Revision Rhinoplasty
Serving Beverly Hills, Los Angeles,
Newport Beach, & Orange County, California
Revision Rhinoplasty is the most difficult of all nasal cosmetic procedures. The complicated healing process of an original Rhinoplasty often makes it difficult to predict what structures are still intact and to what degree they have been altered. In almost all cases, at least one year of postoperative healing should occur before attempting any revision. It is, however, valuable to see the patient early on in order to allow observation and follow-up of the healing course.
There are many indications for revision Rhinoplasty. These indications may be a cosmetic or functional problem. Some of the problems seen in revision Rhinoplasty include open roof deformity, inverted V deformity, pollybeak deformity, asymmetry of the nasal tip, or collapse of the nostrils.
The open roof deformity is caused by removal of a dorsal nasal hump. If this deformity remains after a primary Rhinoplasty then a secondary Rhinoplasty may be indicated. In this situation osteotomies or fractures of the nasal bones must be performed in order to close the open roof.In some circumstances a dorsal graft of cartilage may be needed to further improve the appearance of the open roof deformity.
The inverted V deformity may result from collapse of the upper lateral cartilages of the nose or from inadequate osteotomies of the nasal bones. The cause of the deformity should be determined and then the proper treatment can be performed. This may include osteotomies, spreader grafts, or onlay grafts.
A pollybeak deformity is the appearance of supratip fullness. This may result from inadequate tip projection, inadequate dorsal hump reduction, or from scar tissue. The cause must be determined by the surgeon and the proper treatment can be performed.The treatment may be cartilage grafting or tip suturing to improve tip projection. Dorsal reduction may also improve the appearance if the problem is caused by prominence of the nasal dorsum. Finally excision of scar tissue maybe needed if the problem is caused by scar tissue in that area.
Asymmetry of the nasal tip may be corrected through a number of different techniques. Exposing the tip surgically will allow for an assessment of the cause of asymmetry. Tip grafting or suturing techniques may be used to correct the problem.
Collapse of the nostrils may result from loss of support from the lower lateral cartilages. In order to re-establish support, cartilage grafts are frequently required.hese cartilage grafts may be harvested from the septum or the ear. The collapse of the nostrils may cause difficulty breathing through the nose.The correction of this deformity should help this airway problem.
Revision Rhinoplasty is a complicated procedure.; The surgeons at Bray Plastic Surgery specialize in this surgery and encourage any unsatisfied patient to seek a consultation. Please contact us today to schedule a complementary consultation.
