Revision Rhinoplasty

Revision rhinoplasty is often performed when a patient is not satisfied with the results from a previous rhinoplasty. Also referred to as secondary rhinoplasty, revision septo-rhinoplasty can also be performed to address uncorrected problems or complications following a previous nose surgery. Revision rhinolplasty may become necessary due to cosmetic concerns, breathing problems, or both. As an experienced revision rhinoplasty surgeon, Dr. John Vartanian is experienced in revision cases that can range from simple touch-ups to difficult multi-revisional cases.

Dr. Vartanian is board-certified in facial plastic surgery and utilizes advanced rhinoplasty techniques to achieve great results for his patients. Revision rhinoplasty is a science and art that Dr. Vartanian has been practicing for over a decade using the latest as well as time-proven techniques. His training in revision rhinoplasty began during his residency, where he worked with and learned from leading nasal surgeons like Drs. Dean Toriumi, Frank Kamer, Gene Tardy, Regan Thomas, and Gary Burget. With over a decade of experience with hundreds of revision cases, Dr. Vartanian uses a wide range of techniques to address each patient’s unique needs and concerns.

Revision rhinoplasty problems can be due to:

• Inadequately addressed problems in the first surgery. For instance: leaving behind a hump in the nose. Such problems can often be fixed by removing residual bone and/or cartilage, or performing other improvements to the nose.
• Too much tissue removal during the previous surgery, such as pinching and nasal collapse. These are cases where structure and support needs to be replaced into the nose.
• Changes due to unpredictable healing of the nasal tissues, such as scarring.
• Combinations of the above.

In cases where structure needs to be replaced into the nose, cartilage taken from the septum, or from behind the ear can be used to repair the nose. In rare cases, rib cartilage may be required to replace structure to a badly damaged nose.

• Insurance and Revision Nasal Surgery
• Benefits of Revision Rhinoplasty
• The Revision Rhinoplasty Procedure
• Recovery from Revision Rhinoplasty
• What to Expect

Insurance and Revision Nasal Surgery

In revision nose surgery cases where nasal breathing, allergy, or sinus problems are present, a portion (or all) of revision nasal surgery case may be covered by third party entities, such as your insurance company. During the consultation, Dr. Vartanian can talk with you about whether your insurance may potentially be used for the reconstructive, functional, or medically necessary part of your procedure.

Benefits of Revision Rhinoplasty

Revision rhinoplasty can be a godsend for the patient who suffers from a debilitating inability to breath, and/or from a deformed or unattractive nose. Dr. Vartanian’s approach treats both function (breathing) and form (beauty) in one operation designed to fix the nose inside and out. Our typical revision rhinoplasty patient enjoys a much higher quality of life after their surgery due to having a better-looking nose and an improved ability to breath normally.

The Revision Rhinoplasty Procedure

During your consultation, Dr. Vartanian will listen to your concerns, examine your nose, and discuss his revision rhinoplasty treatment plan. Using computer-imaging software, he can show you the potential outcome of your surgery. The computer before-and-after images are printed for the patient to take home and reflect on the proposed changes. Dr. Vartanian also uses the simulated picture during surgery to remind him exactly of the cosmetic goals agreed upon during the consultation.

Dr. Vartanian uses both open and closed rhinoplasty techniques in revision rhinoplasty cases. Each case is customized to the patient’s needs. Some cases may require minor modifications. Other cases may require more involved surgery. Dr. Vartanian uses a wide variety of techniques to fix specific nasal problems. Additional cartilage may be needed to repair problems due to previous surgery. Different suture reshaping and cartilage grafts may be used to help achieve the desired outcome. In cases of internal nasal valve narrowing or collapse, spreader grafts can be used to expand and support the middle part of the nose. In some cases, breathing problems due to vestibular stenosis or narrowing can be corrected by relatively simple techniques. Rim grafts can be used to reduce nostril retraction and create a better nostril contour. On-lay camouflage grafts can be used to augment or smooth the nasal bridge. Columellar grafts and columellar-septal setback can be used to support the tip of the nose. Septal perforation (holes) from previous surgery can also be repaired during revision rhinoplasty cases. Dr. Vartanian has successfully operated on many multi-revisional noses, including one patient who had nine previous nasal procedures.

Revision rhinoplasty cases are typically performed on an outpatient basis, with patients returning home the same day of the operation. Procedure times will vary depending on the extent of your needs.

Recovery from Revision Rhinoplasty

Following surgery, most patients are pleasantly surprised with how good they feel – often taking their first normal breath through the nose in a long time. Dr. Vartanian does not routinely use nasal packing so as to maximize your postoperative comfort. Pain is usually minimal, and less than 20 percent of our patients generally need to take pain medications. Heavy bruising and significant swelling are less common in Dr. Vartanian’s hands due to his use of custom smaller nasal instruments, pre-surgical anti-bruising medicine, and careful operative technique.

It is a good idea to take about a week off from work or school in order to fully recover after your procedure. Many patients can return to work in a matter of days, but most choose to do so after the nasal cast (bandages) are removed five-six days after surgery. Dr. Vartanian recommends that exercise or strenuous activity be limited for about a month following surgery. He also advises that you avoid contact sports for at least four to six weeks.

Additionally, patients are welcome to spend the night at one of our recommended aftercare facilities.

What to Expect

• How long will the procedure take? Procedural times vary from patient to patient. During your consultation, Dr. Vartanian will assess your specific goals and provide you an estimate based on your needs.
• Who will perform the procedure? All revision rhinoplasty surgeries are performed by Dr. Vartanian from start to finish.
• What is recovery like? Recovery generally varies, but any bruising and swelling can be controlled with medication and most patients can expect to return to normal daily routines within one week.
• What about results? Results are typically immediate and long-lasting. There will be initial swelling in the nose, which will progressively go down with time. The swelling takes longer to go down in revision cases and can vary widely from case to case. Look at our before and after revision rhinoplasty gallery for some examples.

Schedule Your Consultation

For more information on the revision rhinoplasty procedure, or to schedule a one-on-one consultation with Dr. Vartanian, please contact our office today. We will be happy to assist you in any way we can.