Revision Rhinoplasty 

Secondary Rhinoplasty

A significant portion of Dr. Cuno’s practice is devoted to revision rhinoplasty or septo-rhinoplasty, which is correcting problems from a previous rhinoplasty done anywhere else. Revision is needed when the previous rhinoplasty does not adequately resolve cosmetic or functional issues.

We strive to provide a good long-term outcome with structure rhinoplasty techniques. However, no surgeon is immune to revisions and each rhinoplasty surgeon has his own revision cases.

It is also very difficult to attain perfection with rhinoplasty and patients who seek perfection may have higher revision rates. Other causes for revision can be poor execution of technique, poor healing, unanticipated issues and especially the change of shape over time (scar contracture). The nose changes naturally over time, which intricates the situation.

Revision rhinoplasty can be more complex than a primary surgery. Successful secondary rhinoplasty surgeons typically have – and should have – experience with more complex issues around structure and function that may have been compromised or incompletely addressed by primary surgery.

In revision surgery, very often, graft material needs to be harvested (either rib or ear cartilage). Rib cartilage is a high-quality and a strong durable grafting material.

Patients often have scar tissue after a primary rhinoplasty, which makes the dissection more difficult and there is a large degree of variability in secondary rhinoplasty deformities. Some patients have problems that are difficult to correct. For this reason, some noses can be effectively corrected while others have a higher risk of problems or persistent deformity that may require an additional surgery (revision). It is not surprising then that the revision rate is higher after a first revision.

The patients must understand that their nose will often look even more swollen and possibly wider after revision surgery and possibly wider early on, and this will improve with time.