Secondary Rhinoplasty surgery is a procedure that corrects the problems associated with a previous rhinoplasty. Some issues are easily resolved, some are more challenging, but secondary Rhinoplasty is generally more challenging than primary Rhinoplasty.
Secondary Rhinoplasty is potentially challenging to the surgeon because the original tissue has already been altered and potentially requires reconstruction or rebuilding of the nasal framework to attain ideal rhinoplasty results. Furthermore the original rhinoplasty surgery will have created scar tissue. Scar tissue makes separation and repositioning of the remaining cartilage and bones technically more difficult. Secondary rhinoplasty performed by a skilled Nasal surgeon, employing meticulous and precise surgical techniques can often create significant and dramatic improvement in nasal appearance and function.
As an expert in Rhinoplasty surgery, Dr. Parag is able to assess each revision rhinoplasty case and determine the anatomical cause contributing to suboptimal cosmetic and functional outcomes resulting from the original rhinoplasty. Understanding such intricacies comes from a career focused on cosmetic, and reconstructive Rhinoplasty surgery. Dr. Parag has developed a keen sense of judgement and technical skill from the 1000s of rhinoplasty surgical procedures he has performed. While every nose is different Dr. Parag has likely treated a case similar to yours in the past. A surgeon who tells you that he has no photos or that it is unethical to show photos likely does not have results that he wishes to share. All of our cases that we show online have provided consent and are generally proud of the results achieved.
What is a 'natural-looking' nose?
From a surgical perspective, a natural-looking nose has gentle transitions between each aesthetic subunit of the nose: the bridge, the tip, the alae, and the columella. The transitions should be soft and free from extreme angles or sharp lines. With some Rhinoplasty procedures, the nose has been made to look unnatural with transitions between the different subunits that look artificial. Therefore the primary aim of Rhinoplasty surgery is to create gentle transitions between subunits and to take into account the patient's goals, facial features and nasal characteristics.
Common Concerns of Patients Considering Revision Rhinoplasty
Anxiety : The prospect of an additional Rhinoplasty surgery can understandably cause some feelings of anxiety and cautiousness. But those same emotions can actually help patients proceed carefully and find a Facial Cosmetic and Reconstructive Plastic Surgeon they feel comfortable with.
Learning more about your current nasal condition and what improvements can be made will help you become more comfortable in making a decision to proceed. As an expert Rhinoplasty Surgeon, Dr. Parag has the experience and skill to assess your situation identify your areas of concern and help your understand which refinements and alterations are possible with revision rhinoplasty surgery.
Breathing Issues : Dr. Parag assesses concerns with nasal function in a number of ways to establish the nature and severity of the problem. With published research in nasal airflow and outcomes in facial plastic surgery, and specialized training focused on Otolaryngology-Head and Neck Surgery and Cosmetic and Reconstructive Facial Plastic Surgery, Dr. Parag finds that nasal function can be improved in most cases. Limitations are dependent on the patient's individual situation.
Secondary Revision Rhinoplasty Surgical Goals
Dr. Parag's surgical goals in secondary revision Rhinoplasty are to create a nose that functions properly, looks natural, and is in harmony with other facial features. Since these patients have issues regarding appearance and function arising from previous nasal surgery, reconstruction and reshaping of the framework of bone and cartilage and redraping of the skin are necessary. There can be limiting factors. The texture and thickness of skin, facial proportions and contours and the amount of scar tissue from previous surgery will play an important role in determining what can be achieved. Dr. Parag, has the requisite experience and skills necessary for the complexities of revision Rhinoplasty and will discuss all of the options available based on each patient's individual situation.
Rhinoplasty and Nasal Reconstruction
Reconstruction of the underlying nasal structure may be required in some instances. This may be achieved utilizing cartilage grafts from a patient's nose, ear, and rib. In certain situations Fascia from the scalp may be used to cover imperfections on the nasal tip or bridge. Dr. Parag prefers using a patient's own natural tissue, but in some augmentation Rhinoplasty procedures, the use of a widely used and reliable implant material such as Gore-Tex or Medpore may be considered. Some patients choose implant material because of limited natural tissue or an unwillingness to remove cartilage from an ear or rib. The potential for rejection or infection is one of the possible issues with such materials. Any such risks will be discussed with you by Dr. Parag if you are a candidate for its use.
Cartilage from the ear is good for the nasal tip, but it often lacks strength and support needed for some reconstructive revision Rhinoplasties. The ribs are the ideal source for cartilage if multiple, sturdy or large grafts are required. Grafting cartilage has its downside: harvesting a rib for a cartilage graft can be discomforting; patient's may be unwilling to accept a chest incision; and the graft may potentially shrink or bend with time.