How to Choose the Best Revision Rhinoplasty Surgeon

 

It’s a shocking statistic, but every year in the U.S., upwards of 30,000 people require revision rhinoplasty to fix a botched nose job.

Primary rhinoplasty, or your first rhinoplasty, is a tricky enough procedure. Revision rhinoplasty, on the other hand, poses an entirely different set of challenges to your surgeon.

In this blog, we explain why revision rhinoplasty is such a complicated procedure. Because of this, it is critical to your rhinoplasty success that you choose your revision rhinoplasty surgeon very carefully.

Here, the team at Plastic Surgery Services of Fredericksburg gives you a step-by-step checklist you should follow when deciding on your revision rhinoplasty surgeon.

First, let us re-cap why revision rhinoplasty requires extensive expertise in facial anatomy and superior surgical skill.

Modified Structure, Scarring, and Tissue Strength

When performing a primary rhinoplasty, surgeons know what to expect because they know the structure of a typical human nose. In revision rhinoplasty surgery, this is no longer the case, as the bone structure, nasal cavities, soft tissues and cartilage of the nose have been modified in the initial rhinoplasty procedure. This could present challenges to rhinoplasty surgeons, who must react quickly and correctly when presented with unforeseen complications arising during a revision rhinoplasty procedure.

The modified structure of a previously rhinoplasty-d nose also means the tissue and bones are weaker, making it more difficult for a surgeon to produce safe, effective results when performing a revision rhinoplasty.

Surgeons will also need to harvest cartilage from other parts of the body during revision rhinoplasty, as the preferred donor site of the septum is used in the initial rhinoplasty procedure.

For these reasons, it takes a highly experienced, confident, and specialized plastic surgeon to take on any revision rhinoplasty jobs successfully. To adequately prepare yourself to have a successful revision rhinoplasty procedure, you should follow the following advice. 

Prepare Yourself

Do Your Own Research

By equipping yourself with knowledge about the procedure, you give yourself the best opportunity at finding an excellent surgeon.

It is essential that you understand the complications and difficulties associated with revision rhinoplasty so that you can take choosing your surgeon seriously. Look through our blog, and also look at other credible websites such as The American Society of Plastic Surgeons to fully understand what occurs during your revision rhinoplasty.

Set Realistic Expectations

Identifying the aesthetic you wish for, and aiming for a realistic goal are other important parts of successful revision rhinoplasty. Once you do this, you can approach specialized surgeons and seek their guidance and services in helping you achieve the nose that you want.

Have a List of Questions Ready for Your Consultation

Before you go into any consultation room, you should prepare a list of questions to ask your surgeon. Important questions include;

  • How many years have you been a practicing surgeon?
  • How many revision rhinoplasty procedures have you performed?
  • Do you have a gallery of patient photos I can examine?
  • Do you have any testimonials of past patients?

These four questions are straight forward, and help you directly assess the aptitude of the surgeon you are vetting for your procedure. 

Vet the Surgeon

Ultimately, the choice of who does your revision rhinoplasty rests in your hands. As such, you will want to properly screen every surgeon you consult to do your rhinoplasty.

Ensure they are Board Certified

Many practicing surgeons do not meet the high standards required to achieved certification by the American Board of Plastic Surgery. YOU MUST INSIST THAT YOUR REVISION RHINOPLASTY IS CERTIFIED BY THIS BODY.

While this doesn’t guarantee specialized experience, this certification guarantees a high level of proficiency and practicing standards.

Make Sure Revision Rhinoplasty is one of their Top Three Surgeries

When you demand that revision surgery is a top-three of your surgeons’ procedures, it gives you an excellent chance of finding a revision rhinoplasty specialist.

Closely Examines the Surgeon’s Gallery

Perusing photos of the surgeons’ past results can give you an excellent idea of what to expect. You can find patients of your own ethnicity and similar facial structure and get a good idea of how the surgeon works with a canvas such as the one you present.

Choosing a revision rhinoplasty surgeon should not be rushed. You should at least discuss the procedure and look to find a surgeon who instills you with confidence regarding the procedure.

The expert team at Plastic Surgery Services of Fredericksburg encourages you to contact them and ask these exact questions and look at our rhinoplasty gallery. Call 540 371 7730 or fill out our online form to arrange your consultation.

Why Revision Rhinoplasty is More Difficult than Primary Rhinoplasty

Rhinoplasty accounts for over 210,000 surgeries every year. Though most rhinoplasty surgeries provide satisfactory results, about 15% of these patients end up getting revision rhinoplasty. That means that every year, more than 30,000 people choose a second rhinoplasty because the first one wasn’t done to their liking.

