Rhinoplasty

Rhinoplasty is a common plastic surgery procedure chosen by millions of people worldwide to improve their nasal shape. Most nose job procedures deliver the desired results. But the possibility of a revision is still there, with 5 to 10 percent of people requiring a second operation.

The need for a revision after nose job does NOT mean that the procedure was “botched.” Most of those patients who have a second nasal procedure are interested in further refinement of an otherwise acceptable result. The most common “complication” after rhinoplasty is not really a complication as most of us think of it; rather, it is that the surgical result falls short of the patient’s ideal outcome, NOT that there was a catastrophe. Only a small percentage of rhinoplasties results in a complex, over-operated condition that is difficult to repair.

Here are some of the more common anatomic conditions for which a second, revisionary operation may be required:

1. Polly beak deformity: Most female patients (but not all) desire a slight depression just above the tip. When there is excess fullness in this area, it can make the tip appear beak-like and a revision is often indicated.

2. Nose too long or too short: While most patients fear an overly turned up, excessively shortened nose, it is also possible to leave the nose too long. When a bump is removed it makes the nose appear longer and it is usually necessary to turn up the tip very slightly. It is turned up (what surgeons call rotated) too much, the nose is too short. If it is not turned up enough, the nose is too long. As in all the conditions in this list, it is easier to repair an under-corrected (long) nose than an over-corrected (short) nose.

3. Knuckling or distorted tip: Patients often want the nasal tip refined and thinned. If too much cartilage is removed, the remaining cartilage can form a point that is visible through the skin, or one or both nostril rims may appear slightly collapsed. The nose plays such a central role in the appearance of the face that even slightly asymmetry of the tip may be bothersome to the patient

4. Nasal bridge deformities: Patients often want a nasal hump reduced. If the hump is not quite removed there may be a residual bump and if too much is removed the patient may have what’s called a “saddle nose” or excessively scooped out bridge. Once again, while everyone including the surgeon and the patient is trying to achieve a perfect result, it is preferable to have under-resected nasal bumps requiring a little more rasping than over-resected bumps that require the addition of cartilage or bone

5. Breathing problems. If the middle third of the nose or the nasal tip is narrowed excessively, it can result in breathing problems that may require a second operation to improve.

How to Avoid a Botched Nose Job?

Aside from over-or under-doing parts of the operation, other factors may also result in undesirable results, such as infection or unpredictable changes with healing. If you have experienced an imperfection after rhinoplasty, consult a board-certified plastic surgeon to explore your options for a corrective rhinoplasty.

Most rhinoplasties that require revision have not been botched. The days of horrible, overdone rhinoplasties are coming to an end as more and more surgeons are trained in the benefits of conservative rhinoplasty procedures. Every surgery comes with certain risks, but there are certain things you can do to reduce your risk of unhappiness after rhinoplasty:

1. Communicate

The relationship between the rhinoplasty patient and the plastic surgeon is like any relationship; communication is key! The surgeon needs to know what the patient desires and the patient needs to know the extent to which the surgeon thinks he/she can deliver on those desires. There is no substitute for frank discussion and that may require more than one appointment.

2. Choose a Surgeon Wisely

It is helpful if you can get a recommendation for a surgeon from more than one source. For example, if you see a name advertised AND you have a friend who was happy with that surgeon AND you go online and verify that he/she is Board Certified AND the reviews are overall positive, then that surgeon is likely a good choice. A single source of information such as an advertisement or mention in the media or one friend who had success may not be enough information.

3. Have Realistic Expectations

Most patients have an image of what they want their nose to look like. As a general rule, they will NEVER look exactly that way! If the surgeon is able to get the patient close to what he/she wants and the patient can be happy with a result that is close to but perhaps not exactly what he/she was seeking, then the operation will be a success.

Consult a Plastic Surgeon

It is imperative to find a qualified plastic surgeon who will listen and take the time to communicate because it plays a huge role in determining success. Dr. Charles Thorne is a Park Avenue plastic surgeon with decades of aesthetic plastic surgery experience. Schedule an appointment with Dr. Thorne to address your concerns about rhinoplasty.