Revisions

A rhinoplasty revision procedure may have been predicted from the beginning or be unexpected. Procedures that can be predicted are secondary alar base reductions and nostril sill reductions.

Unexpected revisions may be adjustment to nasal bone and septum positions when a bent nose was incompletely straightened, adjustment of tip tilt if this is wrong and smoothing of persisting irregularities on the dorsum of the nose.

Sometimes the nasal pyramid has widened during the healing process. Internal swellings may have pushed against the bones. Pressing against the bones can help in the early stages. If necessary, the bones can be repositioned surgically after the swelling settles - a new external splint is needed.

It may be necessary to inject a steroid into the nose if there is persisting swelling above the tip. That may be done 6 weeks after surgery.

Sometimes, a little too much cartilage was removed and some cartilage needs to be replaced. This would often be done as an office procedure, taking a cartilage graft from the septum.

Septal adhesions can occur after septal and turbinate surgery. The adhesions are usually very easy to deal with in the office but they can recur. The adhesion could be treated again and a silicone splint placed in the nose for about one week to stop further recurrence.

Sometimes we see patients who have had substandard rhinoplasties. They require more extensive revisions (nasal reconstructions) with cartilage grafts, bone grafts or perhaps the Medpor Nasal Shell.

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