Rhinoplasty is one of the top five most commonly performed plastic surgery procedures in the United States, with more than 200,000 patients undergoing nasal surgery every year. While many plastic surgery procedures are specific to a particular age group or demographic, nasal surgery is commonly performed on both male and female patients of all ages, primarily because it can address functional as well as cosmetic concerns. Even adolescent rhinoplasty has been proven to be safe and effective when performed by a skilled and experienced plastic surgeon. However, because the tissue, cartilage, and bone that make up the nose are all constantly growing and changing, rhinoplasty procedures require a great deal of experience and technical skill in order to perform successfully. Even under the best of circumstances, complications can occur that can make revisionary rhinoplasty procedures an unfortunate necessity.
Arguably one of the most complex procedures in cosmetic surgery, revisionary rhinoplasty is designed to address the cosmetic and anatomical complications that may arise as the result of a previous rhinoplasty surgery. Its goal is to correct these functional issues while leaving the patient with a natural appearance where the size and shape of the nose is in a harmonious balance with the patient’s other facial features. A successful rhinoplasty requires that a number of factors be taken into account simultaneously. The nose must be reshaped in such a way as to allow an adequate pathway for air flow while also providing enough support so that the underlying cartilage does not pinch or buckle. A surgeon must predict and account for the regrowth of bone and the shifting of cartilage that can occur as well as the development of scar tissue and healing processes that vary significantly between individuals. Because the nose is such a central and prominent facial feature, even the tiniest imperfection or asymmetry can be plainly noticeable. As a result, a significant percentage of rhinoplasty procedures are unsuccessful in meeting the goals of the patient and the expectations of the original surgeon.
The key to successful revision rhinoplasty is to formulate a surgical plan that addresses both the cosmetic and functional elements of the nose, one that finds a way to correct the external appearance, including asymmetry, twisting, and projection, while at the same time dealing with the more troublesome problems that can range from breathing troubles to a collapse of the nasal bridge. It is generally accepted that before undergoing a revision rhinoplasty, the operation should be postponed for nine months to one year, during which time local swelling decreases, and the scar tissue is given time to soften and heal. Revision rhinoplasty is never a cookie-cutter procedure and must be customized to each individual in order to address the specific issues that may have developed from previous nasal surgery. A thorough and honest discussion of realistic expectations and potential pitfalls is essential during the consultation and preoperative period in order to help ensure the best possible outcome.
In the more than twenty-five years that I have served as a board certified plastic surgeon and otolaryngologist, I have performed more than 5,000 rhinoplasty and revision rhinoplasty procedures, and in my practice revision surgery has been necessary in fewer than 5% of cases. My extensive experience with facial anatomy and development helps to give me keen insight into repairing and restructuring the nasal bones and cartilage in order to achieve optimal rhinoplasty results. If you have additional questions about revision rhinoplasty, or any of the other facial plastic surgery procedures I perform, please contact me, Dr. Fernando Burstein, in order to schedule a consultation. Don’t forget to connect with me on Facebook, Twitter, and Google+ for the latest facial plastic surgery news.