Revision Rhinoplasty
Repair or improve the results of your previous rhinoplasty and achieve the harmonious outcome you’ve always wanted with revision nose surgery from one of the best revision rhinoplasty surgeons, Dr. Raghu Athré.
What is revision rhinoplasty?
Revision rhinoplasty is the term applied to patients who have had a prior procedure on their nose. Other terms that mean the same thing are secondary rhinoplasty and secondary nasal surgery. Some patients may not have had a prior surgical nose job but might still be considered revision rhinoplasty patients. Examples of such patients include:
- patients with a prior septoplasty,
- patients with other surgical procedures of the nose, such as a Moh’s skin cancer surgery
- patients with prior nasal filler injections, and
- patients with significant or multiple nasal traumas.
This type of surgery is exceptionally complex because previous nasal surgery causes a certain amount of scarring. If the previous surgery was performed incorrectly, or the patient’s tissues did not heal well, the scarring can:
- significantly alter the shape of the nose,
- can cause twisting of the nasal tip,
- can cause twisting and loss of support of the nasal septum (deviated nasal septum)
- and can cause breathing difficulty.
In primary rhinoplasty, all anatomic structures are intact and without scarring or distortion. When nasal surgery is done, just elevating the tissues of the underlying cartilage causes mild scarring.
But cartilage is cut, removed, and repositioned in primary nasal surgery. The result of this can be a nose that is twisted, has lost support, lacks septal cartilage, etc.
A revision rhinoplasty is a delicate procedure where first, the tissues are elevated, and all the structures that need to be repaired or rebuilt are categorized. Frequently, additional cartilage is required for revision rhinoplasty. This additional cartilage may be obtained from your ear, one of your ribs, or cadaveric rib cartilage grafts.
Why should I do a revision rhinoplasty?
A revision rhinoplasty is done for two main categories of reasons: Cosmetic and Functional.
Though we draw an artificial line between cosmetic and functional issues, these two categories are intimately related, and it is impossible to completely divide these issues into two separate categories.
The nose is perhaps the most defining facial feature. When the nose is in balance with the entirety of the face, the nose disappears into the background. However, when the nose is not proportionate to the features of the face, it stands out.
A beautiful nose is a nose that is straight, balanced, soft, natural, proportional, aesthetically pleasing, AND FUNCTIONS WELL.
Here’s an example of how closely cosmetic and functional attributes are.
Before and after of a patient with two prior rhinoplasty surgeries is shown. Revision rhinoplasty via open approach was done under general anesthesia.
Her main complaint was the bulbousness of the tip and the increased width of the tip and dorsum (nasal bones). She underwent a tertiary rhinoplasty for correction of these cosmetic concerns. In her surgery, her alar cartilages and her alar sidewalls were reshaped to give her more definition overall. The nasal bones were rasped as a cosmetic portion of her surgery.
The result of this modification of her lower lateral cartilage actually improved the patient’s nasal airway. The slight change in the angle of the nostrils improved the external nasal valve, and the patient looks better and breathes better.
Before & After Photos
What happened in my primary rhinoplasty? Why do I need a revision?
In the best of rhinoplasty surgeon’s hands, some patients will require a revision rhinoplasty. There is no surgeon who can boast that they have never had to do a revision rhinoplasty on one of their own patients. Why? What happened?
When rhinoplasty surgery is done, cartilage and tissues are modified. Once the surgery is over, we depend on the body’s natural healing mechanisms to scar the tissues, heal the tissue, and achieve their final shape.
This scarring process is sometimes unpredictable and can cause significant contracture of the tissues. As this happens, twisting, etc, can happen, which can necessitate a revision. Also, patients can complain of breathing problems and a deviated septum as the nose has lost support after primary surgery. To combat this, cartilage grafting, etc, is performed to combat the forces of scarring and contracture.
Despite this, contracture and scarring can still occur. Dr. Athre’s extensive experience with primary and revision rhinoplasty and his engineering background allows him to perform rhinoplasty surgery, controlling as many variables as possible to give you the most reproducible result and minimize the chance of such complications. Experience is key to the best revision rhinoplasty results.
I need a revision rhinoplasty, but am scared
Being scared is NORMAL!
The revision rhinoplasty patient is one of the most difficult patients.
Why? The revision rhinoplasty patient has already undergone surgery. That first surgery was filled with hope and expectations of an amazing result. When that result did not quite happen, and complications arose, a certain amount of depression, anxiety, disappointment, and fear set in.
