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Dr. Schwartz offers a meticulous and thorough approach to patients seeking revision rhinoplasty.
Regardless of the reason for the outcome that makes a patient seek revision rhinoplasty, Dr. Schwartz understands that having already experienced one or more failed procedures, the patient is anxious, scared and somewhat disenchanted with the surgical process.
Dr. Schwartz recommends that patients look for and select a surgeon with the following qualifications for revision rhinoplasty:
- The surgeon should have dedicated interest and experience in both primary and revision rhinoplasty.
- The surgeon should have the experience to be able to correctly identify the underlying anatomic cause for the deformity.
- The surgeon should be familiar with and skilled at using a wide variety of surgical techniques which may be needed to correct the deformity. He should not have one cookbook approach to every problem.
- The surgeon should be willing to devote the necessary time to both the consultation and the operating room to achieve the desired result. Some revisions may be simple to perform, but some may require significant operative time commitment.
- The surgeon should be confident that they can achieve improvement for the patient but never promise perfection.
The following case studies of actual patients of Dr. Schwartz illustrate these principles.
1. On frontal view (preoperative on left) the patient demonstrates narrowing of the middle third of the nose (inverted V deformity), asymmetry, deviation and pinching of the tip and over rotation of the tip and excess nostril show. After revision (right side) the middle third is restored, the tip is more symmetric and midline, the pinching, rotation and nostril show are improved.
Base views shoe the improvement in tip pinching and nostril collapse.
Lateral and oblique views show the decrease in projection, improvement in nostril show and tip-profile harmony.
The patient is seen at 6 months post revision. Over time the skin will continue to shrink and remodel around the new tip framework resulting in a more refined appearance. Extensive revisions like this one will continue to improve over 18-24 months.
2. The patient (preoperative on left) has had two previous surgeries. The nose is short, tip is turned up with asymmetry and excess nostril show. After revision (left) the nose is lengthened, nostril show improved as is symmetry.
Lateral and oblique views show the lengthening, derotation and improvement in nostril show.
3. The patient has had two previous surgeries (preoperative on left). The first was complicated by skin necrosis. She presents with a flat bridge, deformed and scarred tip and middle vault. The problems are further worsened by the patients naturally thick skin which usually requires adding additional structure in order to achieve definition and refinement, not structural removal.
After revision (on right) there is restoration of the bridge, support of the tip and lower nose providing counterbalance to the shrunken, scarred skin.
On lateral and oblique view the restoration of bridge and tip complex are seen.
Correction of tip and nostril pinching is seen on base view.
4. The patient (pre operative on left) presents with scar contracture and asymmetry of his right nostril and columella with resultant tip roundness. After revision the nostril rim has been released and brought down creating better tip appearance.
Oblique view shows restoration of rim contour.
Base view shows improvement in tip distortion and contracture.
5. The patient (preop on left) presents after three previous surgeries. The tip is pinched in, over rotated with excess nostril show and flattening of the nasal bridge. Nine months post op the tip is derotated, the pinching improved and bridge is not washed out.
Lateral and oblique views show the derotation of the tip, lengthening of the nose, improvement in pinching and nostril show.
Base view shows the improvement in pinching and nostril collapse. As with other patients, the tip will continue to remodel and refine itself on the new framework over the next 18 months.
Revision Rhinoplasty Patient Testimonials
C.C. writes:
"Words cannot express the gratitude I feel for the outcome of my rhinoplasty surgery in 2007. Prior to seeing the outcome of your surgery, for over 22 years I did not allow myself to explore my feelings about the 2 previous rhinoplasty surgeries I had been through. I did not fully realize the effect it continued to have on me up until the day of your surgery.And thanks to you with the most beautiful outcome that exceeded my every expectation.
After 22 years I can now look in the mirror and be at peace with what I see. Its like the old me, prior to any rhinoplasty surgery, only much better. It is now the perfect nose."
K.A. writes:
"I want to thank you for my new nose! I absolutely love the results. After the unfortunate experience I had with my first rhinoplasty, I was very skeptical and nervous about a revision. .you listened very carefully and was able to show me a computer rendition of how my new nose would look. .I now love the way I look and I feel so much better about myself and my appearance."
S.F. writes:
"My heart will always be full of gratitude to you...
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Rhinoplasty
