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Revision Rhinoplasty San Francisco

Based on American Society of Plastic Surgeons (ASPS) statistics, rhinoplasty (nose reshaping) is the third most popular cosmetic surgery in the U.S., with 223,000 procedures performed in a recent year. Unfortunately, it is also one of the most difficult surgeries to perform. The American Journal of Cosmetic Surgery reports that revision rhinoplasty procedures in the U.S. are steadily rising.

When a Rhinoplasty Goes Wrong

Dr. Dino Elyassnia performs revision rhinoplasty in San Francisco to correct problems with primary rhinoplasty surgery. Dr. Elyassnia is a board-certified plastic surgeon with extensive training in both plastic and reconstructive surgery, with a practice focused on cosmetic procedures of the face. He is dedicated to surgical excellence and maintains the highest standards of integrity.

What Is Revision Rhinoplasty?

Revision rhinoplasty is a surgical procedure to repair form and function of the nose after previous nose surgery. The need for this secondary surgery is great because rhinoplasty is one of the most difficult plastic surgeries to perform. After initial (primary) rhinoplasty surgery, patients may be unhappy with the appearance of the nose or have difficulty breathing, or both.

As a secondary surgery to correct primary rhinoplasty, revision rhinoplasty tends to be an even more complicated procedure. For patients who need revision rhinoplasty to correct problems with previous nose surgery, it is essential to find a plastic surgeon with the right qualifications, experience, and knowledge to correct all the problems in function and appearance produced by the earlier surgery.

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What Problems
Can Be Corrected
in Revision Rhinoplasty?

The need for revision rhinoplasty is generally due to excessive removal of bone, cartilage, and lining of the nose. Dr. Dino Elyassnia performs revision rhinoplasty in San Francisco to correct a range of functional and cosmetic issues, including:

Polly Beak Deformity

When the area of the bridge above the nasal tip is too high, it can create an appearance similar to a parrot’s beak. This deformity can occur when:

  • Too much cartilage is left after surgery;
  • Too much soft tissue is removed, so the skin does not flatten out properly and excess scar tissue forms; or
  • The surgeon did not leave enough support for the tip, causing it to droop and making the bridge area above it appear to project too much.

Profile Deformities

This problem can arise when a surgeon attempting to correct a bump on the nose fails to smooth out all the bone and cartilage. A “scooped out” profile can occur when the surgeon has removed too much bone.

Collapsed Central Nose

This deformity is known as the “Inverted V” or the “Middle Vault.” It occurs when the center of the nose collapses after the surgeon removes a bump but fails to provide adequate support for the central part of the nose structure.

Deviated Nose

A deviated nose is one with a twist in the upper or middle portion or in the tip. This problem is difficult to correct with rhinoplasty and may persist after surgery. It can also be a problem created during surgery, when the surgeon’s efforts to remove a bump or correct other problems causes the nasal bones to shift.

Problems with the Tip

When the area of the bridge above the nasal tip is too high, it can create an appearance similar to a parrot’s beak. This deformity can occur when:

  • A tip that projects too far from the face is a common problem in rhinoplasty after a prominent bump has been removed.
  • An over-shortened appearance of the nose and a tip that is rotated upward revealing the nostrils can occur when too much of the supporting structure has been removed.
  • A nasal tip that droops with the end of the nose collapsed downward can be caused by removal of too much cartilage supporting the nasal tip.
  • A pinched tip can result from tissue collapse after removal of too much cartilage.
  • The nose can appear to come to a single point when a surgeon pulls a suture too tightly between the two points of cartilage that form the nasal tip.

Problems with the Nostrils

When the area of the bridge above the nasal tip is too high, it can create an appearance similar to a parrot’s beak. This deformity can occur when:

  • Collapsed nostrils can occur when too much of the tip cartilage is removed during rhinoplasty.
  • The columella (structure separating the two nostrils) can hang down too far and the nostrils can retract, creating a snarl-like appearance, if too much of the structures that support the nasal tip have been removed.
  • The inside of the nostril sidewall may be too visible when the surgeon has removed too much cartilage and excess upward scarring occurs inside the sidewall.

How Is Revision Rhinoplasty Performed?

The surgical techniques used in revision rhinoplasty will depend on the nature and extent of the problems being corrected. It can range from a simple procedure performed to remove excess bone or cartilage in the bridge to a complicated, delicate operation in which the nose is completely restructured.

Revision rhinoplasty performed on a patient who has had too much tissue removed is the most difficult type of nose surgery. Such a procedure typically requires the use of tissue grafts harvested from the ear, the rib, or the temple region to restore the structures of the nose.

Incisions for revision rhinoplasty may be confined to the inside of the nose (closed rhinoplasty), or an additional incision may be made across the columella (open rhinoplasty). In some cases, open rhinoplasty is the preferred technique because it allows for better access, direct visibility, and overall superior results.

What Is Recovery Like after Revision Rhinoplasty?

There tends to be less post-surgical bruising and swelling with revision rhinoplasty than with the primary rhinoplasty. Pain and discomfort can be controlled with prescription medication. Most patients are able to return to work in approximately one week, although strenuous activities should be avoided for two to three weeks after surgery.

You will have a nose splint and sutures, which will be removed within approximately six or seven days after the procedure. Although it can take up to a year for swelling to subside completely, bruising will have faded in approximately ten days.

Am I a Good Candidate for Revision Rhinoplasty?

If you have structural or cosmetic complications from previous nose surgery, revision rhinoplasty may be appropriate for you. Schedule a consultation with Dr. Dino Elyassnia to find about what can be done to repair a botched nose job with cosmetic or function problems with arguably the best revision rhinoplasty San Francisco has to offer.