Q) Who is a good candidate for Revision Rhinoplasty?
A) Anyone over 18 year of age who is at least 12 months post a previous Rhinoplasty and would like further realistic improvements. Many patients who come in for consultation for secondary Rhinoplasty are understandably depressed, angry, frustrated with their previous experiences and their prior surgeries and are looking for a skillful Facial Plastic Surgeon who can fix prior mistakes and improve the balance and harmony of their face.
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Q) What is the goal of Secondary Rhinoplasty?
A) To correct aesthetic and functional problems that may have either not been addressed by the previous plastic surgeon or may have been caused by the previous nasal surgery. The ultimate goal is to create an aesthetically appealing nose and a functionally sound nose that will not attract undue attention to itself. The goal of any Rhinoplasty is to redirect attention to the beauty and intrigue of the eyes.
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Q) Is secondary Rhinoplasty done through an open or closed approach?
A) It depends on the issue. Significant changes and improvements can be made skillfully through an endonasal or closed technique. Scar tissue can be removed, excess bone or cartilage can be shaved down, the width of the nose can be narrowed, precise pocket grafts can be created and placed very effectively. However, when major reconstruction is necessary "from the ground up" then the external or open technique is used to allow placement of structural grafts.
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Q) Where does Dr. Naderi obtain cartilage for the grafts?
A) Dr. Naderi will look for cartilage from the septum. Luckily, most Plastic Surgeons who perform Rhinoplasty are not comfortable with surgery of the septum and hence leave this area alone. In these situations, valuable septal cartilage is used for graft creation and placement. In other situations or if more cartilage is needed, Dr. Naderi will turn to one or both ears or even the ribs for a source of tissue.
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Q) Will my ears look different if Dr. Naderi takes cartilage from there?
A) No. His incision is placed in the crease behind the ear where it is hidden. The location on the ear where he takes cartilage does not change the shape or structure of the ear. Most of the time when patients return for their long term post-op visits, they forget which ear cartilage was taken from.
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Q) Does Dr. Naderi use any implants in the nose?
A) Dr. Naderi is a firm believer of using your own natural tissue for Rhinoplasty and revision Rhinoplasty. He prefers cartilage or fascia from behind the ears to the use of implants. Implants and foreign material in the nose have a high risk of infection, shifting, rejection, extrusion and other problems. Occasionally if absolutely necessary he may use Gortex strips or Alloderm sandwiched in your own tissue which is much safer than other implants. He will discuss these possibilities with you during the pre-op consultation.
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Q) Is Revision Rhinoplasty more expensive than a primary Rhinoplasty?
A) Usually unless very minor changes and improvements are needed. In major cases there is loss of tissue from over aggressive resection of cartilage by the previous plastic surgeons as well as diffuse scarring making the surgery more involved, more time consuming and more challenging. Therefore, these surgeries are often more expensive.
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Q) Do you have any words of advice?
A) You have already been though the stress, the cost, and the recovery of the previous Rhinoplasties plus the disappointments of sub-par results. You should take your time and do plenty of research. Make sure you see several Rhinoplastic Surgeons and insist of digital photo imaging or morphing and then finally make your choice of a Revision Rhinoplasty Surgeon with confidence. If that choice results in you and your loved ones trusting your self and your nose to the skillful and compassionate care of Dr. Naderi, then you can rest assured that you are in good hands and you will be taken care of throughout the process.
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