Revision rhinoplasty (correction of the aesthetics of the nose) is an operation performed to eliminate the undesirable results of a previous operation on rhinoplasty (aesthetics of the nose). This is also called secondary rhinoplasty. Unfortunately, rhinoplasty does not lead to a positive result in all patients, and after primary rhinoplasty, 5-15% repeated surgery is required.
These indicators are taken from the average number of publications on the results of nasal aesthetics in our country and in the world. The frequency may vary depending on the experience of the surgeon, the complexity of the nose in the initial operation, or whether the surgeon operated on complex noses. However, each surgeon who performs the operation has a certain number of revisions.
We can divide the editions into minor and major editions. In a minor wording; the result of the first operation is acceptable and requires small turns. The patient may be pleased with his real nose and overall appearance but may require minor corrections. However, if there is significant deformity as a result of a previous rhinoplasty operation, a serious audit is required. Minor revisions can often be completed in 30-40 minutes. Major revisions may take 3-6 hours depending on the volume of the operation.
The Most Common Causes Of Revision Rhinoplasty
The tip of the nose can be compressed-narrowed, wide, asymmetric, low, lowered or extremely shortened and raised (pig nose). Possible collapse of the side walls of the nose and shortness of breath. The nasal crest can continue, deformation of the nasal crest, the appearance of a steamy nose as a result of inadequate removal of the cartilaginous belt in the nasal crest or saddle collapse of the nose as a result of excessive ingestion.
There may be a reverse appearance of V in the middle of the nose, a twisted nose, a continuation of deviation, irregularities in the nasal crest, excessive scarring inside or outside the nose, problems with skin and soft tissues.
Almost all noses requiring a major revision have difficulty breathing through their nose. The continuation of nasal obstruction after the first operation is mainly associated with the continued deviation of the septum, swelling of the nasal flesh (turbinate hypertrophy), insufficiency of the nasal valve (internal and / or external), adhesions in the nose, perforation of the septum.
Why Is Rhinoplasty Revision Surgery More Difficult?
Revision surgery involves differences from primary surgery. Tissue plans are often narrowed, cartilage and bone tissue, which are very valuable to us, are removed excessively or asymmetrically, and weak or weakened cartilage is twisted by the forces during healing. This requires a more careful and gentle operation during surgery. Rhinoplasty is very important for the skin and soft tissues. In most cases, there may be scars on the skin.
Revision rhinoplasty has a more intense inflammatory tissue response than primary rhinoplasty. In addition, nasal septum cartilage is often used or inadequate in a previous operation. Deformed and defective normal anatomical structures make revision surgery more complex than primary rhinoplasty. At this stage, the experience and patience of the surgeon becomes very important. Moreover, even when everything is done correctly in revision surgery, the healing reaction of existing tissues and skin will also affect the result.
A detailed analysis of the nose is necessary for a successful surgical outcome. Here, the skin is seen first. The thickness, quality, integrity, mobility of subcutaneous tissue and its connection with the underlying structures of the nose are evaluated. During this process, low resection, excessive resection, and asymmetric resection are detected. In a previous nose operation, intact areas are trying to understand.