The most important part of the revision rhinoplasty process is the consultation. Dr. Athré specializes in revision rhinoplasty and has successfully corrected patients who have had as many as 5 prior rhinoplasty surgeries. In consultation, all of the above apprehensions and fears are discussed with the patient, including expectations and the chances of success.
The consultation is for the patient and Dr. Athre. The patient normally has questions and concerns about the revision rhinoplasty procedure. Dr. Athre needs to understand what happened in the prior procedure, make sure that the patient has realistic expectations, AND develop a detailed plan on what is necessary.
The only way to combat the fear and apprehension is with honesty and information! During the consultation process, Dr. Athré will create a detailed schema of items that need to be corrected, and a blueprint of possible options that may be required in your case will be outlined.
As in anything, the first step of the process is the hardest step. If you are interested in learning more about a revision rhinoplasty, please contact us through our contact form.
Ancillary procedures in revision rhinoplasty
As discussed in many places, cartilage is the key structural component of the nose. It is the “framing” behind the structure of the nose. You cannot build a house without wooden studs, and you cannot build a nose without cartilage.In revision rhinoplasty procedures, cartilage has frequently been resected, is missing, or is deformed and cannot support the nose. In such cases, additional cartilage is required to rebuild the nose. There are 3 general sources of cartilage.
- Auricular cartilage. Auricular cartilage is cartilage from your own ear.
A small amount of cartilage is removed from the ear through an incision made on the back side of the ear. This procedure does NOT change the cosmetics of the ear, the shape of the ear, the size of the ear, or your capacity to hear. You will never know that a small piece of cartilage was removed from the ear. This type of cartilage is really poor for structural support but is excellent for contouring and for camouflage.
- Costal cartilage. Costal cartilage is rib cartilage.
A small incision (approximately 2 inches) is made on the right side of the chest. In women, this incision is made in the inframammary fold of the crease, where your bra strap sits against the bottom part of your right breast. This type of cartilage is awesome for structural support and poor for camouflage.
- Cadaveric rib cartilage. This type of cartilage is rib cartilage, except that it is harvested from a donor cadaver.
Persons who have indicated that they would like to donate their bodies are the source of these biological products. The cadavers of these persons are screened for numerous diseases such as HIV, Hepatitis A/B/C, CMV, HPV, etc. Once the cadaver has passed all the exams, it is appropriate for willed body donation. The rib cartilage from these cadavers is harvested, processed, and sold for implantation in such surgical cases. More Info (PDF)
| Cartilage Source | Positive Attributes | Negative Attributes |
|---|---|---|
| Auricular (Ear) | Easy to harvest Soft Pliable |
Not structural |
| Costal (Rib) | Structural Autologous (It’s your own tissue) |
Increased OR time Increased surgery |
| Cadaveric (Rib) | Structural Does not require increased OR time |
Not Autologous |
Revision Rhinoplasty FAQs
What is the success rate of revision rhinoplasty?
Some studies show that the rate of revision after a rhinoplasty is in the 10-15% range. This means that 10-15% of the patients having a rhinoplasty surgery will go in for a second revision surgery.
First, Dr. Athre’s revision rate after primary rhinoplasty is less than 2%. His revision rate for a revision rhinoplasty is 0% over 15+ years.
How can the revision rate of revision rhinoplasty be so low? When you start the process on a revision rhinoplasty, Dr. Athre first starts with the philosophy of do no harm. So, if the revision surgery does not have a significant probability that the patient is going to be better and the risk/benefit analysis does not favor the patient, he will not offer revision surgery to the patient. Second, during revision surgery, Dr. Athre is aware that the primary surgery did not work out. Hence, revision surgery is “over-engineered” to minimize the risk of complications.
Revision rhinoplasty surgeries are almost always done via the open rhinoplasty technique. This is because the open rhinoplasty technique allows better visualization of all possible issues and structures contributing to the suboptimal result after primary nose surgery.
Is a revision rhinoplasty more or less expensive than a primary rhinoplasty? Why?
A revision rhinoplasty starts at about $10,000 and can go up depending on what all is needed.
A revision rhinoplasty is more expensive than a primary rhinoplasty. A primary rhinoplasty starts at about $5,500 and is approximately $9,000 when facility fees and anesthesia fees are added.
Additional cartilage requirements, like rib cartilage, will make the price go up.
