Secondary surgery should not be taken lightly as revision surgeries carry their own set of risks. But there are times when a patient may need to improve respiratory issues or the aesthetic appearance of the nose. For the patients who come to her unhappy with the outcome of a prior rhinoplasty, New York facial plastic surgeon Lee Ann M. Klausner, MD says she helps them carefully weigh the benefits and the risks of a revision rhinoplasty.
NewBeauty: Who is a good candidate for a revision rhinoplasty?
Dr. Klausner: Someone displeased with the appearance of his or her nose; someone who underwent nasal surgery and still has breathing issues; or someone with poor cosmetic results from prior surgery. Someone who broke his or her nose after having primary rhinoplasty.
NB: When should you consult a doctor for a rhinoplasty revision?
Dr. Klausner: It’s best for a patient to wait until most of the swelling has resolved. This typically takes one full year after the first operation. The earliest I see patients in consultation for revision rhinoplasty is six months after their first operation. Earlier than that, it is too soon to tell what needs to be addressed because of swelling. More commonly, I see patients one year to several years after their first operation.
NB: What goes into a rhinoplasty revision surgery?
Dr. Klausner: First, I perform an in-depth consultation to determine what bothers the patient about his/ her nose. We also discuss what the patient should expect from a revision surgery. For these cases, the period of swelling is longer than the swelling following primary rhinoplasty. It’s important to impart realistic expectations and communicate that the goal is improvement and not perfection. The procedure may also take longer due to scar tissue. There are specific challenges associated with revision surgery because the nasal tissue has been altered from a prior operation.
NB: Do you perform revisions on patients who’ve had multiple rhinoplasty procedures and do you approach those cases differently?
Dr. Klausner: Yes. I discuss with those patients that it is best to have very specific and realistic goals. It’s always best to preserve what is working and try to address specific problems. We don’t want to make new problems with a revision procedure. The goal is improvement and not perfection.
NB: What are the risks associated with a revision surgery?
Dr. Klausner: Yes, all of the risks of rhinoplasty plus the patient may have new scarring, worsening of the prior condition or a lack of resolution of the condition they were hoping to fix. There are no guarantees of clinical outcomes and patients should only undergo a revision surgery if the benefits outweigh the risks.
NB: What is your best advice for someone considering a revision rhinoplasty?
Dr. Klausner: Consult a board-certified, facial plastic surgeon with extensive experience in rhinoplasty.
NB: What rhinoplasty innovations can we expect to see in the future?
Dr. Klausner: We hope that with primary rhinoplasty there will be a greater attention given to preserving structure of the nose in order to maintain functionality. In the future, we hope there is the potential for tissue engineering that will allow us to create new cartilage and viable tissue that can be used in nasal reconstructions.
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