A significant procedure in itself, rhinoplasty involves the modification of nasal cartilage and bones, with tissue being added or taken away. This is tricky the first time – but once the original nasal structure has been modified, it becomes more difficult to safely and accurately provide outstanding aesthetic and functional results.

Here, the expert team at Plastic Surgery Services of Fredericksburg explains the importance of getting rhinoplasty done correctly the first time, and why revision rhinoplasty is more complicated than primary rhinoplasty.

Why Might Patients want revision Rhinoplasty?

Patients who seek revision rhinoplasty often do so on the basis of being unhappy with the results from the first operation. This can be because of aesthetic or functional problems. 

  • Their new nose looks unnatural
  • Their new nose is not in balance and harmony with their other facial features
  • The results of their new nose are not as pronounced as they would have liked
  • It is difficult to inhale and exhale through their new nose
  • Their new nose either didn’t adequately address their snoring or has caused them to snore 

In some cases, accidents such as falls or motor vehicle collisions can damage a rhinoplasty-d nose, which necessitates revision rhinoplasty. 

In any case, regardless of the motivation driving the revision rhinoplasty, it is a more laborious surgery than the initial procedure for several reasons.

Compromised Structural Integrity

Once the cartilage and bones of the nose have been modified in a primary rhinoplasty (the first rhinoplasty procedure), their relative strength and integrity can become weakened. Surgeons usually require extra cartilage from other parts of the body to reinforce the region during revision surgery. 

In primary rhinoplasties, surgeons use cartilage from the septum to reinforce the structure of the nose. Septal cartilage is ideal for this purpose due to its pliability and relative strength. 

In revision rhinoplasty, the septal cartilage is no longer available, requiring the surgeon to harvest cartilage from other parts of the body, such as the ear or ribs. Recently, we have used MTF cartilage grafts (cadaver cartilage) with great success. This eliminates morbidity from having a secondary donor site. While effective in providing structural support, cartilage from the ear and rib is far harder to manipulate than septal cartilage, and it takes more skill and experience for your surgeon to use this cartilage successfully in revision rhinoplasty.   

Scar Tissue

Scarring from the initial rhinoplasty procedure is one of the biggest challenges faced by revision rhinoplasty surgeons. How this impacts the second procedure depends on the extent of scarring, but there is always internal scar tissue from primary rhinoplasty. 

The more scar tissue there is surrounding the nasal passage and bones, the longer and harder the revision rhinoplasty procedure becomes. The revision rhinoplasty surgeon must make very precise incisions to change the aesthetic of the nose, without further contributing to additional scarring. 

Scarring dramatically impacts the way in which the nose heals and settles after the procedure, and patterns can be unpredictable if the surgeon performing the revision rhinoplasty is not experienced or careful enough during the procedure.  

Unforeseen Complications

When performing primary rhinoplasty, surgeons know what to expect – they know the structure of a human nose and can plan their operation accordingly. 

In the case of revision rhinoplasty, surgeons might have a rough idea of what their patients’ internal nasal structure and cavities will look like, but because they are operating on a modified body part, they can’t be 100% sure what to expect. This requires split-second decision making and experience to provide the best possible results from revision rhinoplasty. 

Because of these complications, the vast majority of board-certified surgeons don’t offer revision rhinoplasty. It’s not worth their reputation – the procedure is complicated, and many surgeons can’t get it right. This is why it is so important to choose the right surgeon for your primary rhinoplasty. 

If, however, you are seeking revision rhinoplasty, the expert board of doctors at Plastic Surgery Services of Fredericksburg, composed of Dr. Howard Heppe, MD, Harold Bautista, MD and Pejman Aflaki, MD, have each handled a wide range of rhinoplasty challenges on patients of all ages and ethnicities. Call 540 371 7730 or fill out our online form to arrange your consultation and fix your nose properly.

The Benefits of Rhinoplasty

Rhinoplasty is one of the most transformative elective surgery procedures in the world! It can boost a patient’s self-esteem and allow them to focus on the facial features they love. If you are wondering what this procedure can do for your life, we’ve outlined some of our favorites rhinoplasty benefits below:

  • Provides flattering facial contours.
  • Corrects any bumps or lumps.
  • Refines the tip of the nose.
  • Changes the width of the nostrils.
  • Produces a balanced nasal profile.
  • Corrects any breathing obstructions.

 

 

 

Schedule your consultation to learn more about rhinoplasty and the benefits it can provide you.

