“Beauty Through Mastery” Serving Miami, Boca Raton, Florida and surrounding areas
Many patients seek revision rhinoplasty for any number of reasons. In most instances, the initial procedure(s) fell short of the patient’s expectations, or did not meet their intended goals. Revision rhinoplasty becomes more challenging because of the scar tissue that exists within the nose. Scar tissue may cause thickening of the tissue, and distortion of the nose in severe cases.
HOW IS REVISION RHINOPLASTY PERFORMED?
Often times, revision rhinoplasty can be performed without the need for cartilage grafts to achieve the intended goals. However, sometimes in order to overcome scar tissue and provide structural support to restore the natural appearance of the nose, cartilage grafts may be necessary in revision rhinoplasty. The need for cartilage grafts is usually determined during your consultation.
There are typically three places where cartilage can be harvested: the nasal septum, a portion of the ear, and the rib. Each individual patient’s nose will determine the amount of cartilage required for revision rhinoplasty. Sometimes the nasal septum may provide a sufficient amount of cartilage. This avoids the need for another incision on the body, as this cartilage is accessed through standard rhinoplasty incisions. However, sometimes additional cartilage is necessary, and these grafts are taken through inconspicuous incisions hidden behind the ear, or through a 1 to 3 cm incision over a rib, just below the breast. If performed properly by an experienced rhinoplasty expert, taking this cartilage has no harmful consequences, and the incisions are well-hidden, and inconspicuous.
Along with the several advanced rhinoplasty techniques, the cartilage is used to provide structural support to restore a natural, aesthetically-pleasing and durable shape to the nose.
PROBLEMS WITH BREATHING
Sometimes, prior nasal surgery can adversely affect breathing. Normal breathing depends partly on the anatomy of the nasal septum, the adjacent sidewalls, and structures within the nose called turbinates. A deviated septum may contribute to breathing problems, but other nonsurgical factors such as allergies and chronically swollen tissue within the nose may also contribute to suboptimal breathing. Improvement of breathing after surgery in these cases may be limited despite complete correction of any coexisting structural deformities.
A large portion of breathing problems can be corrected by correction of the portion of the septum that is deviated, or blocking the nasal passage. If the turbinates are large and blocking the nasal passages, they are typically reduced in their size to create a larger nasal passage for airflow. If breathing is compromised by collapse of the nasal sidewalls during inspiration, there are several techniques used to support and open the internal nasal valve. Sometimes, these techniques involve the use of cartilage grafts termed “spreader grafts.” Spreader grafts can provide additional support to straighten the nose, but may also slightly widen the nose, therefore, they are used only if necessary.
WHAT IS THE RECOVERY PROCESS FOR REVISION RHINOPLASTY?
Depending on the extent of surgical correction, the initial recovery period is usually between 7-10 days. During this time, patients will likely have a small splint on the nose, as well as soft silicone splints in each nostril. These splints provide support and reduce swelling during the healing phase. The sutures used inside the nose are almost always absorbable and will not need to be removed. The stitches on the outside of the nose are removed between 6-8 days.
Very few patients complain of pain or discomfort after rhinoplasty. The biggest inconvenience is the requirement to rest and take it easy after surgery. Proper rest and reduced activity is essential to minimize swelling and ensure a smooth recovery.
While the initial period of postoperative swelling resolves in about 4-6 weeks, residual swelling exists for 12-18 months. Therefore, the true results of a rhinoplasty cannot be entirely appreciated until 12-18 months.
WHY SELECT DR. PAUL N. AFROOZ FOR REVISION RHINOPLASTY?
Dr. Paul N. Afrooz has had a passion for rhinoplasty since medical school, during which he spent elective time with Dr. Bahman Guyuron, one of the foremost world experts in rhinoplasty and revision rhinoplasty. During that time, Dr. Afrooz cultivated his passion for rhinoplasty through research and the writing of seminal articles and book chapters in rhinoplasty.
Following residency training at the University of Pittsburgh Medical Center, Dr. Afrooz trained with two additional world rhinoplasty experts, Dr. Rod J. Rohrich, and Dr. C. Spencer Cochran. Dr. Rohrich serves as Editor-in-Chief of the Journal of Plastic and Reconstructive Surgery, as well as Chairman of the Dallas Rhinoplasty Symposium. Dr. Cochran is also a world leader in rhinoplasty and the successor of Dr. Jack P. Gunter, well-known as a pioneer in rhinoplasty.
During fellowship, Dr. Afrooz participated in over 150 rhinoplasties; honing and mastering the intricacies of the operation. Rhinoplasty remains his greatest passion in plastic surgery, and he now serves as faculty for the Dallas Rhinoplasty Symposium, and has served as faculty for the International Dallas Rhinoplasty Symposium. He continues to serve as a rhinoplasty educator as the author of numerous book chapters and rhinoplasty articles in peer-reviewed journals.
Understanding the delicate aesthetic balance of the nose, together with a passion for rhinoplasty are essential to achieving consistent, pleasing, and natural results.
If you are considering revision rhinoplasty, please call our office today at 305.854.8828 to schedule your confidential consultation with Dr. Paul N. Afrooz, rhinoplasty specialist.