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Revision Rhinoplasty in Philadelphia

Revision rhinoplasty has helped thousands of patients in New Jersey and the Philadelphia region correct cosmetic and functional nasal complaints. Revision rhinoplasty, or a secondary nose job, is a procedure performed to correct problems arising as a result of a primary nose job. Problems associated with prior rhinoplasty procedures usually affect either the appearance of the nose or nasal function. Prior surgery also may have led to nasal tip collapse, an overly sculpted tip, nasal contour irregularities, a “ski slope bridge”, or nasal collapse leading to airway obstruction.

State-of-the-art technique: Dr. Corrado

Rhinoplasty surgeons will employ many state-of-the-art techniques to attempt to restore the patient’s nose to its proper form and function. Many times, nasal surgery is performed without respect for maintaining the vital structural components of the nose.

In these instances, the overdone nose needs to be re-built to re-establish natural cosmetic form and nasal function. Top Philadelphia rhinoplasty surgeon Dr. Anthony Corrado will often utilize cartilage of the nose, ear, or even a portion of the rib in an effort to improve the appearance of your nose, as well as its function.

Revision rhinoplasty is a very complex procedure. Patients should seek a top rhinoplasty surgeon with extensive formal training in this highly specialized surgical field.  The surgeon should be board certified in facial plastic and reconstructive surgery, as well as otolaryngology (ear, nose, and throat surgery).

Exceptional outcomes in revision rhinoplasty: Dr. Corrado

After undergoing nose surgery, it can be devastating to be left with an unsatisfactory result. Whether your nose changed over time or you were disappointed with the results from the beginning, the revision should be performed by a skilled specialist who has access to the most advanced techniques.

Dr. Corrado has the level of training and experience that is needed to repair even the most egregious surgical errors. As a board-certified facial plastic surgeon and otolaryngologist (head and neck surgeon), he offers an extraordinary degree of experience, knowledge, and skills.

Before & After

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Why you might consider a revision rhinoplasty

Several common complications can lead to the need for revision surgery after a nose job. These include:

  • A scooped bridge: In cases where a hump on the bridge was reduced too much, the nose profile may appear concave, requiring revision. This happens when a surgeon miscalculates the amount of bone to remove due to lack of experience or a failure to execute the procedure correctly.
  • Polly beak deformity: A failure to correctly re-shape the nose structure can result in the area above the nose tip being too full, appearing similar to the shape of a parrot’s beak. The cartilage may not have been appropriately reduced, an excess of scar tissue may have developed, or the surgeon failed to ensure the nose tip was supported correctly.
  • Nostrils left too large, or a “hanging columella”: The columella is the thin strip of skin and cartilage that separates the nostrils. This problem typically comes as a result of a surgeon removing too much of the tip cartilage when trying to re-shape the nose tissue, leaving the nostrils to appear larger than they should.
  • Bossae knuckling: If the surgeon who performed the primary rhinoplasty was too aggressive in removing cartilage and did not ensure the nose structure was supported, the weakened area could have developed lumps called bossae.
  • An over-projected nose tip: If the nose shape was not re-sculpted correctly, a primary rhinoplasty could leave a nose tip that is noticeably over-projected, which requires revision surgery.
  • Valve collapse: This error occurs when a surgeon removes too much of a nasal hump or fails to re-attach the cartilage properly. This mistake can cause the bridge to narrow and the inner nose valve to collapse, causing breathing issues, cosmetic issues, or both.
  • An overly-rounded or pinched nose tip: It requires meticulous skill to re-shape the nose tip cartilage. When performed aggressively or without an eye for symmetry and balance, the nose shape will change over time, eventually appearing pinched or oddly-shaped.
  • Open roof: This surgical error is apparent when the nose bridge looks unnaturally flat. It happens when the nasal bones are incorrectly altered and not appropriately secured.
  • A crooked nose: A crooked nose after a rhinoplasty is often the result of the nasal bones shifting after surgery, which usually happens after a surgeon causes excessive damage to the interior nasal structure or the removal of too much cartilage.

Dr. Anthony Corrado discusses rhinoplasty

Revision Rhinoplasty Procedure Facts

The surgical goal is to correct cosmetic or functional issues of the nose as a result of prior rhinoplasty surgery.

The procedure

An external rhinoplasty approach is utilized. Areas of cosmetic or functional problems are improved, many times using cartilage grafts. These grafts help to “re-build” certain cosmetic defects or help to improve the nasal airway. Dr. Corrado does not place traditional packing in the nose—he uses nasal splints inside the nose and a packing material which dissolves over time. A small cast will be placed over the nose to protect it and allow it to heal in the immediate recovery period. Other procedures, such as chin augmentation or neck liposuction, may be performed to complement the procedure.  Revision rhinoplasty is performed under general anesthesia.

Length of time

The amount of procedure time varies based upon what types of refinements are necessary. These times can range from one hour or longer depending on the complexity of the case. All procedures are performed at a fully accredited outpatient surgery center.

After the procedure

All patients are sent home the day of surgery and are given a set of post-procedure instructions to follow. The patient will follow up the next day in the office for a post-procedure check, and again on the day after surgery.  At this visit, the sutures and nasal splint will be removed.

Recovery

Most patients can return to work in about a week, although all individual patient recovery times vary. Patients are asked to refrain from physical exertion for a period of three weeks. Bruising is variable depending on the patient, although most are resolved within one to two weeks. Most of the extensive swelling is resolved in the first few weeks after surgery. Revision rhinoplasty typically takes longer to fully heal compared to primary procedures. Subtle changes in nasal swelling and appearance will be seen for up to two years as the nose completely heals.

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