Revision Rhinoplasty

Revision rhinoplasty, also known as secondary rhinoplasty, involves addressing unsatisfactory aesthetic outcomes or functional issues resulting from previous nasal surgery. Common reasons for revision may include persistent asymmetry, inadequate tip projection, a residual dorsal hump, or functional impairments such as nasal obstruction. Rhinoplasty is one of the most complex surgical undertakings due to the intricate nature of nasal anatomy and the diverse aesthetic goals of patients. Rhinoplasty revision rates span a range of 5% to 15%, highlighting the variability in outcomes and the potential need for secondary procedures. ^[1]

Specializing in revision rhinoplasty, Dr. Kriya Gishen in Beverly Hills and Santa Monica, CA brings a wealth of experience and expertise – and board certification – to address the challenges associated with revision cases. With a deep understanding of nasal anatomy and a keen eye for aesthetics, Dr. Kriya aims to provide patients with natural-looking results that align with their individual goals. Let’s get things right the second time so you can love your reflection when you look in the mirror. Call (310) 584-9990 or complete our online form.

Before and After Photos

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About Revision Rhinoplasty

Revision rhinoplasty is performed on patients who have already undergone previous nose surgery. As a result, the nasal anatomy may be altered, scar tissue may be present, and the underlying structures may be compromised. These factors make the surgical procedure more complex and require the surgeon to navigate and address the changes effectively.

In primary rhinoplasty, surgeons typically have more flexibility in choosing graft materials to reshape and support the nose. However, in revision cases, the availability of grafting materials may be limited due to previous graft usage or altered anatomy. Furthermore, previous nasal surgeries can compromise the structural integrity of the nasal tissues, leading to weaker support and less predictable outcomes, which is why it is imperative you choose a surgeon with such specialized experience as Dr. Kriya.

Aesthetic Issues Addressed by Revision Rhinoplasty

The most prevalent aesthetic and functional concerns expressed by patients undergoing primary rhinoplasty included a dorsal hump, a large nose, a bulbous tip, and nasal obstruction. Individuals seeking revision rhinoplasty commonly reported aesthetic issues such as ^[2]

Addressing Functional Issues with Revision Rhinoplasty

Using rhinomanometry, a technique to measure nasal airflow, reveals that nasal valve obstruction and collapse of the lateral wall of the nose are equally or even more significant contributors to obstruction than septal deviations.

Revision rhinoplasty requires a high level of surgical skill and expertise. The surgeon must accurately assess the patient’s unique nasal anatomy, identify previous surgical changes, and plan a comprehensive surgical strategy. The procedure often involves intricate maneuvers and delicate adjustments to achieve the desired aesthetic and functional outcomes.

What are the Benefits of Revision Rhinoplasty?

Revision rhinoplasty offers several potential benefits for patients who have undergone a previous nose surgery and are seeking further improvement or correction:

Advances in surgical techniques, technology, and the experience Dr. Kriya has gained from previous surgeries contribute to improved outcomes in revision rhinoplasty. She employs innovative approaches and refined methods to achieve better results and overcome the challenges presented by the previous surgery.

Ideal Candidates for Revision Rhinoplasty

Revision rhinoplasty patients often arrive with a unique set of emotional experiences and expectations. ^[3] They may have previously undergone an unsatisfactory rhinoplasty or faced disappointing outcomes, leading to a range of psychological concerns such as

Patients should wait for approximately one year to allow for optimal healing before considering revision rhinoplasty. Candidates should have specific aesthetic or functional concerns that persist after the primary rhinoplasty.

Revision rhinoplasty can be a complex and intricate procedure, often requiring more time and effort compared to primary rhinoplasty. Candidates should be patient, committed, and willing to undergo the necessary recovery process to achieve the desired results.

Personal Consultation

During the consultation process, Dr. Kriya conducts a comprehensive evaluation of the patient’s previous rhinoplasty procedure, carefully assessing both the functional and aesthetic aspects. She may use different imaging techniques to assess the nose and might request access to photos of your nose before your primary surgery.

Effective communication becomes crucial in bridging the gap between the patient’s perception and the surgeon’s evaluation in revision rhinoplasty. Dr. Kriya will use her expertise to explain her observed nasal deformities to the patient, educating them about the anatomical complexities and the potential impact on both aesthetic appearance and functional aspects. This open dialogue enables the patient to gain a more comprehensive understanding of their nasal condition, facilitating mutual agreement on the operative goals and aligning the patient’s expectations with the surgical possibilities.

