Because it is such an intricate and complicated surgery, rhinoplasty can sometimes result in unwanted outcomes. A carefully chosen facial plastic surgeon is your best chance for perfect results, but all surgeons are human and sometimes humans make mistakes. Whether it’s a miscommunication or just a miscalculation, your poor results might lead you to a secondary or revision rhinoplasty procedure. While it might seem like all nasal surgeries are the same, there are many differences between a primary and secondary rhinoplasty procedure.
Different Reasons for Rhinoplasty
First-time prospective rhinoplasty patients share many of the same goals: changing the size and shape of their noses, balancing the facial features, and even improving breathing. The noses of these patients are likely the same size and shape they were born with, barring accidents that might have altered them.
Alternatively, a prospective patient of revision rhinoplasty may have slightly different reasons, usually connected to their first surgery. They will definitely have had surgery at least once before and the look of their nose may be dramatically different as a result. Common reasons given for a revision rhinoplasty include:
- Poor results from a previous rhinoplasty
- A change of heart about their new look
- A functional problem resulting from a previous rhinoplasty
- An injury sustained following surgery
- Excessive scar tissue around the nasal area after a previous surgery
Finding the right facial plastic surgeon is essential to the success of both a primary and secondary rhinoplasty surgery. This can eliminate many of the reasons that a patient might seek a revision surgery, lessening your odds significantly.
Using the Same Surgical Approach
Anytime the same area is being surgically altered, there are special considerations that must be taken to ensure the patient’s safety and achieve the desired results. Revision rhinoplasty, as the follow-up to a previous nasal surgery, must be performed carefully regardless of how much time has passed between surgeries. The area has already been altered by surgical means, so a delicate and steady hand is required to build on these primary chances.
Despite the differences in the surgeon’s approach, the actual surgical methods used are often the same. For any nasal surgery, your facial plastic surgeon may use an open or closed approach. In closed rhinoplasty, all of the incisions are carefully contained within the nostrils, leaving behind no visible scars or signs of surgery. An open rhinoplasty may involve incisions within the nostrils, but will also include one incision placed on the underside of the nose, just between the nostrils. While it may leave behind a scar, its location makes it nearly undetectable. The open rhinoplasty approach gives your surgeon better access to the finer areas of the nose, including the nasal tip.
Your surgeon’s choice of incision placement will vary based on what is required to achieve your desired results. Some changes can be made with only a closed rhinoplasty approach, but the majority will require the improved access of the open rhinoplasty techniques. For a revision rhinoplasty, most surgeons will opt for the open approach as well. If only minor changes are needed, this can also affect the duration of your procedure and the type of anesthesia used. Talk to your facial plastic surgeon about the specifics of your individual procedure, whether it’s your first surgery or not.
Two Rhinoplasty Procedures, Two Surgeons
Most rhinoplasty patients don’t return to the same facial plastic surgeon for a revision surgery, but the choice really depends on the situation and your personal motivation. For both surgeons, your choice should be a careful one. Rhinoplasty is perhaps the most complicated of aesthetic facial surgeries and so it should only be performed by an experienced, board certified facial plastic surgeon with a proven record of successful surgeries. You should also consider that an expert in rhinoplasty is not necessarily also an expert in revision rhinoplasty. While the surgeries seem the same, there are some subtleties of a secondary surgery that only a well-trained surgeon will be able to successfully manage. Find a surgeon who specializes in rhinoplasty to give yourself the best chances at success, whether it’s the first time or second time around.
Plan a First or Second Rhinoplasty Today
Your best chances for satisfactory rhinoplasty or revision rhinoplasty results is to choose the right facial plastic surgeon to perform it. Dr. Ran Y. Rubinstein has been practicing in the Hudson Valley for more than 14 years and specializes in facial plastic surgery, nasal, and sinus disorders. He uniquely combines his medical and surgical expertise to help patients feel better and look better. He holds dual board-certification from the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology – Head and Neck Surgery and is an Assistant Professor at New York Columbia Presbyterian Hospital.
