Rhinoplasty, or nose surgery, is an intricate surgical procedure that requires exceptional surgical skill, precision and a keen eye for aesthetic detail. Revision rhinoplasty is an even more complex procedure, given that the nasal structure has already been altered during the initial procedure and the resulting scar tissue that is often present must be taken into consideration. Fortunately, Dr. R. Laurence Berkowitz is an extremely talented rhinoplasty surgeon who has helped countless revision rhinoplasty patients finally achieve the aesthetic results they desire with nose surgery.
What Revision Rhinoplasty Corrects
Revision rhinoplasty is similar to primary rhinoplasty in that it is performed to modify the size or shape of the nose, the nostril span or the angle between the upper lip and the tip of the nose. Both primary and revision rhinoplasty can also be performed to correct a nasal abnormality that has been present since birth, a nasal injury or structural issues that are causing difficulty breathing.
About the Revision Rhinoplasty Procedure
Revision rhinoplasty is performed with the use of general anesthesia or local anesthesia with intravenous (IV) sedation. Before starting the procedure, Dr. Berkowitz may draw small lines on or around the nose to use as guidelines during surgery.
Dr. Berkowitz uses one of the same techniques during revision rhinoplasty that he does during primary nose surgery: either the closed method or the open method. With the closed method, the plastic surgeon adjusts the structure of the nose with the use of internal incisions, positioned within the nostrils. With the open technique, Dr. Berkowitz uses the internal incisions as well as an additional incision positioned on the columella, or thin strip of tissue separating the nostrils.
The exact details of the procedure vary by patient, depending on the person’s nasal structure and their aesthetic goals for surgery.
For instance, for individuals with a wide or bulbous nasal tip, Dr. Berkowitz might remove a section of cartilage from the tip of the nose. He may also place internal sutures to pull the cartilage inward, creating a narrower nasal tip or modifying its position. Or, for patients with an undesirable dorsal hump (a bump on the bridge of the nose), Dr. Berkowitz might remove sections of bone or cartilage from the nasal bridge in order to eliminate the dorsal hump.
Removing bone or cartilage from the nasal structure may leave an exposed area on the bridge of the nose. Dr. Berkowitz may reposition the nasal bones to close the exposed area, or he may use cartilage grafting techniques. To perform the latter step, the surgeon takes cartilage from the nasal septum, or, if a more extensive amount of cartilage is needed, from the ear or the ribs. Dr. Berkowitz might also place nasal implants to adjust the shape of the nose.
Once the surgeon is satisfied with the new shape of the nose, he closes the incisions generally using dissolvable stitches.
What to Expect Following Revision Rhinoplasty
Following nose surgery, patients might notice that nasal airway splints have been placed to stabilize the nose and provide support as it heals. If nasal bones were adjusted during surgery, an overlying splint might be present. Stitches, bandages and splints are removed about one week following surgery.
As with any surgical procedure, there might be pain, bruising and swelling throughout the treatment area. With rhinoplasty, the bruising often extends into the upper section of the face and around the eyes. Taking pain medication as directed by Dr. Berkowitz helps alleviate any discomfort.
The majority of swelling improves within about two weeks, but minor swelling can persist for several months. The full aesthetic benefits of rhinoplasty — especially revision rhinoplasty — may take up to one year to become fully apparent, as the nasal structure settles into its final position.
Achieve Your Desired Rhinoplasty Results
If you are unsatisfied with the results of a primary rhinoplasty procedure performed by another surgeon, contact Dr. Berkowitz for help. He can assess your nasal structure, listen to your motivations for pursuing a revision procedure and establish your candidacy for revision rhinoplasty. To schedule a one-on-one consultation with Dr. Berkowitz, contact his practice by calling (408) 559-7177 now.