Rhinoplasty is used as a way to help balance facial symmetry and to keep proportions sculpted. Rhinoplasties are some of the more complex types of cosmetic surgery. And because of this, sometimes, secondary rhinoplasty is necessary. There are several reasons why one may require or recommend having a second surgery. It is important to understand the risks as well as the rewards that go along with such a surgery. Many are not aware of the preparation that goes along with a secondary rhinoplasty as well as the surgery itself. It is sometimes required that a patient gets x-rays or other imaging done for the surgery itself.
Reasons for Secondary Rhinoplasty
One of the most common reasons why a person would get a second rhinoplasty is simply because they are unhappy with how their nose looks after the first. This can be common as it takes a long time for a rhinoplasty to fully show itself truly healed.
Another reason may be because a patient is having difficulties breathing after their initial rhinoplasty. In cases such as these, the patient may be perfectly happy with the look of their new nose, but struggle to breathe. If this is the case, then it is important to see a surgeon. The reasons behind this could be a pre-existing nasal condition or an over-resection of the cartilage. No matter what the reasoning is behind the breathing issues, it is important to have this issue addressed as it can affect a your ability to sleep, exercise, or simply go about day to day life comfortably.
Some patients may find themselves loving their new nose, and have no issues breathing out of it, but then sustain physical trauma to it. After surgery, the nasal tissues and structures are often more delicate and therefore prone to injury, this is especially true in the first couple of years.
Ethnic rhinoplasties are best done by surgeons who have experience in these specific types of surgeries. These types of rhinoplasties are performed with the hope of preserving nasal characteristics that epitomize a specific ethnicity while still reshaping the nose to a in order to achieve a more desirable balance and facial symmetry.
It is crucial to find a plastic surgeon who is experienced in secondary rhinoplasties as this surgery is even more complex than the first.
Revision Rhinoplasty Considerations
It is important for you to know whether or not you are a prime candidate for revision rhinoplasty. About 15% of primary rhinoplasties will require revisions for one of the aforementioned reasons. It is important to be honest with the surgeon in the reasoning behind the need for the second rhinoplasty. Expectations and goals need to be clearly discussed in order to achieve success the second time around.
Many doctors recommend you wait at least a year in order to fully see the final results. This is how long it can take for the nose to “settle”. After a year has gone by and if you are still not happy with the results, then it is time to begin talk of getting another rhinoplasty. One of the main reasons for this is because it takes about this long for the scar tissue to soften. This is especially true if this is more than the patient’s second rhinoplasty.
Some surgeons will use 3D imaging programs in order to show you what your new nose will look like on your face. This can be helpful in managing your expectations. However, it is always important to look at examples of the doctor’s work, especially those that replicate both your goals and/or dilemmas. This will help you to really get a sense as to whether or not this doctor is the right one for the job.
While an initial rhinoplasty can take one to two hours, a second rhinoplasty can take up to four hours. They can be performed under sedation, general or local anesthesia. In some cases, extra cartilage may be needed in order to restore function and structure. In order to do this, the doctor may need to take cartilage from the patient’s ear or from a rib.
The Need for Imaging
In many cases, a doctor will have to take x-rays or other forms of imaging in order to get a good idea of what they have to work with. After the initial rhinoplasty, there is often an issue of cartilage as well as tissue to consider. It is important that these types of imaging are done in order to tell whether or not a patient is a candidate for revision rhinoplasty. It is important for a plastic surgeon to gather all of the necessary information in order to have the authority to tell a patient whether they are truly a good candidate. If a surgeon goes in without all of the necessary information they could end up doing more harm than good. This is why it is important for a patient to prepare themselves to have imaging done on their nose before their second rhinoplasty.
Finding the Surgeon
Getting a revision rhinoplasty is a big decision, and one that should not be taken lightly. It is important to know all that goes along with getting this surgery and what all to expect. Finding the best surgeon for the job as well as preparing yourself for each step will ensure your second rhinoplasty will be your last.
Dr. Daniel G. Becker is a plastic surgeon board certified by the American Board of Plastic Surgery. He is the Founder and Medical Director of the Becker Rhinoplasty Center, as well as Clinical Professor in the Department of Otorhinolaryngology-Head and Neck Surgery at the University of Pennsylvania. Dr. Becker has published over 100 articles in the medical literature with a special emphasis on rhinoplasty. He is the author/editor-in-chief of 4 textbooks on Rhinoplasty. You can learn more about him at www.therhinoplastycenter.com
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