Unhappy with Your Rhinoplasty? Revision Rhinoplasty Explained

In an ideal world, every surgery would turn out exactly as expected. Unfortunately, when it comes to rhinoplasty, a number of variables exist that are beyond even the most skilled surgeon’s control. Most notably, the way scar tissue contracts can differ substantially from person to person, and this can make it difficult to predict the results of rhinoplasty with 100 percent accuracy. Fortunately, if you’re not happy with your rhinoplasty (or you develop breathing problems after having a rhinoplasty), you can have what is known as a “revision rhinoplasty.” During this procedure, structural and/or cosmetic issues created by your prior rhinoplasty will be corrected. Here’s what you need to know before you book a consultation:

5 Things to Consider Before Having a Revision Rhinoplasty

1. You will need to let your initial rhinoplasty heal completely before having revision surgery.

Before you decide to have revision rhinoplasty surgery, you should be aware that it takes a long time for the results of rhinoplasty surgery to “settle.” It can take up to one full year for your nose cartilage to completely heal, and before that occurs, your rhinoplasty may not look as good as you hoped it would. Waiting until your nose surgery has healed will help you determine whether or not you actually need revision surgery.

Furthermore, operating on the nose too soon after rhinoplasty can cause damage to the delicate structural tissues within the nose. You must wait until your nose is strong enough to handle a second round of surgery before proceeding with a revision rhinoplasty.

2. You should choose the most experienced and skilled surgeon you can find when having this procedure.

Revision rhinoplasty is much more complicated than initial rhinoplasty surgery. Revision rhinoplasties often need to be performed as “open” surgeries. This means that the surgeon will need to make additional incisions around the nose and lift some of the nasal tissue in order to make the desired alterations. As such, finding a highly skilled surgeon who is deeply familiar with advanced surgical techniques is of paramount importance. Take the time to verify your chosen surgeon’s credentials and make sure he or she has performed successful revision rhinoplasties in the past.

3. You’ll probably need to take more time off work in order to recover from revision rhinoplasty surgery.

Many patients feel better about one week after having revision rhinoplasty surgery. However, the initial stages of recovery from this procedure sometimes last as long as two weeks because of the more invasive nature of this operation. It’s therefore a good idea to err on the side of caution and plan to take at least two weeks off work.

4. There’s a limit to how many revision rhinoplasties you can have.

The tissue of the nose gets progressively more fragile with each subsequent rhinoplasty operation, so you won’t be able to have a succession of revisions until you are 100 percent satisfied with the appearance of your nose. It usually is not possible to have more than two revision rhinoplasties without risking serious damage to the nose.

The best way to make sure that you will be satisfied with the results of your surgery is to choose a skilled surgeon and develop realistic expectations. It’s important to realize that while rhinoplasty surgery can make your nose much more photogenic and proportional, it cannot give you a nose that is completely different to the one you were born with. Plastic surgeons cannot, for example, make a very large hooked nose into a tiny button nose. They must work with the structural tissues that are already in place while making changes to the shape of your nose.

5. You will need to budget for the additional cost of this surgery.

The complex nature of revision rhinoplasty surgery adds substantially to its price tag. As such, you will probably need to research what kind of financing options are offered by your chosen plastic surgery practice before proceeding with this operation. (Note that we can arrange financing through Care Credit in order to help you afford complicated surgeries like revision rhinoplasty.) You may also be eligible for assistance from your insurance company if you are having trouble breathing due to your initial rhinoplasty.

Having revision rhinoplasty surgery can improve the functionality and appearance of your nose, but only if you choose your surgeon carefully. Selecting a surgeon with decades of experience, such as PSSF’s board-certified surgeons, is strongly advised when considering this type of procedure.

Types of Rhinoplasty

Rhinoplasty is one of the most versatile facial surgeries in use today. In addition to being capable of meeting diverse aesthetic objectives, this procedure can correct a number of different functional problems with the nose. Some of the most popular forms of rhinoplasty are discussed below:

Functional Rhinoplasty

Functional rhinoplasty is used to correct structural problems with the nose, though it is usually possible to combine cosmetic alterations with this type of procedure. Functional rhinoplasty is often necessary when a patient has breathing problems as a result of a congenital abnormality, such as a deviated septum or an unusually flat nasal bridge. By altering the nasal passageways, a surgeon can help the patient achieve better air flow through the nose, thereby allowing him or her to breathe more easily. This has a range of secondary benefits for the patient; it can, for example, cure sleep apnea and make it much easier for the patient to exercise. Functional rhinoplasty can also be used to remove nasal polyps (growths that sometimes form within the nasal passages and interfere with breathing).

