Due to the highly intricate and nuanced nature of a revision rhinoplasty procedure, it can require many different techniques to attain optimum surgical success. Each revision case involves a unique set of cosmetic or functional issues, or a combination of both, which means that every procedure must be customized in order to meet the patient’s individual needs and ensure graceful, aesthetically-pleasing results.
Rhinoplasty can be performed using either the open or the closed approach. Both can be used for revision nose surgeries, but it will depend on the specific adjustments involved, as well as the extent of the overall revision.
Closed Approach (Endonasal Rhinoplasty)
With this approach, the surgical incisions are created inside the nostrils to access the internal nasal structures. Due to the limited visibility, it is generally reserved for less complex cases.
Open Approach (External Rhinoplasty)
The open approach makes use of incisions along the columella, or the bridge of skin between the nostrils. This allows the skin to be lifted, which will expose the underlying nasal framework and provide better exposure of the structures involved, thus facilitating optimum execution of more extensive techniques and maneuvers.
While both primary and secondary nose jobs use the same approaches and techniques, one distinction between the two is that the latter can often be more challenging due to the lack of usable cartilage or skin that remains. In most cases, the previous rhinoplasty surgery will have significantly depleted the available nasal cartilage, leaving your next surgeon with little to work with.
Since most revision procedures require reconstruction of the nasal structure, Dr. Sedgh may use medical-grade implants or cartilage grafts harvested from the rib, ear, or septum to use as structural or shaping material for the nose. If there are visible imperfections on the nasal bridge or tip, fascial grafts may also be used to reshape the area.