Revision Rhinoplasty

Revision  Rhinoplasty İn Turkey

Revision rhinoplasty – correction rhinoplasty, nasal surgery patients who had one or more, and the recovery period is needed to solve the problems that emerged after the operation is given.

Revision rhinoplasty may be required due to minor problems, or it may also be applied to correct unsuccessful surgeries.

With unsuccessful rhinoplasty surgery, the tip of the patient’s nose may be squeezed-narrowed, wide, asymmetrical, low, drooping, or excessively shortened and upturned in appearance. Or people may have a collapse in the side walls of the nose and breathing difficulties.

As a result of insufficient removal of the cartilaginous arch in the nose, there may be a collapse on the back of the nose again due to the appearance of a parrot nose or excessive removal. The appearance of an inverted V in the middle part of the nose, the continuation of the curved nose structure, irregularities in the back of the nose, skin and soft tissue problems are other problems seen after unsuccessful operations.

First – aesthetic and functional complications in primary rhinoplasty may constitute the justification for revision rhinoplasty. Revision surgery may be required at a rate of 5-15% after the first surgery. Some of these operations require minor, and some require major revision.

In minor revision, as a result of the first surgery, the patient may be happy with the existing nose and general appearance but may request minor corrections. If there is a significant deformity as a result of previous rhinoplasty surgery, a major revision is required.

Revision rhinoplasty has some differences from primary rhinoplasty. Tissue plans are often narrowed, cartilage and bone tissues are removed excessively or asymmetrically, and cartilage may be weakened and twisted during healing. This condition requires more careful work during surgery.

Skin and soft tissue revision are very important in rhinoplasty. In patients with thin skin, all protruding structures should be filed, the grafts should be properly thinned, and if necessary, wrapped with fascia should be used. On the other hand, in thick skin, strong cartilage is needed to keep the tip of the nose stable and to bear the weight of the skin. In thick-skinned people, swelling resolves later.

The duration of surgery in revision rhinoplasty varies according to the shape of the nose and the approach. Minor retouching can be done in 30 minutes, while major revisions can take an average of 3-4 hours.

Revision rhinoplasty often requires a graft. The nasal septum cartilage is often used or insufficient because it has been operated on before. In this case, it may be necessary to take cartilage from the ear or ribs according to need. In this case, the duration of the operation is even longer. However, it should be remembered that the important thing is not the duration of the operation but the result.

The success of revision rhinoplasty depends on well-developed reasoning, talent, knowledge, and, above all, experience. In this process, the surgeon must have a very good knowledge of anatomy and know the surgical approaches well.

In addition, the doctor needs to know what to do in the face of undesirable developments and consequences. Patients should also be followed for a long time after surgery.

As an ENT specialist, my philosophy in rhinoplasty is to be the first and last doctor to perform the patient’s nose surgery, to make the patient happy in revision rhinoplasty, and to be the last doctor to perform the nose surgery.

What Are the Reasons Why Rhinoplasty – Rhinoplasty Surgery Fails?

• The doctor’s experience may be insufficient.
• The surgeon’s goal may be overly ambitious.
• The patient’s expectations may not be realistic.
• Functional problems may appear due to poor healing.
• There may have been nose trauma after the operation.
  

What Are the Ways to Prevent Failure in Rhinoplasty Operations?

Good planning should be done together with a detailed examination before the operation, and careful and patient work should be done during the operation.

In places where the surgeon does not get into it during the operation and realizes that it is not exactly what he wants, he must necessarily, and if necessary, go back to the beginning and make the necessary correction.

For rhinoplasty surgery, it requires at least 5-7 years of experience. It is stated experienced surgeons that rhinoplasty surgery is one of the most difficult plastic surgeries.

Just being a skilled doctor is not enough for rhinoplasty surgery. At the same time, it is necessary to be a surgeon with a strong artistic direction, patient, meticulous worker, gentle and respectful of tissues.

It is necessary to think about and repair the many structures that make up the nose and their relationship with each other in 3 dimensions. In addition, it is necessary to predict which forces will affect the nose to what extent during the postoperative recovery process and how the nose will remain stable in the long term.

It should be remembered that healthy breathing is the main function of the nose, and one should not focus only on the external appearance. It is necessary to try to correct the nose as a whole without compromising either the breathing function or the aesthetic image.

All of these things require experience. Revision rhinoplasty, on the other hand, requires more expertise and experience than normal rhinoplasty.

How is Revision Rhinoplasty Surgery Performed?

In revision rhinoplasty, as in primary rhinoplasty, an open or closed approach can be used. Revision in rhinoplasty, the open or closed approach is not the surgical technique but the way used to reach the cartilage and bone structures of the nose.

In the open approach, the cartilage and bone structures of the nose are reached by lifting the skin after a small incision is made to the structure separating the nostrils from each other. At the last stage of the operation, the incision in the skin is sutured and closed.

This incision scar after healing is normally not noticeable, but it can be noticed if looked at very closely and carefully. In the closed approach, all incisions are made through the nose.

For curved noses, noses that require major revision, and noses with pronounced asymmetry at the tip of the nose, an open approach is usually preferred.

The advantage of the open approach is that all cartilage and bone structures of the nose are mastered, allowing all kinds of sutures to be applied.

Why is Revision Rhinoplasty Difficult?

The best result in rhinoplasty is achieved in the nose that has undergone surgery for the first time. For this reason, it is very important that the person who will be operated on for the first time researches and selects his doctor well and aims to be the first and last operation of this operation.

Revision rhinoplasty is relatively the most difficult of rhinoplasty aesthetic surgeries. Depending on the interventions performed in the previous surgery, sometimes there may not be enough cartilage left in the nose. For this reason, ear or rib cartilage may be needed in revision rhinoplasty.

Although the operation is more complicated for the doctor, there is no increased risk or danger compared to the first nose surgery. After revision surgery, as with the first rhinoplasty surgery, you may experience complaints such as swelling and bruising around the nose and eyes.

At What Rate is Revision Rhinoplasty a Condition That Can Occur?

Current literature says that the need for revision after rhinoplasty may be required with a probability of 5-15%. Our revision rate after rhinoplasty in our clinic is about 5%, and most of these revisions are minor complementary procedures.

When Can the Revision Be Done at the Earliest?

Revision rhinoplasty should be expected for at least six months to 1 year for the results of the first surgery to fit exactly and for the correct determination of where to intervene in the revision.

Do You Perform Revision on Patients Who Have Undergone Surgery in Other Clinics?

We apply revision rhinoplasty to patients who do not want to continue their journey with their physicians after failure. In these patients, extensive operations are often needed, during which we use additional cartilage.

What Should Be Considered After Revision Rhinoplasty?

Revision after nose surgery, the patient should avoid forceful movements of the nose. During the healing process, they should avoid any activity that will shake or bump the nose. He or she should not engage in intense activities for 2-3 weeks and should not wear glasses for two months.