How to Prevent the Need for Revision Rhinoplasty

What if I am not happy with my nose job?

Having surgery performed on your nose is a big decision and one you expect to live with for the rest of your life. Or, at least, you thought so. What if you do not get the results that you expected? Is it too late to make some adjustments or are you basically stuck with the outcome?The encouraging news is that, no, you do not have to simply accept the results. Revision rhinoplasty is a fairly common procedure, which is basically a second, or, even third or more, surgery to either correct something not adequately addressed the first time or make additional changes. Although statistics vary, it is estimated that roughly 15 percent of initial nose jobs require revisions, either for functional or aesthetic reasons.If the purpose of the original procedure was functional, chances are it was to correct problems that affect breathing, such as:

• Deviated septum
• Enlarged turbinates (tissue on the inside of the nose that cleans and humidifies the air)
• Sleep apnea and snoring
• Nasal deformity and collapse
• Sinus issues
• Birth defects

Today, the reason most people undergo rhinoplasty, or nose jobs, is for cosmetic reasons. There is something unappealing, out of balance or misshapen that they want changed. Common aesthetic reasons for seeking what is basically nose reshaping, include:

• Dorsal hump (large hump on nasal bridge)
• Crookedness
• Flaring or irregular nostrils
• Large nose
• Drooping tip
• Nasal deformity

Revision rhinoplasty is much more complicated than the initial surgery, takes longer and comes with a higher price tag. Scar tissue and weakened nasal structures pose challenges and grafts of cartilage from other parts of the body are often required due to much of the original nasal cartilage being depleted in the first surgery. This is one of the most complicated types of cosmetic surgery and requires a highly skilled and experienced surgeon.

Getting It Right the First Time

Few things in life are guaranteed. Surgical results do not and, most likely, will not ever fall into that category. The most common reasons cited for revision surgeries are breathing issues resulting from weakened nasal structures, asymmetries and depressions that appear as the swelling subsides, insufficient support for the nasal tip causing it to droop, unresolved issues and poor healing. Most of these may well have been out of the control of the surgeon and poor healing, especially, often results from the patient not properly attending to post-op instructions.The reason for the majority of repeat surgeries, however, has nothing to do with the “success” of the procedure, and responsibility must be shared by patient and doctor. Poor or inadequate communication will almost always lead to unrealistic goals and expectations. This is one of those “rules” in life that creates problems in relationships on every level; personal, professional, political and even global. But nowhere is it more critical than between surgeon and patient.Without a specific reason to the contrary, the goal of any surgery, cosmetic or otherwise, should be to do it one time and achieve the outcome that the patient is expecting to see when the swelling is gone. Clear communication from the client expressing all that is hoped for and from the surgeon explaining what is possible and what can be expected would go far in eliminating the need for revision surgery.If you would like to discuss options relating to revision or corrective cosmetic surgery, please do not hesitate to contact Geoffrey Tobias, M.D., a revision rhinoplasty specialist. To request a consultation, simply call 347-830-7065 or click here.