A successful rhinoplasty can transform a patient’s appearance and breathing function, but when results from a previous surgery do not align with your expectations, you may require a revision rhinoplasty. At West End Plastic Surgery, we specialize in addressing both the aesthetic and functional challenges that arise from prior nasal surgeries. Our Double Board-Certified Facial Plastic Surgeon, Dr. Lexie Wang, brings a high level of skill and experience to these complex procedures, ensuring that every patient receives personalized, comprehensive care.
What Is Revision Rhinoplasty?
Revision rhinoplasty, or secondary rhinoplasty, is a corrective surgical procedure aimed at resolving issues stemming from a prior nasal surgery. This can include a previous septoplasty, rhinoplasty, or even skin cancer surgery involving the nose. Whether it’s addressing asymmetry, structural collapse, excessive scar tissue, or ongoing breathing difficulties, Dr. Lexie Wang is equipped to provide solutions that improve both form and function.
Primary Rhinoplasty vs Revision Rhinoplasty
Primary rhinoplasty is the first rhinoplasty that a patient undergoes. In most cases, primary rhinoplasty yields ideal, permanent results and is the only surgery necessary. However, occasionally unfavorable results or future trauma can necessitate additional surgery. This is called a revision rhinoplasty. Although both procedures are performed similarly, revision rhinoplasty does require extra care due to its complexities, as noted below.
Why Is Revision Rhinoplasty More Complex?
Revision rhinoplasty is often more complicated than primary procedures due to factors like:
- Scar tissue from the initial surgery
- Altered nasal anatomy
- Limited availability of natural cartilage for structural support
- Altered blood supply from previous surgery leads to a higher risk of complications
This complexity requires advanced surgical planning and a deep understanding of nasal anatomy to achieve optimal results.
The Revision Rhinoplasty Consultation
Your journey begins with a detailed consultation with Dr. Lexie Wang. She will review your medical history, discuss your concerns, and understand the outcomes you are hoping to achieve. It can be extremely helpful for the consultation for you to collect the operative reports from any previous nose surgeries. Using advanced imaging and analysis, she will assess:
- The structure and stability of your nasal framework
- Areas of scarring or deficiency
- The impact of the previous surgery on nasal function and aesthetics
During this consultation, Dr. Wang will discuss potential surgical plans, the types of grafts that may be required, and any special concerns related directly to your needs. Each patient’s case is unique, and we customize our surgical approach to meet your specific needs. A comprehensive plan will outline the necessary steps to achieve improved symmetry, structural support, and nasal airflow.
Before & After Gallery
Want to see more of the incredible transformations our talented team of skilled surgeons, nurses, and aesthetic experts can achieve? Check out our gallery for more amazing before and after images! From surgical procedures to non-surgical treatments, our experts deliver stunning results that help our patients look and feel their best. Click here to explore!
Types of Rhinoplasty Grafts for Revision Procedures
To restore and enhance the nasal structure during revision rhinoplasty, we may need to use grafts. These grafts reinforce weak areas, improve nasal contours, and enhance functionality. Here’s a look at the various graft options available:
- Cartilage Grafts
- Septal Cartilage: When available, cartilage from the nasal septum is often the preferred grafting material because of its durability, natural integration, and the fact that it is already within the nose, so no additional surgical site is required. However, previous surgeries may have depleted this source.
- Ear Cartilage (Conchal Cartilage): Harvested from the ear, this cartilage is softer and ideal for minor structural corrections, tip refinements, lowering nostrils, or filling depressions without affecting ear shape.
- Rib Cartilage: For extensive reconstruction, rib cartilage provides a robust, substantial source of material. It’s especially useful when significant structural support is needed. Our surgeons take care to contour rib cartilage precisely to achieve natural-looking results.
- Fascia Grafts
- Temporalis Fascia: This is a thin layer of connective tissue harvested from the temple area. It is often used for smoothing out irregularities or adding volume to areas with indentations. Because it is thin and flexible, it provides a natural contour.
- Alloplastic (Synthetic) Implants
- In rare cases, synthetic materials like porous polyethylene may be used to augment the nasal structure. These materials are generally reserved for patients who cannot use their own tissue, but they come with a higher risk of complications and are used with caution.
