Board Certifications: American Board of Facial Plastic and
Reconstructive Surgery American Board of Otolaryngology - ABO

Revision Rhinoplasty Complications

If you had a nose job (rhinoplasty) and are unhappy with the outcome, you’re probably anxious to get in to a facial plastic surgeon to address it. You are likely very disappointed and feeling sensitive about your appearance. However, before you decide to move forward with your revision rhinoplasty, it is important to put these feelings aside and consider the possible complications a secondary nose surgery.

Revision rhinoplasty is perhaps the most complicated of all facial plastic surgeries — even more complicated than primary rhinoplasty, in fact. Complications are more common with revision rhinoplasty than with primary rhinoplasty. Therefore, your expectations should be lower with this procedure than with primary rhinoplasty.

But this is not to say that all revision rhinoplasty patients have negative outcomes. By doing your research, having the proper expectations and choosing an expert in revision rhinoplasty to perform your surgery, you can greatly increase your odds of a positive result.

What Are the Potential Complications?

Revision rhinoplasty is a tricky procedure for many reasons, but primarily because the nasal structures of patients in need of this procedure are often compromised. The presence of scar tissue and the lack of cartilage and tissue to work with often make this procedure very challenging. Cartilage may need to be harvested from other areas of the body.

In addition to these issues, your revision rhinoplasty surgeon will also face all of the challenges posed by a primary rhinoplasty procedure.

Though rare, some patients can have a reaction to the medications or anesthesia administered prior to the surgery. However, an airway tube is placed in the throat to ensure proper breathing, should this take place.

Following the procedure, while you are still in the surgical facility, potential revision rhinoplasty complications include bleeding or reaction to medications.

There are also some potential complications that can arise once you have been released to go home, including unexpected swelling, bleeding, reaction to medication and trauma to the nose (if you bump into something, for example); if you experience any of these complications, it is important that you contact your revision rhinoplasty surgeon immediately. All patients undergoing primary or revision rhinoplasty procedures experience some swelling around the eyes. However, Dr. Rizk uses special techniques to minimize both swelling and bruising.

In addition, there are also some potential complications you should be aware of following the recovery period. These include sun damage, injury to the septum, infection, nasal blockage and skin-related problems.

You can go a long way to preventing postoperative complications by closely following the instructions given to you by your surgeon.

Is it Worth the Risk?

This depends on a number of factors specific to your own anatomy, as well as what actions were taken during your primary rhinoplasty procedure. Here are some other factors that come into play:

  • How much cartilage was removed
  • The integrity of your nasal skin
  • The thickness of your skin
  • Whether or not you need grafts
  • Extent of deformities
  • Amount of scar tissue
  • Your psychological condition

A good way to help determine if the potential complications of revision rhinoplasty outweigh the potential benefits is to schedule an appointment with a revision rhinoplasty specialist. Remember that it is extremely important to have realistic expectations of your revision rhinoplasty surgery.

Minimizing the Risk of Revision Rhinoplasty Complications

There are a number of things you can do to minimize your risk of experiencing complications following your revision rhinoplasty procedure.

Choose the Right Surgeon

Many revision rhinoplasty procedures involve grafting and other complex techniques. As a result, the first — and perhaps the most important — step is to choose an experienced, board-certified facial plastic surgeon who specializes in rhinoplasty and revision rhinoplasty procedures. General plastic surgeons are well trained but do not have the same expertise in facial plastic procedures.

In contrast, because many facial plastic surgeons have obtained dual board certification in facial plastic surgery and otolaryngology-head and neck surgery, they have an in-depth knowledge of the internal nasal structures as well as the outside appearance of the nose, and know how to properly operate on both. Facial plastic surgeons are also trained to address functional issues such as breathing.

Prepare for Your Surgery

One step you should take even prior to the initial consultation with your surgeon is to stop smoking far in advance of surgery, because smokers do not make good candidates for revision rhinoplasty.

Before heading to your consultation, gather all of your medications, over-the-counter products and any supplements you take so that you can show them to your doctor (in case any of them might cause problems with your surgery).

Prior to your surgery, your surgeon will most likely give you a list of preoperative instructions. It is very important that you follow these instructions closely. Your surgeon also may ask you to get lab tests, and will probably advise you to stop taking anti-inflammatories, aspirin and herbal supplements, which can increase your risk of bleeding. He or she will also provide you with a list of things you should purchase to help with your recovery.

Make sure to arrange for someone to help you with your aftercare. All revision rhinoplasty patients need some assistance during the postoperative period.

Things to Avoid

There are a number of things you should avoid if you will be undergoing revision rhinoplasty.

Definitely avoid having your surgery overseas. While it might save you money in the short-term, it might cost you more if something goes wrong. More importantly, the care you receive will likely be lower-quality than the care you would receive in the U.S. Other things to consider include what you will do in case of complications, and how you will go about receiving follow-up care from your surgeon. There are many other reasons to avoid having plastic surgery abroad. To learn more, read our article on this subject or contact the office of Dr. Rizk.

There are also a number of things you should avoid after your revision rhinoplasty procedure.

For one, it is just as important that you avoid smoking after your surgery as it is before. Smoking can interfere with the healing process and adversely affect the ultimate outcome of your procedure.

Avoid any situations that might put you at risk of sustaining trauma to the nose.

Also avoid exposing your nose to the sun for six weeks following your revision rhinoplasty. During the rhinoplasty procedure, the nasal skin is lifted and stretched to gain access to the nasal bone. It takes time for the skin to recover from this stretching. Sunburns interfere with the skin’s ability to recover from this, as they damage the outermost layer of skin.

Here are some more things to avoid during your revision rhinoplasty recovery:

  • Sniffing
  • Blowing your nose
  • Smiling (it moves your nose)
  • Touching or rubbing your nose
  • Bumping your nose
  • Sleeping on your side (it can move the nasal structures)
  • Bending over
  • Traveling (for a couple weeks)
  • Caffeine
  • Alcohol
  • Contact sports
  • Wearing glasses

For more tips on recovering from revision rhinoplasty, contact the office of Dr. Rizk today.

Written by Dr. Sam Rizk

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