Revision rhinoplasty is a plastic surgery procedure which rebuilds and reshapes deformities of the nose that have resulted from a previous rhinoplasty surgery. It may also be referred to as secondary or tertiary rhinoplasty.
Revision rhinoplasty is a highly customized and individualized surgery. Good candidates include healthy men and women who are unhappy with the current appearance of their nose following a previous rhinoplasty surgery and are seeking an improvement.
Why Choose Dr. Schwartz?
With over 25 years of plastic surgery experience, Dr. Schwartz is an expert in facial plastic surgery. But what sets him apart from other plastic surgeons is his ability to create aesthetically beautiful results while ensuring full proper functionality of the nose. As a double board certified doctor, Dr. Schwartz is not just a talented facial plastic surgeon but also a skilled ENT.
With Dr. Schwartz you can achieve the look you want with the comfort of knowing that the air passages within the nose will not be affected. Often times, Dr. Schwartz performs revision rhinoplasties to amend surgeries performed by other doctors that either aesthetically missed the clients desires or caused breathing issues post-surgery. As an ENT, Dr. Schwartz knows how to achieve the right design without any interference with breathing.
Dr. Schwartz performs revision rhinoplasty in an outpatient surgical center. IV sedation or general anesthesia may be used and the surgery takes about three hours to complete. Incisions are typically made on the inside of the nose.
While the exact nature of the surgery will depend upon the particular individual and the problem, the desired shape may be achieved by repositioning cartilage or replacing missing structures. In some cases, grafts may be required from another area of the body, such as the cartilage of the ear.
Time Off From Work or School
One of the things a revision procedure has in common with a primary rhinoplasty is that you will need to take some time off from work or from school if you’re a student. Many patients find that a week off from work or school is sufficient, though some prefer to take two weeks off. If you are in school, you might find that scheduling your surgery and recovery during summer or winter break makes the most sense and helps you avoid falling behind in class.
When you’re able to go back to work largely depends on the type of work you do. Most office workers can go back after a week. But, people who work in jobs that require a lot of movement might need to wait as long as three weeks before returning.
Bruising and Swelling
In many cases, swelling of the nose and bruising in the area is less noticeable after a revision rhinoplasty than it is after the first surgery. Still, you might want to do want you can to minimize the swelling and bruising as much as possible. Keeping the head elevated at at least a 30 degree angle is a must. You can do that by sitting up in a chair, relaxing in a recliner, or by placing several pillows on your bed and sleeping on your back. Cold compresses can also help bring down swelling and will minimize any discomfort you’re experiencing.
What to Avoid
During the first few weeks and months after your revision surgery, you’ll want to do what you can to avoid bumping or otherwise harming the nose. That means that any type of contact sport or any sports that involve balls that fly through the air are off limits, at least for the first few months after your procedure. Your surgeon might also advise you to avoid swimming or any water related activities for several months after your surgery. The chlorine in most swimming pools can irritate the healing nasal passages.
Just as after your primary rhinoplasty, you might need to make some adjustments to what you wear. If you need glasses to see, it might be a good idea to switch to contact lenses during the first few weeks of recovery. If you don’t like contacts or are bothered by them, you can try to tape your glasses to the forehead, just above the nose. The important thing is not to have them put any weight on the delicate, healing nose.
Sweatshirts and T-shirts that pull on over your head might be comfortable, but they also increase the chance of you bumping your nose when you get dressed. It’s usually recommended that you switch to shirt that you put on arms first and that button or zip up the front instead.
After your surgery, the skin around the nose will be fragile and more prone to sunburn. For that reason, you need to be particularly careful to avoid any sun exposure for about two months after the surgery. You don’t have to stay inside all day, just make sure to use sunscreen and wear a hat with a fairly wide brim when you do go out, to keep the sun off of your face.
Revision Rhinoplasty Before and After Photos
* All patients are unique and individual results may vary.
Recovery after revision rhinoplasty takes about one week. There tends to be less bruising, swelling, and pain than after primary rhinoplasty procedures. The stitches are removed in about five to seven days. Patients can usually return to work in about a week, though more strenuous activities should be avoided for about two weeks.
Revision Rhinoplasty Case Studies
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.
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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 that 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.
Patient 1
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Patient 2
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Patient 3
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Patient 4
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Patient 5
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Patient 6
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Dr. Schwartz’s recommendations for Revision Rhinoplasty patients:
Choosing the right rhinoplasty surgeon is extremely important. If you fall into the wrong hands, you increase your chances of botched results or complications that can compromise your health or your life. Finding a bargain is not the way to go with surgery-just because you may save on your initial surgery doesn’t mean that you’ll be happy with your results, and corrective surgery may be costly. The same goes for seeking treatment outside of the country.
