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Revision Rhinoplasty Surgery

Beverly Hills revision rhinoplasty 1

Beverly Hills plastic surgeon Dr. Pincus provides patients revision rhinoplasty surgery as part of his range of cosmetic surgery procedures. The operation consists of correcting areas of asymmetry and deformity resulting from a prior surgery. Generally speaking, additional surgery is performed no sooner than 6 months after the original operation. This allows time for all the swelling to subside and the nose to settle, so that any deformities/asymmetries that were masked will become manifest. As with the original operation, a revision rhinoplasty can be performed under general anesthesia (totally asleep) or under intravenous sedation (twilight sleep). It is usually a more complex operation because of the scarring and disruption from the original surgery. Additionally, material used to correct the deformities such as nasal septal cartilage may not be available as graft material, and ear cartilage, rib cartilage or synthetic material may be needed. Though most corrections can be accomplished in one revision, occasionally additional procedures may be necessary. The postoperative care is generally the same as with the original procedure, and most patients are healed enough to return to work after one week.

Beverly Hills revision rhinoplasty 2Since each additional surgery is usually more complicated than the previous, it is crucial to ascertain your surgeon’s skill in doing revision rhinoplasties. You should look at as many examples of his work as you can. Remember that not all surgeons who do straightforward, primary rhinoplasties know the techniques or have the experience to do revisions.

Revision Rhinoplasty Cost:

The cost for a revision is generally more than that for the primary or initial surgery. This is directly related to the increase in time and technical expertise required to accomplish the desired goals. As mentioned earlier, graft material may also be needed which requires additional surgery. Because of the increased scarring and anatomical derangement usually seen, the surgical dissection is generally slower and more demanding. Finally, patients place a great deal of hope on the revision surgeon and are much less likely to accept an unfavorable result.

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The Telltale Signs of a Bad Rhinoplasty

Having revised thousands of rhinoplasties, I have noticed certain features common to all.

Even a structurally symmetric, aesthetically pleasing nose can be a poor result if it is out of proportion with the other facial features by being too small or too large. However, the real clues to a poor result are the asymmetries, malpositions, disproportions and decreased function that are seen. We can see collapse of the side walls and/or nostrils producing a “pinched look” or asymmetry between the two sides. The bridge can be too low or too high, and the tip can be overly rotated or not rotated enough. There can be too much “nostril show” from aggressive cartilage resection causing upward migration of the nostril rims. Or too much nostril show from failure to raise the columella (area between the nostrils). Also, irregularities or distortions in the nasal tip can occur which can present technical challenges to the revision surgeon. There can be deflections or angulations of the tip or the entire nose. As mentioned above, nostril asymmetries are particularly common with one nostril appearing higher or wider than its companion. Finally, there can be a worsening of breathing , especially if a reductive rhinoplasty was performed. Making a nose smaller has to be accompanied, many times, by measures to assure that the airflow is not compromised. This means correcting any septal deviations and/or turbinate enlargement, as well as maintaining adequate openings through the nostrils and the areas above called the internal valves. I’ve included photos of a nose showing most of these deformities with the subsequent post-operative results, after I corrected them.








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