The reason that revision rhinoplasty is more expensive is TIME. Dissection in revision surgery is harder and more tedious, requiring more time. Ancillary procedures take more time. All of this adds up and increases the surgical cost and the anesthesia/facility costs for a revision rhinoplasty. Everything included, revision rhinoplasty starts at approximately $15-16,000+.
How long after a primary rhinoplasty can I do a revision rhinoplasty?
There are no steadfast rules on this. The earliest Dr. Athre will see a patient for a potential revision is six months after their primary rhinoplasty. Usually, Dr. Athre likes to wait 9-12 months after the primary rhinoplasty to let complete healing occur. This also minimizes dissection in a fresh surgical site that has a tendency to bleed more, making the difficult discussion even more difficult.
What risks are associated with revision rhinoplasty?
From an entirely surgical point of view, the exact same risks that existed for primary rhinoplasty exist for revision rhinoplasty. This includes difficulty breathing through the nose, poor cosmetic outcome, septal perforation, and nasal synechiae. There might be additional risks IF ancillary procedures are also done.
Despite this, most patients can still return to work within ten days after revision rhinoplasty surgery.
Will insurance pay for my revision rhinoplasty?
Your insurance company may or may not pay for a revision rhinoplasty. Insurance will not cover any cosmetic surgeries and will not cover any of the cosmetic portions of nasal surgery.
Dr. Athre does not accept insurance for revision rhinoplasty. You are welcome to obtain your own pre-authorization and file your own insurance.
Client Testimonial
“Dr. Athre did an amazing job on my nose. His staff treated me like family and I felt very comfortable getting the work done. He was very intuitive on what I was trying to accomplish and knowledgable enough to work through the issues involved to get the result I wanted, especially considering it was a revision surgery. The whole experience was great and helped me so much!”
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Common Questions
What is rhinoplasty surgery?
What is rhinoplasty revision?
What is the rhinoplasty procedure?
Why should you get a nose surgery or rhinoplasty?
Who is a reconstructive surgeon?
How tough is it to perform rhinoplasty surgery?
Cosmetic surgery is a branch of surgical specialty that focuses on enhancing or altering a person’s appearance through surgical procedures. It encompasses a wide range of interventions, including those involving the ear, nose, and cartilage, aimed at improving aesthetic harmony and balance. While cosmetic surgeries can effectively address concerns such as nasal asymmetry or ear protrusion, they also strive to minimize visible scars and achieve natural-looking results that enhance overall facial aesthetics.
Septoplasty is a surgical procedure designed to correct a deviated septum, which can obstruct nasal airflow and cause breathing difficulties. Unlike cosmetic rhinoplasty surgeries, it focuses solely on improving nasal function rather than altering the external appearance of the nose. Surgeons utilize advanced surgical techniques, such as 3D imaging, to precisely navigate the nasal passages and correct any deviation or scar tissue that may be obstructing proper airflow, allowing patients to breathe more easily.
Nose surgery, also known as rhinoplasty, is a surgical procedure aimed at altering the shape, size, or structure of the nose to improve its appearance or function.
Choosing your plastic surgeon carefully is essential as they play a pivotal role in ensuring optimal outcomes and patient satisfaction. A skilled and experienced surgeon can minimize risks such as swelling and complications associated with plastic surgery, while also guiding patients through the process, including considerations such as insurance coverage and post-operative care.
Nasal reconstruction is a surgical procedure that aims to restore the form and function of the nose, often following trauma, cancer removal, or congenital defects, utilizing advanced techniques to rebuild nasal structures and achieve natural-looking results.
You may consider cosmetic procedures to address specific aesthetic concerns, enhance your natural features, or boost your self-confidence, ultimately allowing you to feel more comfortable and satisfied with your appearance.
Cosmetic nose surgery, also known as rhinoplasty, can help address a variety of concerns related to the appearance and function of the nose. Whether it’s correcting a nasal deformity, improving nasal symmetry, or enhancing overall facial harmony, nose surgery offers transformative results through precise surgical techniques tailored to each patient’s unique needs. Additionally, for individuals who may require revision nose surgery to correct unsatisfactory results from a previous procedure, cosmetic nose surgery provides an opportunity to achieve the desired aesthetic outcome and restore confidence through the artistry of cosmetic surgery.