While most revision cases are performed by the doctor who did the initial surgery, “not every surgeon is experienced in revision surgery,” says Dr. Schwartz. “If you have a good relationship with the surgeon who treated you, see him or her first to discuss a revision,” he adds. Should you select a new doctor, make sure they are well versed in revision procedures, especially with the part of the nose that you’re looking to have corrected.
Steps to Ensure Good Results:
- Make sure your expectations are realistic. Revision surgery may not give you a picture-perfect nose but it may make you feel better about how you currently look.
- Ask to see revision images. Before committing to any type of revision procedure, ask your surgeon to see his or hers before-and-after images from revision procedures (not primary procedures). This way you’ll get an idea of what problems they’ve corrected in the past and if you like the work they’ve done. You also want to make sure that the images that you review were performed by the same doctor who will be operating on you.
- Know that you may need additional procedures. One revision surgery may not correct the problem completely and additional procedures may be needed to get the results you desire, especially if there are major complications or disfigurement. This is not a ”failure” of the revision procedure but part of the process in challenging noses.
- Don’t look for a bargain. Revision surgery is expensive and may be as costly, if not more, than your original procedure.
- Follow doctor’s orders. Surgery is only part of the process—how you care for yourself pre- and post-procedure affects the final outcome too. Make sure that your doctor provides you with a list of what you should and shouldn’t do after your surgery. These instructions may be different than what you received the first time around.
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Revision Rhinoplasty FAQ
Revision rhinoplasty, also referred to as secondary and tertiary rhinoplasty, is a plastic surgery procedure which corrects deformities of the nose resulting from a prior rhinoplasty surgery.
During the consultation with Dr. Schwartz you will discuss what you dislike about your nose and what you want to achieve through surgery. Your nose will be examined, a thorough medical history taken, and your options discussed. All details of the revision rhinoplasty procedure will be explained and any questions or concerns that you may have will be addressed. Because revision rhinoplasty is a highly customized and individualized surgery, the consultation is very important.
Dr. Schwartz performs revision rhinoplasty at an outpatient surgery center.
Revision rhinoplasty takes about 3 hours to perform.
Healthy men and women who are looking to improve the appearance and/or function of the nose after a prior rhinoplasty surgery may be good candidates for revision rhinoplasty.
Dr. Schwartz performs revision rhinoplasty with IV sedation or general anesthesia.
Because revision rhinoplasty is a highly customized and individualized procedure, the exact nature of the surgery will vary for each patient. In general, however, incisions may be made on the inside of the nose only or may include a small incision made on the underside of the nose between the nostrils. Once the incisions are made, the desired shape is achieved by repositioning cartilage or replacing missing structures. Grafts may be needed in some cases which may be taken from another area of the body such as the ear cartilage.
The incisions for revision rhinoplasty made be made entirely on the inside of the nose or an additional small incision may be made between the nostrils on the underside of the nose.
When the incisions are made entirely on the inside of the nose there is no visible scarring. When an incision is made on the underside of the nose between the nostrils it results in a small, well-concealed scar.
Pain and discomfort tends to be less than after primary rhinoplasty procedures. Any discomfort that patients do experience can be managed with medication.
Patients can expect a recovery time of about one week after revision rhinoplasty. Some swelling and bruising may occur, though typically less than after primary rhinoplasty procedures. Pain also tends to be less than after primary procedures and can be managed with medication. The stitches are removed after five to seven days. While patients may be able to return to work after one week, more strenuous activities will need to be postponed for about two weeks.
Patients can usually return to work in about one week after revision rhinoplasty.
Exercise and other strenuous activities should be postponed for at least 2 weeks after revision rhinoplasty.
The stitches are removed in about 5 to 7 days after the revision rhinoplasty procedure.
As with all types of surgery, there are potential risks associated with revision rhinoplasty and these may include adverse anesthesia reactions, excessive scarring, prolonged swelling, pulling of the nose to one side, small burst blood vessels, and the need for additional surgery.
Revision rhinoplasty procedures that are performed for cosmetic reasons are generally not covered by insurance. When treating problems or deformities or when used for reconstructive purposes, some coverage may be available. Patients should consult with their own insurance company.
There are financing options available for many plastic surgery and cosmetic surgery procedures.
Why choose Dr. Schwartz?
- Dr. Michael Schwartz is certified by both the American Board of Facial Plastic and Reconstructive Surgery and American Board of Otolaryngology.
- MD from Baylor College of Medicine, where he completed his General Surgery Residency at Beth Israel Medical Center and ENT Residency at Columbia Presbyterian Medical Center.
- He is also a fellow of the American Academy of Facial Plastic and Reconstructive Surgery, the American Academy of Otolaryngology-Head and Neck Surgery, and the American College of Surgeons.
- Dr. Schwartz is an active staff member with Good Samaritan Medical Center, West Palm Beach, Florida.
- He has over 30 years of experience as a surgeon and is extensively trained in the latest advancements in facial plastic surgery.
