Secondary rhinoplasty ia term given to Corrective reshaping of a nose which was operated earlier by a different surgeon. It requires exceptional analytical and surgical skill. Only surgeons with extensive training and significant rhinoplasty experience can restore breathing function and improve less-than-desirable results from previous nose surgery. A secondary rhinoplasty is corrective nasal surgery that serves to alter the form and/or function of the nose after a previous rhinoplasty. Secondary aesthetic and reconstructive nasal re-shaping is indicated for cosmetic or functional deformities not properly treated or made worse from the primary operation. Some also refer to secondary rhinoplasty as "revision rinoplasty." This broader terminology can apply to rhinoplasty required beyond a secondary operation, such as a third or fourth operation.
Patients request secondary rhinoplasty to address specific imbalances that persist, are newly created, or that have become more severe. Often the nose is imbalanced or in disharmony with the rest of the facial features due to an un-anticipated healing complication, improper, or incomplete surgical maneuvers. A secondary rhinoplasty is often much more complicated than a primary rhinopasty. The first time in rhinoplasty is always the best time to address all the cosmetic and functional nasal issues, however with appropriate application of advanced techniques by a rhinoplasty specialist, secondary procedures can be successful. The majority of surgeons who specialize in rhinoplasty also have necessary experience with more complex revisional surgeries and will be able to address patient concerns. Of course, as with primary rhinoplasty, your expectations and goals need to be appropriate and thoroughly discussed with your surgeon. It may be helpful to bring in photos of your nasal appearance prior to your previous operation. Your rhinoplasty surgeon may also request previous operative records and medical records, although this is not mandatory.
Common Indications for Secondary Rhinoplasty:
The changes necessary in secondary rhinoplasty can be done through a "closed" or "open" approach. Typically, if there are major structural changes required, and open approach may be preferred. Minor contour corrections can be performed via a "closed" technique. Closed rhinoplasty is when only internal incisions (endonasal) are made for access to the nasal structures. Open rhinoplasty refers to the addition of an incision in the skin bridge between the two nostrils (columella) in order to lift up the nasal skin for more direct visualization of the structures to be altered. The decision to use either the closed or open approach in revision rhinoplasty is based on surgeon preference and each technique has its pros and cons.
Cartilage grafts (portions of cartilage from the septum, ear, or a rib) are often necessary to accomplish the cosmetic and functional goals in secondary rhinoplasty. It is very common for the primary procedure to have depleted much of the nasal cartilage. A lack of septal cartilage is the most common indication for needing ear or rib cartilage sources for graft material. These segments of cartilage are then shaped into structural and shaping pieces for use in the nose. As with primary rhinoplasty, there is very little room for error and it is vital that you seek a rhinoplasty expert who is skilled and has vast experience in secondary techniques. In order to reduce the rates of further revisions and ensure a successful outcome, it is best to seek a plastic surgeon or facial plastic surgeon who specializes in rhinoplasty and revision rhiinoplasty.
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