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Secondary Rhinoplasty

In some instances, the outcome of rhinoplasty is not as the patient or surgeon expected. Further intervention may be necessary to achieve results that produce better balance with the facial features, improved alignment and the nasal shape more improved breathing through the nose. This is typically referred to as secondary rhinoplasty or revision rhinoplasty.

Revision rhinoplasty poses more significant challenges because of the addition of scar tissue mostly over the tip of the nose, and previously reduced cartilages and nasal bones.

Good planning and in-depth discussion between patient and surgeon is necessary to identify the areas of concern and to plan for corrective surgery. Realistic expectations are an important part of setting sensible goals and the likelihood of achieving them.

More than any other surgery for the nose, secondary rhinoplasty benefits from seeing several surgeons before committing to surgery. This helps patients to identify the treatment pathway they are most comfortable with and the surgeon may feel safest with.

Swelling after the surgery is frequently more significant and can take longer to settle down compared to the first operation. It is an important source of distress in particular because in some of the photographs the nose generally appears larger than it is. This is frequently associated with anxiety during the recovery period.

Preparation for surgery with a psychologist and intervention of a psychologist after surgery can bring benefits toward realistic expectations from change and management of the anxiety that follows surgery.

Depending on their personal experience, surgeons may recommend using cartilage grafts from the ear, from the rib or sometimes just from the nasal septum if sufficient cartilage is available. There is no system that has established consistently superior outcomes and therefore a frank discussion with the surgeon or surgeons consulted needs to bring out the benefits and limitations of each approach for patients to be able to decide on their preferred course of action.

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