Dr. Ran Y. Rubinstein of Laser & Cosmetic Surgery Specialists is an expert in facial plastic surgery and has developed a loyal patient base in his practice area of Hudson Valley, New York. Aside from performing primary facial cosmetic procedures, the doctor also repairs issues resulting from prior plastic surgery. Rhinoplasty is one of the top surgeries performed today, but patients may not always heal as expected to form the intended results. A poor outcome is especially prevalent in inexperienced surgeons, such as those who do not specialize in facial plastic surgery. Inexperienced surgeons tend to have a higher revision rate than those who specialize in facial plastic surgery and rhinoplasty in particular. Other times, the various tissues in the face that are disrupted by rhinoplasty may fail to heal as intended. In these cases, revision rhinoplasty can be performed.
Tissue Removal from the Prior Procedure
Dr. Rubinstein may not know how much tissue was removed during the initial procedure. If too much bone and cartilage were shaved away, secondary rhinoplasty surgery may evolve into reconstructive rhinoplasty. Because these issues may be encountered, the doctor can prepare for secondary rhinoplasty prior to the date of surgery. Dr. Rubinstein may request the previous surgeon’s medical records on the patient, and send the patient for bone and tissue scans of the face to determine the structures he may be presented with.
There are a number of ways to rebuild structures of the nose, if necessary, using the patient’s own tissues. Cartilage can be grafted from the ear, and bone may be harvested from the ribs to provide a more pleasing structure. If necessary, cosmetic injections such as Juvederm or Restylane can be injected into minor indents in the nose to raise the level of the skin. In minor cases, surgery may not be necessary and the dermal fillers can be performed alone, while other patients may wish to combine a second rhinoplasty with this technique.
Formation of Scar Tissue
Whenever tissue is damaged, the natural healing process will promote the formation of scar tissue. Following rhinoplasty, scar tissue may be especially prevalent, even if it is only present under the skin. Irregularities are seen primarily in the tip of the nose in the form of divots and bumps. While Dr. Rubinstein may not be able to offer full correction due to the placement of blood vessels or with the risk of additional tissue damage, he can address the area through additional tissue removal or cortisone shots following the surgery. This portion of the surgery can be difficult to plan prior to the procedure as the doctor may be faced with a unique case of scar tissue.
The Placement of Implants
Unpopular among U.S. facial plastic surgeons, and more common in Asian countries, synthetic nasal implants often create the need for revision rhinoplasty. The material performs multiple functions in Asian rhinoplasty, building up the height of the bridge, extending the length of the nose, and refining the nasal tip. Unfortunately, the implant is prone to shifting in the nose, while wearing away the tender tissues of the area. Once removed, Dr. Rubinstein may need to compensate for the lack of material by using the patient’s own harvested tissues to replace the synthetic implant.
Though there are a number of doctor and patient concerns during revision or secondary rhinoplasty, a rhinoplasty specialist such as Dr. Rubinstein has solutions to each issue he is presented with. The doctor has been a fixture in Hudson Valley, New York as a local facial plastic surgeon for 14 plus years. The doctor is careful to address both the aesthetics and important functions of the nose. The dual board certified surgeon is also an Assistant Professor at New York Columbia Presbyterian Hospital.
During a consultation with Dr. Rubinstein, patients interested in revision rhinoplasty can undergo medical imaging through the state-of-the-art Canfield VECTRA 3D imaging system to view potential postoperative changes. Call 845-863-1772 to schedule your consultation today.