Non-surgical rhinoplasty is a minimally invasive procedure that utilizes dermal fillers or other injectable substances to alter the shape or contour of the nose without the need for surgical intervention. Unlike the traditional surgical technique, it offers a non-permanent solution with minimal downtime, making it an attractive option for individuals seeking subtle enhancements or corrections to nasal imperfections. This approach eliminates concerns such as scarring or the need for glasses during recovery, making it a popular alternative to more invasive surgical procedures. However, it’s essential to note that non-surgical rhinoplasty may not be suitable for addressing certain issues, such as septal perforation or significant structural deformities, which may require surgical intervention.
- Revision rhinoplasty allows for correction of aesthetic concerns that may not have been fully addressed in previous nasal surgeries.
- Revision rhinoplasty can improve nasal symmetry and balance for a more harmonious facial appearance.
- With revision rhinoplasty, patients can achieve more satisfying and natural-looking results compared to their initial procedure.
- Revision rhinoplasty in TX offers an opportunity to refine and enhance nasal contours for enhanced facial aesthetics.
- Patients undergoing revision rhinoplasty often experience improved self-confidence and satisfaction with their nasal appearance.
- Revision rhinoplasty can address functional issues such as breathing difficulties or nasal obstruction that may persist after initial surgery.
- Through revision rhinoplasty, patients can correct residual or new deformities that have developed since the previous procedure.
- Revision rhinoplasty allows for the removal of scar tissue or irregularities left behind from previous surgeries.
- Revision rhinoplasty procedures are tailored to each patient’s specific needs and goals, ensuring personalized results.
- With advances in surgical techniques, revision rhinoplasty offers improved outcomes and reduced risks compared to earlier procedures.
- Revision rhinoplasty can restore or improve nasal function, allowing for better airflow and breathing.
- Patients who undergo revision rhinoplasty often report greater satisfaction and improved quality of life following the procedure.
- Revision rhinoplasty provides a second chance for patients to achieve their desired nasal appearance and address any lingering concerns.
- Overall, revision rhinoplasty offers patients a valuable opportunity to achieve optimal nasal aesthetics and function, leading to enhanced well-being and confidence.
What is the Houston TX revision rhinoplasty procedure?
The Houston revision rhinoplasty procedure TX is a surgical intervention aimed at correcting or improving the results of a previous rhinoplasty surgery procedure. This specialized procedure done in Houston TX addresses concerns such as asymmetry, breathing difficulties, or aesthetic dissatisfaction that may have arisen from the initial surgery or procedure. In Houston, TX, the revision rhinoplasty procedure is performed by skilled surgeons in Houston with expertise in nasal anatomy and advanced techniques to achieve optimal outcomes. The procedure involves careful manipulation of the nasal structures to refine shape, restore function, and enhance overall facial harmony. Patients undergoing Houston revision rhinoplasty procedure can expect personalized care and attention to detail to achieve their desired nasal appearance.
Who should get the Houston TX revision rhinoplasty procedure done?
Individuals in Houston TX who are dissatisfied with the results of a previous rhinoplasty procedure done in Houston or experiencing functional issues with their nose may benefit from the Houston revision rhinoplasty procedure in Texas. Suitable candidates for this procedure in Houston, Texas, include those seeking correction of aesthetic concerns such as asymmetry, irregularities, or over-resection of nasal tissues. Additionally, patients experiencing breathing difficulties due to nasal obstruction or deformities may find relief through revision rhinoplasty Houston. Consulting with a qualified surgeon in Houston Texas (TX) specializing in Houston revision rhinoplasty is essential to determine candidacy and explore treatment options tailored to individual needs and goals.
Who performs the Houston revision rhinoplasty procedure in Texas (TX)?
In Houston, Texas, the revision rhinoplasty procedure is typically performed by board-certified plastic surgeons or otolaryngologists with specialized training in facial plastic surgery. These highly skilled and experienced TX surgeons have expertise in nasal anatomy, advanced surgical techniques, and aesthetic principles necessary to achieve optimal outcomes in revision rhinoplasty. Patients seeking revision rhinoplasty in Houston TX can trust in the proficiency and professionalism of these surgeons to address their concerns and deliver natural-looking results that enhance overall facial aesthetics and function.
What are the benefits of the Houston (TX) revision rhinoplasty procedure?
