Matthew Bridges M.D.

Facial Plastic Surgeon

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Revision Rhinoplasty - Richmond, VA*

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Overview

Revision rhinoplasty is a rhinoplasty performed on a nose that has been operated on before, sometimes more than once.  Revision rhinoplasty presents unique challenges that make it a highly specialized and complicated surgery.   Only a surgeon with the utmost expertise in nasal surgery, such as Richmond area facial plastic surgeon and revision rhinoplasty expert, Dr. Matthew Bridges, should undertake this type of surgery. The most common issue from prior rhinoplasty is over-resection of cartilage and bone.  This can cause collapse of cartilage due to weakening exacerbated by scar contracture, so one of Dr. Bridges' main goals of revision rhinoplasty is to restore the underlying structure of the nose. 

Surgical Technique

Full Rhinoplasty Revision

Revision rhinoplasty can be challenging as the surgeon works to correct or fix a problem stemming from the first surgery. During this procedure, the majority of surgeons will use an open approach. This entails separating the skin from the support framework of cartilage and bone, which offers the surgeon full access to the structures within the nose. The surgeon will re-sculpt the nose to a more desired shape depending on the problem being addressed. If additional tissue is needed, an autologous approach is typically taken, which uses cartilage and bone from the patient. 

Touch-Up Rhinoplasty

Some patients may be happy with the look and feel of their nose following surgery, but need a slight touch-up. This may include a visible bump or edge on the tip of the nose. The imperfection is usually found and discussed during a post-operative appointment and it is common for the original surgeon to address the issue. This surgery is less complex than the original surgery and may only involve slight shaving of the bone. It usually produces results both the patient and surgeon are content with.

During/After Surgery

Secondary rhinoplasty is performed under general anesthesia in an accredited surgical facility. The duration of this surgery depends on whether the nose is being fully reconstructed or a minor alteration is being made. After surgery, patients will wear a nose splint and will experience bruising and swelling. For patients undergoing revision surgery, the process can be somewhat unnerving. The goal is for the nose to return to a natural, non-surgical appearance. If an experienced surgeon is performing the procedure, the results are often very good.  

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Revision Rhinoplasty FAQs

Better Results?

An experienced nose surgeon who is trained and skilled in revision surgery will understand the dynamics behind what went wrong during the first operation and how to correct the problems with a secondary procedure. While the procedure itself can be quite complex, the results are often pleasing for the patient. It is extremely important to do your research when looking for a revision specialist. 

Cartilage Grafting?

In some cases, cartilage grafting will be needed in order to produce the desired results. This can be done by taking cartilage and bone from another part of the body, such as the ribs, and using it to correct a certain nasal structure. Cartilage and bone grafting are usually only needed in more severe cases, including framework reconstruction.  

How Common?

Revision rhinoplasty is actually somewhat common. It varies by practice and by rhinoplasty surgeon, but some experts put minor revision rates between 5-15%. A large majority of these patients desire only tweaking and minor adjustments. True reconstruction and major revision cases are on the lower end of the spectrum. 

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*Individual results are not guaranteed and may vary from person to person. Images may contain models.