In this video, Dr. Wang is using Rib Cartilage to build the patient's nose:
Innovative Solutions for Functional Challenges
In some revision cases, structural support alone is not enough to correct nasal airflow issues. For patients experiencing persistent nasal obstruction or overactive nasal nerves, we offer additional treatments like:
- Latera Implant
- What It Is: Latera is an absorbable nasal implant that provides support to the lateral walls of the nose. It is designed to stabilize the nasal valve area, which is crucial for proper airflow.
- When It’s Used: Latera is especially useful for patients whose nasal valve has weakened or collapsed, causing breathing difficulties. If you notice that your breathing is improved when you stretch your cheeks, this may be due to a valve issue, and you could be a candidate for Latera. By supporting the nasal structure without adding bulk, Latera enhances both function and stability.
- ClariFix Treatment
- What It Is: ClariFix is a minimally invasive cryotherapy (freezing) treatment that targets overactive nasal nerves to relieve chronic rhinitis and congestion.
- When It’s Used: If you suffer from constant nasal drip, congestion, or inflammation, ClariFix may be an excellent addition to your revision procedure. It can significantly improve quality of life by addressing underlying nerve issues that trigger excess mucus production.
Rhinoplasty Recovery Process
Rhinoplasty surgery is typically performed on an outpatient basis and you go home shortly after the surgery. You may be sleepy from the anesthesia and you will feel mild to moderate discomfort so it is important to have someone drive you home after your surgery. You may also want to have someone stay with you for the first few days after surgery.
In the first 24 hours after surgery, your face will feel puffy, your nose may ache, and you may have a dull headache. You can use the prescribed pain medication to alleviate much of this discomfort. Most patients are up and around one to two days after surgery. The swelling and bruising around your nose will increase at first, reaching its peak about two to four days after the surgery. Applying cold compresses will help ease the pain and reduce the swelling and bruising.
Your discomfort level will improve rapidly after the first two days. A little bleeding is common in the first day or so after surgery and you may continue to feel some nasal stuffiness for the first few weeks. All dressings, splints, and stitches are usually removed within one week after surgery.
You will notice a marked improvement in your discomfort level during the first few weeks after your surgery. You can most likely return to work approximately one to two weeks after your rhinoplasty unless your work is strenuous.
| Out of Bed | As Soon as You Feel Comfortable |
| External/Internal Splints Removed | One Week After Surgery |
| Stitches Removed | One Week after Surgery |
| Back to Work | One to Two Weeks After Surgery |
| Contact Lenses | As Soon as You Feel Comfortable |
| Driving | As Soon as You Feel Comfortable and are not taking narcotic pain medication |
| Strenuous Activity | Three to Four Weeks After Surgery |
| Wearing Your Glasses | Four to Six Weeks After Surgery |
| Contact Sports | Six to Eight Weeks After Surgery |
Things To Be Aware Of After Your Surgery
- You should not blow your nose for several weeks or so after surgery to give the tissue a chance to heal. You should make every effort to avoid rubbing, bumping, or hitting your nose for several weeks.
- After surgery small burst blood vessels may appear as tiny red spots on the skin’s surface. These spots are usually minor but can be permanent in some cases.
- When rhinoplasty is performed from inside the nose there is no visible scarring. When the incision is made across the bottom the nose or when the procedure corrects wide nostrils, the scars are minor and are usually not visible within a few weeks of surgery.
- Minimize sun exposure for up to one year following surgery.
- The doctor will schedule regular follow-up visits in the months after your surgery. If anything unusual or troubling develops between visits, call West End Plastic Surgery right away.
When Can I Expect to See the Full Results of My Rhinoplasty?
There are two stages to your rhinoplasty recovery, after which your results are definitive. The first stage involves the decrease of visible swelling and bruising. That stage can take about two weeks to one month to reach the point at which you feel comfortable returning to work and social engagements. Keep in mind that, at the two-week mark, moderate swelling may remain. This final stage takes one to three years to resolve, and in cases of revision rhinoplasty, you should expect a longer recovery time. You may notice what we call “semi-final” results as soon as three months after your rhinoplasty procedure. By that time, the majority of your swelling should be gone. From then on, minor changes related to swelling may continue. These, however, are so gradual and subtle that you may not even notice.
Why Choose West End Plastic Surgery for Revision Rhinoplasty?
Dr. Lexie Wang combines precision, artistry, and extensive experience to deliver exceptional results in even the most complex revision cases. We are committed to achieving the best possible outcomes for our patients, using advanced techniques and innovative treatments to improve both aesthetics and function.
