Revision
Rhinoplasty

Revision Rhinoplasty- Secondary Nose Surgery

Problems resulting from a primary rhinoplasty are usually described as Secondary Nose Surgery and the surgical procedure to correct these, Revision Rhinoplasty.
After a primary rhinoplasty, two main problems may arise: functional pathology, i.e. a deterioration of the nasal function and aesthetic issues.

Which are the aesthetic issues more commonly seen after a primary rhinoplasty?

There are set patterns for this procedure that can be analyzed separately:

Closed Rhinoplasty -over-resected nose

The vast majority of cases are those of closed rhinoplasty, leading to inadequate or overzealous resection. Excessive tissue removal takes place and nasal cartilages are over-resected.

This procedure became very popular in the 80’s and 90’s in South America, especially in Argentina and Brazil. It was never widely accepted either in Europe or the USA. Even nowadays many surgeons specialized in this technique or their apprentices still perform this type of surgery. Therefore, the age range of secondary rhinoplasty is remarkably wide, covering patients from 18 to 55 years.
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Most common defects resulting from Closed Rhinoplasty are:

Overresected dorsum
Unwanted nasal feminization in male patients
Rocker deformity
Asymmetrical Nasal Osteotomies
Narrowing middle third of the nose
Dorsal irregularities
Assymetric Nasal Tip
Nasal Valve Collapse /Nasal Valve Synachae
Alar retraction /valve insufiiciency
Hanging Columella
Assymetric nostrils
Over-rotation of the tip (surgical look)

“Rhinomodelation : Non-surgical rhinoplasty: ”

The second group of patients in need of a revision rhinoplasty are those who underwent rhinomodelation, commonly referred to as non-surgical rhinoplasty. Non-surgical rhinoplasty is a medical procedure in which injectable fillers are used to alter and shape the patient’s nose, lifting the angle of the tip or smoothing the dorsal hump. This is the group which has increased the most over the last years.

Nasal Bridge details

The third group of patients in need of a revision rhinoplasty are those patients with soft skin and with nasal bridge details who need skin thickening treatment.

Complex Rhinoplasties

The last group covers those individuals who have undergone a complex rhinoplasty and though they have significantly improved their appearance still wish to enhance even more their appearance or still have problems that have not been completely solved in the first procedure. Concrete examples include patients with deviated nose, deviation of columella, alar asymmetry and facial asymmetries in general.
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