Esta información y sus vínculos no se debe considerar un consejo médico si no ha habido una consulta en persona con historia clínica y examen físico

Revision Rhinoplasty - A second chance

Information in spanish

Rhinoplasty a second time

Your reasons for wanting revision Rhinoplasty and your suitability for this type of procedure will be carefully discussed. Most common reasons are: patient dissatisfaction with the surgery results, persistent nasal air obstruction, and post-surgical sequels. Revisional surgery should never be undertaken before 12 months after the original Rhinoplasty surgery. At a minimum, 12 months are needed after Rhinoplasty for tissue healing and repair.

During a personal consultation, Dr. Espinosa will determine what is reasonable and safe in your specific case. A detailed nasal examination and computer imaging analysis will be performed to identify the problem. Thorough pre-operative evaluation must be combined with intraoperative observation to provide the right answer for correction.

¿How many revisions can I have?

Ideally it would be better to have fewer surgeries. However, most patients for revision Rhinoplasty are dissatisfied about their appearance and concerned about the way they look. They need to know there is a solution.

After Rhinoplasty, the quality of the tissue in the nose cavity is changed. Subsequently, the healing process in a Revision Rhinoplasty is completely unpredictable. In a Revision, the physician should approach the problem in a precise way, in order to provide the most certain diagnosis possible.

¿Is a the Revision Rhinoplasty difficult to perform?

Yes. This is one of the most difficult procedures to perform and requires an experienced rhinoplastic surgeon to adequately handle most of the common problems related to Revisional Rhinoplasty.

¿When should a graft be necessary?

It is not easy to answer without a nasal examination. However, a grafting is usually necessary to generate a shape when excessive reduction of cartilage or nasal cavity tissue has been performed during the first surgery. The surgeon then uses cartilage grafts to restore the tissue and redefine the shape of the nose. In most cases, cartilage from the nose can be used.

¿How is Revision Rhinoplasty recovery?

Recovery from Revision Rhinoplasty is similar to recovery from Rhinoplasty. However, swelling can take months to fully fade.

Dr. Espinosa´s special instructions:

Instructions before surgery:

  • Avoid taking Aspirin (acetyl salicylic acid) or anti-inflammatory medicines.
  • Stop smoking at least one month before your surgery.
  • Inform your surgeon about drug allergies, medical treatments, and current medications.
  • Always have realistic expectations about the results of surgery.

Instructions after surgery:

  • Before you leave the medical center, make sure you have your surgeon’s prescriptions, medical certification, and date of your first post-operative visit to the office.

  • Avoid foods that require prolonged chewing. Otherwise, your diet has no restrictions.

  • After surgery, a nasal cast will remain in place for approximately one week. Do not disturb it and keep it dry. You may take a shower using warm, not hot water; the humidity in the bath may remove the cast from its place. If this occurs, the patient is advised to contact the surgeon as soon as possible. Once the splint is removed, a light tape dressing is placed for approximately 8-15 days.

  • Mucous and some bleeding from the nose after surgery are completely normal. An external nasal tip dressing is placed to absorb oozing. If bleeding does occur, the patient is advised to contact the surgeon immediately.

  • Post-operative swelling, discoloration and ecchymosis in the periocular area are very common until approximately 15 days, and should not be considered a complication. It is necessary to constantly keep ice packs over the nose and periorbital area, especially during the first 48 hours after surgery.

  • During the first days after surgery, it is recommended to sleep in a semi recumbent position. Sleep on your back with an elevation of 30-40 degrees.

  • You may read or watch TV after surgery.

  • You must rest at home at least during the first 3 to 5 days.

  • Although patients report minimal pain, they are discharged with post-operative analgesia. If you have severe pain, inform Dr. Espinosa immediately. Avoid taking aspirin (acetyl salicylic acid).

  • In some cases, it is necessary to use temporary packing in both nasal passages. It will be removed within the following 24-72 hours.

  • During the first days, it is usual for patients to experience some kind of nasal stuffiness. Due to the presence of crusting in the nasal vestibule, the sense of smell and taste may be temporarily reduced. It is important to use a physiologic saline moisturizing spray solution in each nostril, and pass it down your throat, according to the medical prescription.

  • Do not blow your nose. During the first three weeks, the nasal secretions must be swallowed into throat or spit out.

  • In some patients, it is necessary to place a plastic nasal splint just over the nasal dorsum, to protect and promote healing. This will be removed within the following 8 to 15 days.

  • The remaining internal sutures are removed within 5 to 7 days after surgery.

  • Avoid bumping or hitting the nose. It is recommended not to pick up small children.

  • Avoid cleaning the nose and nostrils using cotton-tipped applicators.

  • If you have had a preoperative history of allergic rhinitis, this may be improved by surgery. But remember, rhinitis cannot be completely cured. You must continue your treatment routine of antihistamines.

  • Do not use glasses for the first three months. If it is absolutely needed while the cast is in place, they should be suspended from the forehead with a single piece of tape in the midline. Dr. Espinosa will show you how this is done.

  • Avoid sun exposure as much as possible during the first two months. You must wear sun block and a covering to minimize sun exposure. Excess sun exposure may cause undesirable alterations, such as swelling of the nose and even blistering of the dorsal skin.

  • Sports are restricted for 3 weeks following surgery.

  • The average patient goes back to work or social activities in 8 to 10 days.

  • Avoid changes of temperature, strenuous physical exercise, and hitting.

  • It may take 6 months, and even longer, for the outcome of the surgery to fully refine itself. No surgical procedure should be taken lightly. Rhinoplasty is one of the most complex surgeries. Because Rhinoplasty is not an exact science, the possible need for a secondary revision procedure must be discussed openly. An additional surgery might be recommended to enhance the appearance of your face. Any additional procedures cannot be considered before 6 months after your surgery.

The information provided here is not a substitute for a consultation. Please, do not hesitate to communicate with us if you are concerned about something you consider significant. Your post-operative appointment is really important. Remember, the success of your surgery depends very much upon post-operative care. It is crucial that you follow your surgeon’s instructions.

Revision Rhinoplasty