Cosmetic Rhinoplasty

Cosmetic rhinoplasty is a type of nose surgery that is performed with the specific intention of altering the appearance, rather than the functionality, of the patient’s nose. There are several “sub types” of cosmetic rhinoplasty that serve different aesthetic goals:

  • The reduction rhinoplasty. As the name suggests, reduction rhinoplasties are used to reduce the overall size of the patient’s nose. When a person has a nose where either the bridge or the tip is too prominent (or both of these features are too prominent), he or she can choose to have these features reduced in size via rhinoplasty surgery. Reduction rhinoplasty is also used to correct an overly “bulbous” nasal tip by making it thinner and more refined. These alterations will ensure that the patient’s nose no longer distracts observers from his or her other features. They also help the patient to look better in photographs (as camera lenses tend to accentuate the nose). This is why reduction rhinoplasties are popular with those in the entertainment industry.
  • The augmentation rhinoplasty. While most people think of rhinoplasty surgery as being used exclusively for the purpose of nose size reduction, this operation can actually be used to make the nose larger as well. When a person has a broad face and a narrow nose, for example, rhinoplasty can be used to build up the bridge of the nose so that it’s more proportional with the rest of the face.
  • The ethnic rhinoplasty. The ethnic rhinoplasty is a type of rhinoplasty procedure that is optimized for a particular ethnicity, e.g., African-American, Asian, Hispanic, Caucasian, or Middle Eastern. It’s important to make sure your rhinoplasty surgeon takes your ethnicity into account because people from different ethnic groups have very different nasal structures. People of African-American descent, for example, have thick, strong nasal skin and cartilage, whereas people of European descent have thin, delicate nasal skin and cartilage. These differing tissue compositions pose unique challenges for rhinoplasty surgeons. As such, it’s strongly recommended that you make sure the surgeon you choose has prior experience performing rhinoplasty surgery on people of your ethnicity.

Revision Rhinoplasty

Revision rhinoplasty refers to rhinoplasty surgery that is conducted in order to correct the unfavorable results of a previous nose operation. Revision rhinoplasty may be used to achieve either functional or cosmetic goals. For example, if the patient has had a reduction rhinoplasty and ended up with a nose that is too small for his or her tastes, revision rhinoplasty can be used to make the nose slightly larger. Likewise, if a patient has had a cosmetic rhinoplasty and experienced complications (such as impaired breathing), revision rhinoplasty can restore the functionality of the nose.

Post-Traumatic Rhinoplasty

Post-traumatic rhinoplasty is used to rebuild the noses of patients who have been severely injured. If a patient has had his or her nose badly broken in an automobile accident, for example, he or she can turn to post-traumatic rhinoplasty in order to have both the appearance and functionality of his or her nose repaired. Note that if you have been in a bad accident and need to have your nose repaired, it’s perfectly acceptable to ask your surgeon to make your nose more attractive than it was before, if you wish to. In this way, you can make the best of a bad situation and hopefully emerge from your accident with improved confidence.

If you have any further questions about rhinoplasty surgery or wish to book a consultation, feel free to contact us for more information.

4 Fantastic Facial Procedures

Looking for the perfect Valentine’s Day gift? Plastic Surgery Services of Fredericksburg created this helpful infographic that includes four fantastic facial procedures such as facelift, blepharoplasty, brow lift, and rhinoplasty. For more information on any of the procedures, please contact Plastic Surgery Services of Fredericksburg.

Facelift

A facelift minimizes visible signs of aging in the lower portion of the face by reducing sagging facial skin, tightening the jaw line, and diminishing wrinkles around the mouth. A facelift has a 95% RealSelf.com Worth It Rating.

Blepharoplasty

Blepharoplasty, or eyelid surgery, can fix droopy eyelids with excess sagging skin or bags. It has an impact on the entire face and can make patients look years younger. Blepharoplasty has a 93% RealSelf.com Worth It Rating.

Brow Lift

A brow lift, or forehead lift, is a plastic surgery procedure that can bring your eyes out of hiding if your eyebrows have begun to sag and hang over your eyelids. A brow lift has an 85% RealSelf.com Worth It Rating.

Rhinoplasty

Rhinoplasty reshapes the nose in order to improve its appearance. It can reduce the size of the nose, refine the tip, decrease the width, and correct nose asymmetry. Rhinoplasty has an 89% RealSelf.com Worth It Rating.