Types of Cases That Need Revision Rhinoplasty

The nose is located at the center of our face, and for that reason, it has a major impact on the overall impression of the face.

If you have concerns about the shape of your nose, you may consider cosmetic surgery at least once, and you will see many such cases. Even a slight change in shape can bring a big difference, and seeing that can make you think, “Maybe I should try it too,” leading you to consider surgery.

Nose surgery refers to a method of improving an unattractive nose, which may be called by various names such as a pig nose or a hump nose. It means creating a beautiful line through correction, such as placing an implant in a low nose to make it higher, correcting a crooked shape, or reducing wide nostrils.

Even a small change can alter the image, but since the nose is made of cartilage rather than bone and has many small blood vessels passing through it, there is enough room for problems if something goes wrong. Side effects may occur, or if the relationship with the forehead and lower face, as well as the overall harmony with the facial features, is not considered and the procedure is done simply because you want a certain shape, dissatisfaction often leads to revision rhinoplasty. The ideal nasal angle, when viewed from the side, is about 95 to 105 degrees between the philtrum and the columella, and about 115 to 135 degrees between the forehead and the nasal bridge.

If the angle between the nose and forehead drops below about 115 degrees, the area around the eyes may look sunken and the forehead may appear protruded; if it is over 135 degrees, the forehead may look flat, making the nose appear low and the face look less three-dimensional. When looking at the types that need revision rhinoplasty, first there are cases where the nasal bridge or tip is crooked. If a non-open approach is used and access is made only from one side, the implant can bend inward, so it is important to create a new space so that the pocket created earlier does not shift to one side.

And not only the implant but also structures such as cartilage can be affected by the bent implant and settle in a crooked position, so it must be carefully corrected through revision rhinoplasty.

Next is when the nose is upturned. For people whose nose is congenitally short or upturned, lengthening is possible through septal extension surgery. A contracted nose is a phenomenon in which the nose becomes shorter and upturned due to inflammation. This is a difficult procedure; the capsule caused by inflammation is completely removed, the skin is sufficiently dissected to secure skin tissue, and cartilage that can serve as a support is used to extend the length.

Afterward, ear cartilage, septal cartilage, and costal cartilage are needed as autologous cartilage for revision rhinoplasty so that the lengthened nose does not rise again.

The next type of revision rhinoplasty is when the nasal bridge is too low or too high. If the bridge is low or excessively high, or if a hump nose remains with the middle of the nasal line looking raised, the hump portion is shaved down further or corrected with an implant suited to the nasal bridge. Next is when the nasal tip droops and looks long.

If the support of the nasal tip becomes low, ear cartilage may be used to lift the tip, and in cases where it is very low, the basic structure must be rebuilt to strengthen the framework at the tip so that it does not droop.

Next is when the nasal tip is crooked and the nostrils are uneven. If the tip is raised excessively, the columella may lean to one side and the nostrils can become asymmetric.

The deviated septum leaning to one side should be corrected, and if the alar cartilage is also twisted, it should be dissected and repositioned through revision rhinoplasty. Next is when problems occur due to the implant.

Many clinics use silicone. However, implants that are not autologous tissue, such as cartilage or dermis, are made of artificially produced chemical substances, so the skin tissue may recognize the implant as a foreign body and an immune reaction may occur. In such cases, there may be no problem at first, but over time the surface may become red, silicone may show through, or even contracture accompanied by inflammation may occur, making revision rhinoplasty necessary.

Because the thickness of the bone, skin elasticity, and cartilage-fat layer differ from person to person, the height of the nasal bridge should be raised naturally while considering the harmony and proportions of the entire face, and the tip, nostrils, and their shape should be designed according to the bridge height in order to create an ideal result. In general, the timing for revision surgery is best at around 6 months after the first operation on average. This is because it is preferable to proceed when the overall tissue has recovered and become soft and stable after surgery.

However, if inflammation occurs, it is recommended to first control the inflammation, such as by removing the implant inserted in the nose, and then proceed with revision rhinoplasty after the symptoms subside.

Above all, the best approach is to adjust the timing through consultation and examination with an experienced dedicated doctor, since the appropriate period may vary depending on tissue condition, the surgical situation, and the degree of recovery. Rhinoplasty is more difficult and complicated the second time than the first, and because the shape changes differently from before and each person may have different issues, the skill of the revision rhinoplasty medical team is important.

And just as each person has a preferred face shape, people may also picture the appearance they want when undergoing cosmetic surgery. However, if revision rhinoplasty does not preserve one’s individuality, it may look unnatural and lead to low satisfaction.

That is why our clinic conducts detailed examinations so that the nose can be made natural and attractive while preserving its strengths and characteristics. Each person has a unique impression, and even faces that seem similar can feel different.

Because everyone has different views and standards regarding appearance, as well as different desired improvements, it is advisable to carefully examine the areas where each individual feels lacking and what they hope to improve, and provide care for a satisfying revision rhinoplasty. At our clinic, the dedicated doctor will do their best to help you be satisfied with a natural change, drawing on the know-how gained through extensive clinical experience.

** This post is a promotional post written by DIVA Plastic Surgery Clinic in compliance with the Medical Advertisement Act. **