What is revision rhinoplasty?
Revision rhinoplasty, also known as secondary or tertiary rhinoplasty, is a corrective aesthetic nasal surgery procedure designed to correct aesthetic or functional problems resulting from a previous rhinoplasty performed by another surgeon.
Is revision rhinoplasty right for me?
If you are healthy and looking to improve the appearance or function of your nose after a previous rhinoplasty surgery, revision rhinoplasty may be right for you. Patients should be over the age of sixteen and have realistic goals for improvement.
Are there any age restrictions for undergoing revision rhinoplasty?
Dr. Naderi will perform revision rhinoplasty on patients over the age of sixteen.
What does a consultation for revision rhinoplasty entail?
During a consultation for revision rhinoplasty, Dr. Naderi will examine the structure of your nose and face, take a thorough medical history, and discuss your goals. All aspects of the revision rhinoplasty procedure will be explained including the technique, the anesthesia, the facility, the recovery, the risks, the costs and so on. Digital imaging or photographic morphing is an integral part of the consultation.
Where is revision rhinoplasty performed?
Dr. Naderi performs revision rhinoplasty at INOVA system hospitals which include Fair Oaks Hospital, Loudoun Hospital, Fairfax Hospital, and Mt. Vernon Hospital.
What type of anesthesia is used for revision rhinoplasty?
General anesthesia is commonly used for revision rhinoplasty.
How is revision rhinoplasty performed?
For revision rhinoplasty, incisions may be made on the inside of the nose (endonasal or closed rhinoplasty) or on both the inside of the nose and on the outside of the nose on the skin separating the nostrils (external or open rhinoplasty). The desired shape is then achieved by repositioning cartilage or replacing missing structures, and the incisions are then closed. A splint is applied to the nose after surgery.
How long does revision rhinoplasty take to perform?
Revision rhinoplasty takes one and a half to three and a half hours to complete.
Where are the incisions made for revision rhinoplasty?
About 70% of revision rhinoplasty cases are external or open in which incisions are made on the inside of the nose along with a small incision made on the outside of the nose on the skin separating the nostrils. The other 30% of cases are endonasal or closed in which all incisions are confined to the inside of the nose.
Does revision rhinoplasty leave scars?
External or open rhinoplasty results in a small scar that is well hidden on the underside of the nose between the nostrils. Endonasal or closed rhinoplasty leaves no visible scarring as all incisions are confined to the inside of the nose.
Does revision rhinoplasty involve much pain?
Revision rhinoplasty tends to involve less pain than primary rhinoplasty procedures. Medication can help to control any discomfort that patients experience.
What is the recovery like after revision rhinoplasty?
Revision rhinoplasty may involve more extensive bruising and swelling than primary procedures, though there is generally very little pain. Most of the bruising will fade within ten days and the swelling within several months.
When will I be able to return to work after undergoing revision rhinoplasty?
Patients can return to work within a week after revision rhinoplasty.
How soon will I be able to exercise after my revision rhinoplasty procedure?
Patients will need to wait at least two to three weeks after revision rhinoplasty before partaking in strenuous activities and exercise.
When will my stitches be removed after my revision rhinoplasty procedure?
External stitches are removed in three days.
What are the risks or complications associated with revision rhinoplasty?
All surgery carries potential risks. Those associated with revision rhinoplasty include nose bleed (1-3%) and the need for minor revision (5%).
Is revision rhinoplasty covered by insurance?
Revision rhinoplasty procedures performed for cosmetic reasons alone are usually not covered by insurance, though some coverage may be available when treating breathing problems. Patients should check with their own insurance company.
Can I finance my revision rhinoplasty procedure?
Financing is available for many plastic surgery procedures.
Revision Rhinoplasty Procedure
Who is a good candidate for Revision Rhinoplasty?
Anyone over 18 year of age who is at least 12 months post a previous Rhinoplasty and would like further realistic improvements. Many patients who come in for consultation for secondary Rhinoplasty are understandably depressed, angry, frustrated with their previous experiences and their prior surgeries and are looking for a skillful Facial Plastic Surgeon who can fix prior mistakes and improve the balance and harmony of their face.
