Revision Rhinoplasty

Introduction to Revision Rhinoplasty

Rhinoplasty is a complex procedure, and there are times when the outcome may be less than ideal. A corrective procedure in the form of a revision rhinoplasty will be needed to achieve your goals after undergoing a primary rhinoplasty. Seattle Face & Skin strives to provide our patients with a second chance to look better and feel better with Revision Rhinoplasty in Seattle. To learn more about the treatment and discover if this treatment is right for you, please keep reading below!

What is Revision Rhinoplasty?

If your goals are not met after a rhinoplasty, the thought of needing a revision rhinoplasty is often disappointing. We specialize in revision rhinoplasty and understand that situation. Our goal is to ensure that this procedure is the right choice for you and, if so, that you achieve the best result possible. Revision rhinoplasty is sought for a variety of reasons including issues that were not fully corrected during the initial rhinoplasty or undesirable effects as a result of the rhinoplasty. Each specific issue necessitates its solution and common problems that arise include the following:

• Polly Beak Deformity: A “polly beak” refers to post-operative fullness of the nasal bridge just a little bit higher above the tip, which is called the supratip, giving the nose a parrot’s beak type of appearance. This deformity may occur for a variety of reasons after primary rhinoplasty including failure to maintain adequate tip support resulting in a droopy tip, inadequate cartilage hump removal, or from scar formation in the supratip region. Revision surgery addresses the specific cause of the polly beak.
• Profile Deformities: Persistent Hump Deformity or a Collapsed Nasal Bridge (Saddle Deformity): Persistent deviation after rhinoplasty may occur at the upper nasal bridge (bony nasal vault), middle nasal bridge (cartilaginous vault), or tip of the nose. Bony vault deviations typically require re-fracturing the nose (osteotomies) whereas cartilaginous vault and nasal tip asymmetries often require re-straightening the septum or placing a number of cartilage grafts to maintain symmetry.
• Collapsed/Pinched Nasal Tip: A collapsed or pinched nasal tip can result after rhinoplasty if too much cartilage of the nasal tip is removed. Not only can the nasal tip become pinched, but nasal obstruction can also result. Correction involves using cartilage grafts to strengthen and shape the nasal tip to a more natural appearance with improved function.
• Tip Bossae (Knuckling): A bossae is a knuckling of the nasal tip cartilage at the nasal tip that can occur with healing forces acting on weakened cartilage. Patients with thin skin are especially at risk. Correction can involve trimming or excising the offending cartilage. In some cases, the area is covered with a thin wafer of cartilage, fascia, or other material to smooth the area further.
• Alar (Nostril Rim) Retraction: Alar (Nostril rim) retraction can occur with healing after rhinoplasty if the tip cartilages are weakened or not reinforced. Retraction results in the pulling up of the nostril rim with an excessive show of the columella or septum and tip asymmetry. Retraction and asymmetry can be corrected with the release of the scar and placement of cartilage grafts. An example of corrected alar retraction is shown above.

What are the Benefits of Revision Rhinoplasty?

Our Seattle Revision Rhinoplasty patients have been able to enjoy the following benefits from their treatment:

• Achieve primary rhinoplasty goals
• Corrected nasal function
• Correction of over or under-operation
• Enhanced self-confidence
• Improved breathing
• Improved facial symmetry
• Natural results well-suited to your face
• Rejuvenated appearance

Who are the Best Candidates for Revision Rhinoplasty?

The best candidates for Revision Rhinoplasty in Seattle are those who:

• Are unhappy with their previous Rhinoplasty results
• Can be patient when waiting for final results as this treatment can take more than a year to yield its optimal appearance
• Has allowed at least a year to pass since their initial Rhinoplasty
• Maintain realistic expectations and a positive attitude

What’s the First Step?

The initial consultation centers around your goals of nasal surgery, an examination of your nose in the context of an overall head and neck examination, and a discussion of how best to meet your vision.

During your consultation, a variety of techniques for rhinoplasty may be discussed. A method is chosen that results in the best cosmetic and functional outcome for you. Pre and post-operative examples of other similar rhinoplasties are often reviewed. The details of the procedure and post-operative care are explained, and any questions you may have are answered. If a plan is confirmed to move forward with surgery, you meet with our patient care coordinator to schedule a surgery date.

Before your surgery, you may have one more pre-operative visit. This visit typically involves a pre-operative history and physical at our office. This visit is performed to assess any medical issues you may have and to ensure that your surgery is conducted most safely. Pre and post-operative instructions are reviewed, and this visit is also an opportunity for you to ask additional questions that may have arisen after your initial consultation.

What to Expect on the Day of Revision Rhinoplasty

Once in the pre-operative area, you will meet the nursing and anesthesiology staff who will take care of you during your procedure. Your surgeon will meet with you and your family before the procedure to review the surgery and discuss any last-minute questions you have. After the procedure is performed, you will be taken to the recovery room. You will have a nasal cast and likely intranasal splints in place that will be removed at your post-operative visit. All rhinoplasty procedures are performed as outpatient surgery, and you will be sent home with detailed post-operative instructions and pain medication. We will call you on the night of surgery to ensure that you are doing well and to answer any questions you may have.

Revision Rhinoplasty Recovery

Your first post-operative visit will be approximately one week after surgery to remove your sutures, nasal cast, and any intranasal splints. You will then follow-up up one month after surgery and usually every three months for the first year after your surgery to ensure adequate healing.

How Much Does Revision Rhinoplasty Cost in Seattle?

The cost of Revisional Rhinoplasty in Seattle is determined by a number of factors, including the techniques required to achieve a particular look and the extent of surgery required. After meeting with Dr. Bhrany for a consultation, he will be able to create your personalized surgical plan and our Patient Coordinator will provide you with a price breakdown for your procedure.

Why Choose Us?

At Seattle Face & Skin, we aim to partner with our patients to provide the best possible care for aesthetic facial rejuvenation and reconstruction. From the moment you contact our office, we focus on your needs to ensure you fully understand the possibilities, limitations, and opportunities available to produce the best outcome for you. Our team is led by Dr. Amit D. Bhrany, a double board-certified in Facial Plastic Surgery and Otolaryngology (Ear Nose, and Throat Surgery) and an active member of AAFPRS (American Academy of Facial Plastic & Reconstructive Surgery). After earning his bachelor’s degree in biomedical engineering and doctorate in medicine from Boston University, he completed his residency in Otolaryngology-Head and Neck Surgery at the University of Washington (UW). Dr. Bhrany then spent two years of additional sub-specialty training, developing skills for cosmetic facial plastic surgery, reconstructing all aspects of the head and neck, as well as head and neck cancer surgery and microsurgical reconstruction after being awarded fellowships in Head and Neck Surgery at the University of Auckland in New Zealand and Facial Plastic Surgery at UW.

Schedule Your Consultation

You don’t have to live with results that you aren’t happy with. If you are in Seattle looking for Revision Rhinoplasty, contact Seattle Face & Skin by calling (206) 599-3223, or request an appointment through our website. We’re here to help answer your questions or to get you started with a consultation.