Revision Rhinoplasty or Secondary Rhinoplasty is different and more difficult than performing a primary Rhinoplasty (first time nasal surgery). The surgeon has to be more experienced in the techniques of nasal surgery in order to accomplish a good result on patients who have had previous rhinoplastic surgery.
The surgeon at Premier Image Cosmetic and Laser Surgery, Dr. Louis DeJoseph, have been performing rhinoplastic surgery for a combination of over 45 years. His vast experience in the field of nasal surgery has made them one of the leading Facial Plastic Surgery Centers in the nation to have patients referred to them for revision rhinoplastic surgery
Why is operating on the nose a second or third time that much more difficult?
It is because the tissues of the nose are often scared and the smooth natural surgical planes are not as easily identifiable. Thus a perfect understanding of the anatomy of the nose has to be second nature to the revision rhinoplastic surgeon. Also, nasal breathing problems such as an obstruction often accompany the nasal deformity and that has to be addressed at the same time. So not only does the revision rhinoplastic surgeon have to be able to correct the external deformity that resulted from the previous surgery but also is able to understand the breathing problems that may have either not been corrected at the time of the original surgery or resulted from the problems of the healing from the original surgery.
What are the difficulties of performing revision rhinoplastic surgeries?
Besides having to know the anatomy so extremely well, very often there is a need for grafts to be applied to the nose in order to substitute for tissue that has been removed or injured at the time of the initial nasal surgery. Knowing what types of grafts, whether to use the patient’s own cartilage from other parts of the body such as the ear, the nasal septum, or the rib without creating additional deformities has to be performed quite delicately and with experience. Also, there are times when other materials that do not come from the patient can be substituted for the patient’s own tissues.
In order to correct those types of breathing problems Dr. DeJoseph, not only has training and expertise in Facial Plastic Surgery but also training in Otolaryngology (ENT) as well, where he spent many years treating and diagnosing nasal obstruction problems. Because of his vast experience both in performing complicated revision rhinoplastic surgeries and extensive lecturing and writing on the subject, over half of the patients referred to the practice are referred for a revision rhinoplasty.
Revision Rhinoplasty Surgery Consultation
On the initial consultation with the surgeons, a careful history and complete nasal exam are performed. If available, the previous operative notes are reviewed. Also, every patient is computer imaged prior to making any final recommendations. In very complicated cases the patient is often seen on more that one or two visits in order to make sure the patient fully understands the entire procedure. These extra visits are part of the original consultation but are utilized for the patient as well as the surgeons to reach a beautiful result.