Revision Rhinoplasty – Secondary Rhinoplasty
On this page, we will talk about revision rhinoplasty surgery: What is revision surgery? What kind of pathologies can be corrected with revision rhinoplasty? When is costal cartilage needed?
When is ear cartilage removed? Does removing cartilage from another part of the body cause any deficiency?
You are welcome to our practice in Adana Ziyapaşa for a revision rhinoplasty interview.
Revision rhinoplasty or secondary rhinoplasty is the procedure for performing rhinoplasty for someone who has had rhinoplasty before.
With revision surgery, the bad results of the previous surgery can be corrected. For patients, these surgeries are not much different from the first surgery. However, such surgeries are more laborious and difficult for surgeons.
Revision rhinoplasty may be required if the desired or expected results could not be obtained in the previous rhinoplasty surgery.
Insufficient hump removal in the previous surgery
Excessively resected bony or cartilaginous dorsum in the previous surgery
Asymmetries that could not be corrected in the previous surgery
Uncorrected dorsal deviation in the previous surgery
Dorsal axis deviation that occur after the previous surgery
Noses that were reduced too much in the previous surgery
Noses that were insufficiently reduced in the previous surgery
Supratip fullness (polly beak deformity) due to the previous surgery
Over-rotated tip due to the previous surgery
Nasal tip pitosis
Pinched nose deformity
Depressions and bony irregularities on the nasal dorsum after the previous surgery
Open roof deformity (Leaving the nasal dorsum open after removing the hump in the previous surgery)
Some revision surgeries are performed because of nasal congestion. In this patient group, there may or may not be a problem in the outer part of the nose.
If you still have nasal congestion 2-3 months after the surgery, it would be helpful to get your doctor’s opinion to determine the problem that caused your nasal congestion.
If the surgeon did not make adequate interventions to relieve nasal congestion in the first operation, or if necessary interventions were made but not sufficient, the patient’s nasal congestion will continue.
The most common cause: Uncorrected or insufficiently corrected septum deviation in the first surgery. In this case, the patient will need to be operated again to correct the nasal congestion.
In some patients, the problem is swollen nasal concha (concha hypertrophy). Another cause is undiagnosed allergic rhinitis.
We perform revision rhinoplasty operations under general anesthesia. We prefer the open technique in these surgeries. The average operation time is 4-5 hours.
It can be done 6 months after the first surgery.
It is more difficult than the first operation. Because the procedures that can be done easily in the first surgery are more difficult in the revision surgery.
Extra cartilage tissues are needed in the revision surgeries. In the vast majority of the secondary cases, there is not enough cartilage in the nose for repair. Because a significant amount of the cartilage in the nose was used or removed in the previous surgery. In this case, it is necessary to provide the cartilage required for the revision surgery from the other tissues. We do not prefer the foreign tissues such as Silikon, Goretex, Medpor to eliminate the cartilage deficiencies in the revision surgeries; we prefer to use the patient’s own cartilage tissues. We take the required cartilage from the patient’s auricle or rib.
Costal cartilage is usually needed in the secondary or revision rhinoplasty. In other words, it is used in patients who have had a previous unsuccessful rhinoplasty surgery. Costal cartilage is the first choice, especially in patients who have had a large amount of cartilage or bone removed in their first surgery and who have developed a severe collapse of the nose called “saddle nose” deformity.
An alternative to the costal cartilage is ear cartilage. However, the amount of cartilage in the ear is less than the costal cartilage and does not have a strong enough cartilage structure. An alternative to the costal cartilage is the ear cartilage. However, the amount of cartilage in the ear is less than the costal cartilage, and the ear cartilage does not have a strong cartilage structure as the costal cartilage. For this reason, costal cartilage is preferred in cases where a large amount and strong cartilage structure is needed. For this reason, costal cartilage is preferred in cases where a large amount of cartilage and a strong cartilage structure are needed
The cartilage part of the 6th or 7th ribs is removed from the right side. Removal of the costa does not cause a functional deficiency in the body.
Of course, there are some risks to getting a costa. Just beneath the costa is the pleura and the lung. Therefore, there is a risk of injury to the pleura and air leakage into the rib cage during costa removal. However, this is a very rare complication. When this undesirable situation occurs, it may be necessary to insert a chest tube.
There may be pain in the place where the costa is taken, and this pain may last for 2-3 weeks.
Ear cartilage is also generally needed in revision rhinoplasty. Ear cartilage is an alternative to costal cartilage. If a large amount of cartilage tissue is needed, costal cartilage is preferred. If less cartilage tissue is needed, ear cartilage is preferred.
Does removal of ear cartilage cause scarring?
The ear cartilage is removed by entering just in front of the fold in the inner part of the auricle. It does not cause any change in the general shape and appearance of the auricle. Since the incision is made from the fold in front of the ear, the scar remains hidden. The scar remains hidden because the incision is made just in front of the fold in the ear.