Preparing for Your Revision Rhinoplasty

Plan for someone to accompany you to the surgical facility and assist you with transportation on the day of the procedure. Depending on the extent of the surgery and the type of anesthesia used, you may require someone to stay with you for the initial recovery period.

​​Before the surgery, make necessary arrangements at home to ensure a comfortable and smooth recovery. Stock up on essential supplies such as prescribed medications, ice packs, gauze, and soft, easily digestible food. Set up a clean and quiet recovery area with extra pillows to keep your head elevated, as this can help reduce swelling.

Plan for an adequate amount of time off work or school to allow for proper recovery. The duration will depend on the extent of the revision rhinoplasty and your individual healing process. Dr. Kriya will provide guidance on the expected recovery timeline and when you can resume normal activities.

The Revision Rhinoplasty Procedure

The surgical techniques employed in revision rhinoplasty are largely similar to those used in primary rhinoplasty. However, due to the nature of revision cases, more extensive reconstruction of previously altered cartilage structures may be required. In rhinoplasty, the principles of structure, shape, and support take precedence over reduction. Dr. Kriya will address the nose in three distinct sections:

Revision septoplasty is often performed alongside revision rhinoplasty (about 71% of cases). ^[4] Cartilage grafts can be utilized to address structural deficiencies or deformities in the nose. This may involve harvesting cartilage from the septum, ear, or rib, and using it to reconstruct or support areas of the nose that require revision. Immediately after the surgery, you will be taken to a recovery area where you will be monitored by medical staff. Your nose will be covered with dressings or splints to provide support and protect the surgical site. Dr. Kriya will inform you about when these will be removed, which is typically within the first week after surgery.

Recovery After Revision Rhinoplasty

You may experience some discomfort, swelling, bruising, and nasal congestion during the initial days following the procedure. Dr. Kriya will provide detailed postoperative instructions that you should follow closely. These instructions may include 

Swelling and bruising are common after revision rhinoplasty and can take several weeks to subside. Nasal congestion and difficulty breathing through the nose are expected during the early stages of recovery. It’s important to avoid blowing your nose forcefully and follow any breathing exercises recommended by Dr. Kriya.

While the initial recovery period typically lasts a few weeks, complete healing and the final appearance of your nose may take several months or longer. It’s important to be patient and allow your body ample time to heal. Follow Dr. Kriya’s instructions, maintain a healthy lifestyle, and attend all follow-up appointments to support the healing process.

Your Revision Rhinoplasty Results

As the nerves subside and you begin to see the results of your revision rhinoplasty emerge, you will feel elated. The pain and frustration you felt at the end of your healing journey with your primary revision will become a distant memory. The improvements made during your revision rhinoplasty will be evident in the mirror, and you will be amazed at the transformation that has taken place.

The first time you see your results, you may experience a range of emotions, including joy, relief, and a sense of accomplishment. The issues that bothered you before, such as asymmetry, a misshapen nose, or functional difficulties, will have been addressed, leaving you with a nose that better aligns with your desires and enhances your overall facial harmony.

The enhanced aesthetics of your nose can have a positive impact on your self-image and how you interact with others. You may find yourself smiling more, standing taller, and feeling more comfortable in social situations. Functional issues will no longer plague you and your life will once again be easier and more carefree!

What is the Cost of Revision Rhinoplasty in Beverly Hill, CA?

Dr. Kriya takes into consideration many factors when planning each patient’s treatment plan. She will discuss the expected cost, taking into these considerations, during the consultation process. Call (310) 584-9990 for an appointment in Beverly Hills or Santa Monica.

References

1. Neaman KC, Boettcher AK, Do VH, et al. Cosmetic Rhinoplasty: Revision Rates Revisited. Aesthetic Surgery Journal. 2013;33(1):31-37. https://doi.org/10.1177/1090820×12469221
2. Chauhan N, Alexander AJ, Sepehr A, Adamson PA. Patient Complaints With Primary Versus Revision Rhinoplasty: Analysis and Practice Implications. Aesthetic Surgery Journal. 2011;31(7):775-780. https://doi.org/10.1177/1090820×11417427
3. Adamson PA, Warner J, Becker D, Romo TJ, Toriumi DM. Revision rhinoplasty: panel discussion, controversies, and techniques. Facial Plastic Surgery Clinics of North America. 2014;22(1):57-96. https://doi.org/10.1016/j.fsc.2013.09.002
4. Manafi A, Hamedi ZS, Manafi F. Introduction of a Less Invasive Revision Rhinoplasty Using Closed Nasal Chondrotome. WORLD JOURNAL OF PLASTIC SURGERY. 2019;8(1):108-111. https://doi.org/10.29252/wjps.8.1.108