Revision Rhinoplasty in Miami, FL
Daniel Careaga, MD
Paul Durand, MD
Karl William Schwarz, MD
Revision Rhinoplasty In Miami, FL
Being unhappy with any aspect of your nasal structure or function is frustrating. Having that feeling after undergoing an initial rhinoplasty (cosmetic or functional nose surgery) is even worse.
Rhinoplasty is a complex surgery of millimeters. When successful, rhinoplasty procedures can change your appearance significantly. Unfortunately, healing irregularities and improper surgical techniques can result in lackluster results that leave you wanting additional improvement.
Revision rhinoplasty is a secondary or repeated nose surgery that aims to improve upon or correct your initial results. Due to the challenges and complexities of this procedure, it is essential to choose a skilled plastic surgeon, such as Dr. Paul Durand of Careaga Plastic Surgery.
Why Choose Careaga Plastic Surgery?
Whenever you undergo facial plastic surgery, particularly a revision procedure, you need to be assured that the surgeon you choose is up to the task.
Dr. Paul Durand has a particular focus on nose surgeries, including complex cases, and a part of the rhinoplasties he performs are revision procedures that have been done at a different practice.
Combining the professional expertise, safety, and cutting-edge technology offered at Careaga Plastic Surgery with his revision rhinoplasty training and subspecialized fellowship at the world-renowned Cleveland Clinic, Dr. Durand is dedicated to helping patients realize and achieve their cosmetic surgery needs.
Revision Rhinoplasty Can Correct:
Poor Healing
Even if your initial rhinoplasty is performed perfectly in the operating room, poor healing can result in a lackluster rhinoplasty result. It is very difficult to predict how your nose will heal after surgery. Irregularities can come back, such as scar tissue formation (fibrosis) and deviation.
Improper Initial Surgical Techniques
Many revision rhinoplasty patients seen by Dr. Durand have had lackluster results due to improper surgical techniques performed by surgeons who don’t do a high volume of rhinoplasty. These improper techniques can have lasting effects — this is why surgeon selection is so important.
Deviations And Structural Concerns
Structural concerns (deviated septums) are common reasons patients undergo nose surgery initially. Sometimes, this deviation is not corrected or is caused by the initial procedure, worsening previous breathing complications. With revision rhinoplasty, Dr. Durand can help adjust this for better breathing.
What Does A Revision Rhinoplasty Entail?
Consultation
Rhinoplasty and revision rhinoplasty are delicate surgeries of millimeters. These procedures require extensive planning, which is much more complicated with revisions due to the unknowns of the procedure.
While it is impossible to understand the inner structure of the previously operated-on nose until the surgery has begun, Dr. Durand will use your consultation to evaluate, map, and plan your revision surgery.
During this consultation, Dr. Durand will:
- Determine if you are a candidate for the procedure
- Evaluate your nose for structural and functional concerns
- Explain what you can expect from your surgery and recovery
- Take measurements of your face
- Discuss what you are displeased with from your initial nose surgery
- Show you before and after photos of his previous patients
Anesthesia
Revision rhinoplasty is more complex (and often longer) than your initial nose surgery. Due to these factors, revision rhinoplasty is performed under general anesthesia.
Surgical Technique
Open Method
Although both the open and closed rhinoplasty techniques can be used for revision rhinoplasty, most cases require the open method as it gives Dr. Durand more control.
Rib Graft
Many initial rhinoplasty surgeries use cartilage from the septum as a grafting material to shape and restructure the nose. Unfortunately, because this cartilage has already been used, additional cartilage must be taken from another area.
Rib cartilage is considered to be the gold standard for revision rhinoplasty. While this can be taken directly from the patient, using a rib allograft material (cadaveric rib graft) is also possible. This graft is very safe as there is no way for rejection.
What To Expect After Your Rhinoplasty Revision
How Long Is My Revision Rhinoplasty Recovery?
Your recovery from revision rhinoplasty will likely be very reminiscent of your recovery from your initial nose surgery. There is usually more swelling the second time around; however, there should not be significant pain.
Any discomfort can be alleviated with prescribed or over-the-counter pain medication and cold compresses.
How Long Is My Downtime After Revision Rhinoplasty?
Most patients return to work after one week and their day-to-day activities after two weeks. By this time, bruising and swelling should have subsided enough to be undetectable to the naked eye.
Internal swelling will last for up to one year.
Will I Have Scars After Revision Rhinoplasty?
Scarring is never a major concern regarding rhinoplasty and revision rhinoplasty. This is because so many of the incisions are made on the inside of the nostrils.
Even if your revision rhinoplasty is performed using the open method, the incision made along the columella will be small and easily hidden on the underside of the nose. This scar will fade with time to become hardly noticeable.
Revision Rhinoplasty Frequently Asked Questions
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Any revision procedure (whether it is being performed on the face, breast, or body) is more complicated than the initial procedure. This is because surgery creates a level of fibrosis (or scar tissue). It is very challenging for a surgeon to understand the extent of this formation before they start the operation. It is also difficult to predict how much cartilage is left.
On top of this, the healing process is even more unpredictable for revision rhinoplasty than it is for initial rhinoplasty. Fortunately, Dr. Durand is highly experienced and skilled in complex revision cases.
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Unfortunately, not all individuals who desire revision rhinoplasty are candidates. Sometimes, things cannot be improved. It is important to understand this before you undergo the surgery.
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Patients are required to wait at least one year after their previous nose surgery before undergoing a revision.
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After a revision rhinoplasty, some patients use tape; others undergo steroid shots in the nose to help with scar tissue deposits (however, these are not appropriate for all patients).
Unfortunately, rhinoplasty and revision rhinoplasty recovery require a wait-and-see approach.
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The cost of your revision rhinoplasty procedure will vary depending on the specifics of your surgery. This will significantly depend on the extent of correction needed, the techniques used, and the state of your nose before the surgery. You will be provided with an accurate revision rhinoplasty cost estimate during your consultation with Dr. Durand.
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While initial rhinoplasty is commonly performed alongside other facial rejuvenation surgeries, such as facelift surgery or eyelid surgery, revision rhinoplasty is usually performed as a standalone surgery. This is because revision rhinoplasty is often more complicated and takes longer to perform.
If you are looking to combine any techniques with your revision, be sure to inform Dr. Durand, and he will be able to explain your options.
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There is never any guarantee with any form of cosmetic plastic surgery. Revision rhinoplasty is no different. In fact, it is often less predictable. It is important to understand that before you choose to undergo a second or repeated rhinoplasty procedure.