PROCEDURE
Revision Rhinoplasty
Rhinoplasty stands out as one of the most complex plastic surgeries, primarily due to the nose’s complex structure. Even with top-tier expertise, outcomes can sometimes fall short of expectations, leading to deformities or breathing difficulties.
Revision rhinoplasty is a procedure that aims to correct any deformities or complications caused by a previous attempt. It’s tailored for those who’ve undergone one or more nose surgeries but need more improvements or to correct complications, be it unresolved cosmetic issues or new ones that arose post-surgery. Scar tissue from the first surgery can pose challenges, potentially limiting optimal outcomes.
Furthermore, it’s not uncommon to use additional cartilage in revision cases, especially if the previous operation removed too much. Structural issues, such as a deviated nasal septum or collapsed cartilage, can impede breathing or appearance. To address these, cartilage grafts, known as “spreader grafts”, might be utilised to rectify narrow regions.
Choosing to undergo revision rhinoplasty in London means pursuing a more satisfactory result. With Mr Yapa’s expertise, you’re making an informed choice towards achieving your desired outcome.
At a glance
Procedure Length:
Typically 2-4 hours, depending on complexity.
Hospital Stay:
Usually an overnight stay, depending on the procedure’s extent.
Anaesthesia:
Typically general anaesthesia.
Downtime:
1-2 weeks off work or daily activities; full recovery may take several months.
Showering:
Wait 48 hours post-surgery; avoid hot steamy showers for 1 week.
Sleeping:
Sleep with head elevated for the first week and avoid sleeping on the side or face-down for 4 weeks.
Make-Up:
Avoid application to the surgical site for at least two weeks.
Driving:
Avoid driving for 7-10 days and off pain medications.
Smoking:
Stop smoking 4 weeks before and after surgery.
Direct Sun Exposure:
Avoid for 4-6 weeks; always use a high SPF when outdoors.
Benefits of Revision Rhinoplasty
Revision rhinoplasty isn’t just chosen to correct a previous surgery. It’s about enhancing your overall well-being and confidence. Here are some of the standout benefits this procedure can bring:
-
Boosted Confidence:
Shaping your nose to better match your desired outcome can immensely elevate your self-esteem. It’s about ensuring you feel good every time you catch a glimpse of yourself.
-
Clearer Breathing:
If you’ve been struggling with breathing issues, a revision can clear those obstructions – particularly if obstructions were caused after your initial rhinoplasty. This means better sleep, improved respiratory health, and an overall enhanced daily experience.
-
Restored Nasal Function:
Beyond how it looks, it’s vital that your nose works as it should. A revision can correct any functional issues, ensuring you can breathe, smell, and live without nasal hindrance.
How Revision Rhinoplasty Works
There are multiple ways a surgeon can approach a revision rhinoplasty. The chosen method depends entirely upon the reasons why you need corrective surgery, your anatomy, and the current state of your overall health. The approaches that Mr Kshem Yapa may take include:
Hump Remodelling: Addressing a previously over or under-corrected nasal hump requires precision. The nasal hump, comprising both bone and cartilage, can be rectified with osseocartilaginous vault surgery. Different tools and techniques, such as the rasp, are chosen depending on the specific issue.
Grafts and Reshaping: For challenges like the camelback hump or open roof deformity, grafts are essential. Autografts, sourced from your own bone and cartilage, are often the most effective. Spreader grafts in particular can address deformities like the inverted V, where the cartilage along the bridge appears sunken.
Micro-Osteotomies: This technique involves the precise remodelling of the fragile bony pyramid in the nose. When initial rhinoplasties neglect this area, asymmetry may arise. Advanced methods, such as piezosurgery (ultrasonic rhinoplasty), can be employed to meticulously reshape the nose’s bony structure.
Radix Nasi Correction: The radix nasi, located between the eyes, plays a subtle yet vital role in achieving facial harmony. Ensuring this region complements the entire face is crucial for a balanced appearance.
Advanced Nasal Tip Sculpting: A defining feature, the nasal tip’s projection and shape can profoundly influence facial aesthetics. Correcting deformities such as the pollybeak or misaligned tips demands an intricate blend of surgical skill and knowledge of nasal anatomy.
Profiloplasty: More than a procedure, profiloplasty is a holistic approach, harmonising surgical technique with artistic vision. This method prioritises the overall enhancement of the face, ensuring every alteration complements your natural beauty.
Revision Rhinoplasty Procedure Steps
Understanding the steps to a revision rhinoplasty can be reassuring. Here’s a breakdown of the steps Mr Kshem Yapa follows throughout:
-
Anaesthesia
Typically, general anaesthesia is administered, ensuring you’re unconscious and pain-free throughout the procedure. Occasionally, local anaesthesia combined with sedation might be preferred, depending on the complexity of the revision.
-
Incision
A decision between open or closed rhinoplasty dictates the incision’s placement. An open approach involves a small external incision at the base of the nose, offering broader access. A closed approach involves incisions inside the nostrils, leaving no visible scarring.
-
Correction Based on Technique
Drawing on the detailed assessment of your unique needs, specific corrections are made. This may involve reshaping cartilage, graft placements, or bony adjustments. The exact methods and techniques are tailored to your requirements and the challenges presented by the previous procedure.
-
Closing
Once corrections are completed, incisions are sutured to ensure minimal scarring. Depending on the extent of the revision, internal or external splints might be placed to support and protect the newly structured nose during the healing process.
Risks and Complications
While revision rhinoplasty inherently presents more challenges than a primary procedure, Mr Yapa’s expertise and approach aim to minimise potential complications. Nevertheless, it’s important for you to be aware of possible risks, including:
Surgical procedures inherently carry a risk of bleeding. Gentle handling post-surgery and avoiding certain medications can help mitigate this.
Some people may develop allergic reactions to anaesthesia, but this can be mitigated once we understand all of your known allergies and sensitivities.
Post-surgery swelling or structural changes can cause temporary breathing difficulties. On rare occasions, complications like a perforated septum or collapsed nose might arise, necessitating further correction.
Though rare, infections can occur post-surgery. These can often be managed using creams or oral medicines.
Ensuring realistic expectations and a well-understood surgical plan can reduce the likelihood of post-operative disappointment.
Revision surgeries might lead to a higher risk of noticeable scarring due to previous incisions and the complexities of the procedure. Proper wound care and post-operative follow-up can aid in minimising this risk.
Recovery
You can typically expect a recovery period of one to two weeks after your revision rhinoplasty. It’s recommended that you set aside 7-10 days away from work or daily activities. It’s common to have a splint placed on your nose which will usually be removed after about a week. Fortunately, however, most patients don’t need nasal packing.
In the initial days following the surgery, you may experience swelling, pressure, and some discomfort. You’ll be prescribed medication to help manage this postoperative pain. You might also find it slightly challenging to breathe through your nose for the first few days, but rest assured, this generally improves within two weeks.
By the second day after the procedure, you should feel up to undertaking light activities like walking around. However, try to steer clear of activities that might cause strain or potential nasal bleeding, such as heavy lifting or bending over, for about three weeks.
It’s also advised to avoid certain over-the-counter pain relievers, particularly those containing ibuprofen, for the first two weeks as they could hinder your recovery process. Most people find themselves ready to return to regular routines or work after just one week. And, like traditional rhinoplasty procedures, full results may not be noticed until one year after your treatment.
You will be provided with a direct phone line to our experienced specialist cosmetic surgery nurse who provides an on call service 24 hrs a day, from the moment you have surgery, for any questions or concerns you may have or any other support you may need. We take pride in making sure our patients are well looked after following surgery and want you to feel well supported throughout your journey with us.