What is the goal of Secondary Rhinoplasty?
To correct aesthetic and functional problems that may have either not been addressed by the previous plastic surgeon or may have been caused by the previous nasal surgery. The ultimate goal is to create an aesthetically appealing nose and a functionally sound nose that will not attract undue attention to itself. The goal of any Rhinoplasty is to redirect attention to the beauty and intrigue of the eyes.
Is secondary Rhinoplasty done through an open or closed approach?
It depends on the issue. Significant changes and improvements can be made skillfully through an endonasal or closed technique. Scar tissue can be removed, excess bone or cartilage can be shaved down, the width of the nose can be narrowed, precise pocket grafts can be created and placed very effectively. However, when major reconstruction is necessary “from the ground up” then the external or open technique is used to allow placement of structural grafts.
Where does Dr. Naderi obtain cartilage for the grafts?
Dr. Naderi will look for cartilage from the septum. Luckily, most Plastic Surgeons who perform Rhinoplasty are not comfortable with surgery of the septum and hence leave this area alone. In these situations, valuable septal cartilage is used for graft creation and placement. In other situations or if more cartilage is needed, Dr. Naderi will turn to one or both ears or even the ribs for a source of tissue.
Before
After
Before
After
Will my ears look different if Dr. Naderi takes cartilage from there?
No. His incision is placed in the crease behind the ear where it is hidden. The location on the ear where he takes cartilage does not change the shape or structure of the ear. Most of the time when patients return for their long term post-op visits, they forget which ear cartilage was taken from.
Does Dr. Naderi use any implants in the nose?
Dr. Naderi is a firm believer of using your own natural tissue for Rhinoplasty and revision Rhinoplasty. He prefers cartilage or fascia from behind the ears to the use of implants. Implants and foreign material in the nose have a high risk of infection, shifting, rejection, extrusion and other problems. Occasionally if absolutely necessary he may use Gortex strips or Alloderm sandwiched in your own tissue which is much safer than other implants. He will discuss these possibilities with you during the pre-op consultation.
Is Revision Rhinoplasty more expensive than a primary Rhinoplasty?
Usually unless very minor changes and improvements are needed. In major cases there is loss of tissue from over aggressive resection of cartilage by the previous plastic surgeons as well as diffuse scarring making the surgery more involved, more time consuming and more challenging. Therefore, these surgeries are often more expensive.
Do you have any words of advice?
You have already been though the stress, the cost, and the recovery of the previous Rhinoplasties plus the disappointments of sub-par results. You should take your time and do plenty of research. Make sure you see several Rhinoplastic Surgeons and insist of digital photo imaging or morphing and then finally make your choice of a Revision Rhinoplasty Surgeon with confidence. If that choice results in you and your loved ones trusting your self and your nose to the skillful and compassionate care of Dr. Naderi, then you can rest assured that you are in good hands and you will be taken care of throughout the process.
Dr. Naderi’s office in Reston, VA is conveniently located near the following:
- Virginia
- Northern Virginia
- Fairfax county
- Loudoun County
- Arlington
- Ballston
- Roslyn
- Alexandria
- Town Center
- Annendale
- McLean
- Vienna
- Tysons
- Tysons corner
- Reston
- Centreville
- Chantilly
- Purcellville
- Middleburg
- Winchester
- Ashburn
- Leesburg
- Dulles
- Landsdown
- Richmond
- Norfolk
- Virginia beach
- Williamsburg
- Woodbridge
- Fredericksburg
- Great falls
- Stafford
- Maryland
- Montgomery County
- Howard County
- Bethesda
- Rockville
- Germantown
- Gaithersburg
- Baltimore, MD
- Columbia
- Greenbelt
- Chevy Chase
- Annapolis
- Towson
- White Marsh
- Arundle Mills
- Laurel
- Frederick
- Washington DC
- Washington D.C.
- D.C.
- Georgetown
- Dupont
- Adams Morgan
- Pentagon City
- North west
- Northwest
- Fairfax
- Falls church
