Revision rhinoplasty is a second (or later) procedure carried out on people who have already had nose surgery. The reason is not always appearance; a breathing complaint that persists, or appears afterwards, is equally a subject for a revision assessment.
Why is it different from the first operation?
In the first operation the surgeon works with anatomy that has not been disturbed. In a revision the situation is different:
- There is scar tissue; the layers do not separate as easily as in the first operation.
- The supporting structure may be reduced; cartilage support may have to be rebuilt.
- A graft may be needed. The inside of the nose, the ear or a rib can be considered as a source of cartilage.
- The planning is more detailed; a new plan cannot be made without understanding what the previous operation did.
When is it assessed?
This is the question asked most often, and the answer is about waiting. Until the tissues have settled and the swelling has fully resolved, what you see is not permanent. For that reason a revision is usually considered at least a year after the first operation.
The exception is a situation involving the airway or requiring early intervention; only the surgeon who examines you can make that decision.
What should you bring to the first consultation?
- The operative note or discharge summary from the previous operation, if you have it
- Your own photographs from before and after the operation
- Any imaging you have
- A short note, in your own words, describing what your complaint is
These documents make it easier to understand which structures were involved in the previous procedure, and they take the guesswork out of the planning.
How should expectations be set?
In a revision the aim is to reach the most balanced and functional result the existing tissue allows. The amount of tissue, the state of the scarring and the supporting structure set that limit. A realistic expectation is the soundest part of the process, and for that your surgeon needs to explain clearly what is possible.
How does the process go?
Assessment, planning, surgery and check-ups follow much the same order as in the first operation. The swelling side of recovery, however, can take longer, and keeping to the check-ups matters even more. A schedule of check-ups that is not missed is the most decisive part of the process.
This article is for general information; diagnosis, treatment and the choice of technique are decided individually only after a medical examination. The timings and processes described here vary from person to person.