The Houston (TX) revision rhinoplasty procedure offers several benefits for individuals seeking to improve the results of a previous nasal surgery. In Houston, Texas, this rhinoplasty procedure can address aesthetic concerns such as asymmetry, irregularities, or over-reduction of nasal tissues to achieve a more balanced and harmonious nasal appearance. Additionally, this procedure can correct functional issues such as breathing difficulties or nasal obstruction, improving overall nasal function and quality of life. Patients undergoing this procedure in Houston can expect personalized care, natural-looking results, and enhanced satisfaction with their nasal aesthetics and function.
- Consultation with a qualified plastic surgeon in Texas (TX) specializing in revision rhinoplasty is the initial step in the process. This consultation allows the patient to discuss their concerns and goals with the surgeon, who will assess the nasal anatomy and determine the feasibility of revision surgery.
- Once the decision for revision rhinoplasty is made, the surgical plan is developed in collaboration between the patient and the plastic surgeon. This plan takes into account the specific issues to be addressed and the desired outcomes.
- Pre-operative evaluations, including medical history assessment and physical examination, are conducted to ensure the patient is a suitable candidate for the plastic surgery. Any potential risks or complications are discussed thoroughly.
- On the day of the plastic surgery, the patient is prepared for the procedure in a surgical facility in Houston, Texas (TX) by the plastic surgeons and their team. Anesthesia is administered to ensure the patient’s comfort during the surgery.
- The plastic surgeon begins the revision rhinoplasty procedure by making incisions, typically inside the nose or sometimes externally, depending on the extent of the correction needed. These incisions allow access to the nasal structures for reshaping and refinement.
- Using specialized techniques, the plastic surgeon carefully manipulates the nasal cartilage, bone, and tissue to address asymmetries, irregularities, or functional issues. This may involve adding or removing tissue, grafting, or restructuring the nasal framework.
- If necessary, additional cartilage grafts may be harvested from the patient’s own body, such as the ear or rib, to support and enhance the nasal structure during revision rhinoplasty.
- Once the desired changes are made, the plastic surgeons meticulously close the incisions with sutures and apply dressings or splints to support the newly sculpted nose during the initial healing phase.
- Post-operative care instructions are provided to the patient, including information on pain management, wound care, and activity restrictions. Follow-up appointments are scheduled to monitor healing progress and address any concerns after the procedure.
- Throughout the recovery period, the patient receives ongoing support and guidance from the plastic surgeons and their team to ensure optimal outcomes and satisfaction with the results of revision rhinoplasty.
- Initial Consultation: The process begins with an initial consultation with a qualified surgeon specializing in secondary rhinoplasty or reconstructive procedures. During this consultation, the patient discusses their concerns and goals with the surgeon, who evaluates the nasal anatomy and discusses potential treatment options.
- Pre-operative Assessment: Pre-operative assessments are conducted to determine the patient’s suitability for the plastic surgery. This may include a thorough medical history review, physical examination, and imaging studies to assess the nasal structure and function.
- Surgical Planning: Once the decision for reconstructive surgery, rhinoplasty Houston plastic surgery or a nose job is made, the plan is developed in collaboration between the patient and the surgeon. This plan takes into account the specific issues to be addressed and the desired aesthetic or functional outcomes.
- Anesthesia and Preparation: On the day of the rhinoplasty surgery, the patient is prepared for it in a surgical facility. Anesthesia is administered to ensure comfort during the surgery, and the surgical site is cleaned and prepped for the plastic surgery.
- Reconstructive Surgery: For the rhinoplasty revision surgery, the plastic surgeon begins by making precise incisions to access the affected area of the nose. This may involve removing scar tissue, reshaping the nasal structure, or repairing deformities caused by injury or previous treatment.
- Nose Job Procedure: In this, the surgeon carefully reshapes the nasal structures to achieve the desired aesthetic outcome. This may involve reducing or augmenting the nasal bridge, refining the nasal tip, or adjusting the nostril size and shape.
- Surgical Techniques: Advanced techniques are utilized to ensure natural-looking results and optimal functional outcomes in plastic surgery.
- Incision Closure and Dressing Application: Once the objectives are achieved, the incisions are meticulously closed, and dressings or splints are applied to support the nose during the initial healing phase after the plastic surgery.
- Post-Operative Care: Post-operative care instructions are provided to the patient, including information on pain management, wound care, and activity restrictions. Follow-up appointments are scheduled to monitor healing progress and address any concerns.
- Ongoing Support: Throughout the recovery period, the patient receives ongoing support and guidance from the rhinoplasty surgeon and their team to ensure optimal outcomes and satisfaction with the results of reconstructive surgery.
Telephone No.281-557-3223