct the nose. If septal cartilage is not present, Dr. Marotta is skilled in the more advanced grafting techniques including the use of ear or rib cartilage.
Recovery
Post-operatively, our instructions call for head of bed elevation and limited activity. A revision rhinoplasty requires the placement of a nasal cast for one week to aid the healing process and to minimize movement of the nose. You may have some nasal packing but it will be removed the very next day. If cartilage grafting is required, you may have a dressing on your ear and, less commonly, the chest. Generally, patients experience very little pain and require only occasional prescription oral pain medicine. Nasal swelling may last a bit longer than with a first rhinoplasty. Other complications, like infection, are relatively rare occurring in less than one percent of patients. We will do all in our power to minimize potential complications and insure a smooth recovery.