Revision rhinoplasty– an operation aimed at correcting unsuccessful results after already performed plastic surgeries to correct the nose. Revision rhinoplasty is the only option for patients who, after rhinoplasty, experience significant visible deformations of the external nose or its functional impairment. So, sometimes after rhinoplasty, patients notice an unnatural divergence of the wings of the nose or their noticeable asymmetry. Sometimes a nose with a hump turns into a “saddle-shaped” one - with the bridge of the nose too low, as the surgeon has removed too much bone or cartilage tissue.

It also happens that the reason for the patient’s dissatisfaction may be associated not with the technique of the operation, but with the individual characteristics of the body. For example, after healing, the scar on the columella becomes large and noticeable. The nasal septum looks more convex and visually lengthens the nose due to a predisposition to unpredictable growth of scar tissue, or as a result of incorrectly performed surgery. Repeated rhinoplasty allows you to solve such problems and return the nose to its natural correct shape, restore nasal breathing functions, and restore the patient’s self-confidence and attractiveness.

Secondary rhinoplasty - approaches and methods

As a rule, patients who apply for secondary rhinoplasty are disappointed, wary people who have little faith in the successful outcome of a repeat operation. During the consultation, we try to collect a thorough medical history and study photographs before rhinoplasty in order to understand what manipulations were performed on what structures of the nose. Before undergoing revision rhinoplasty, we recommend that such patients undergo an MRI - analysis of these data allows us to create an objective picture of the internal structures of the nose, outline a surgical plan and agree with the patient on the possibility of revision rhinoplasty.

Crooked nose after rhinoplasty

One of the main complaints of patients is that after rhinoplasty the nose is crooked, the tip of the nose is not graceful enough, the back of the nose has bulges or depressions. Sometimes nose contouring may be recommended to correct minor defects. But, unfortunately, major deficiencies can only be corrected during a repeat operation.

A full report of this patient's revision rhinoplasty surgery can be found in .

Sometimes the situation allows you to avoid repeat surgery and use the possibilities of drug therapy, as, for example, in the case of excessively protruding scars. To correct minor asymmetry, we recommend non-surgical rhinoplasty - the use of fillers, or the use of botulinum toxin-containing drugs to rotate the tip of the nose. But more often, surgical correction is still required, for example, transplantation of one’s own cartilage tissue to fill the saddle-shaped depression or rotation of the tip of the nose and restoration of the shape of the wings of the nose with correction of the position of the nasal septum and alar cartilages of the nose.

About the possibility of holding revision rhinoplasty we can only talk after 6-8 months after the first nose job. This is due, firstly, to the fact that final tissue restoration takes a long time; within several months after the operation, the shape of the nose changes, and the “defects” that the patient observes immediately after plastic surgery may completely disappear over time. In addition, an operation, even a minimally invasive one, always injures tissues and nerve endings to a greater or lesser extent - therefore, before performing a second operation, you should wait for complete healing.

The latest methods of performing rhinoplasty using micro-instruments are such that the consequences of any unsuccessful operation can be eliminated. The main thing is to seek help from a qualified specialist.

Strict, millimeter-calibrated proportions are the lot of engineers, mathematicians and architects. Nature does not operate with round numbers, so no person can boast of perfectly smooth facial features.

Nose asymmetry occurs in more than 80% of the inhabitants of our planet. It can manifest itself in different sizes or shapes of the nostrils, unequal wings, deviation of the back and tip from the midline. Sometimes such nuances are completely invisible to others, but sometimes they literally catch the eye.

Can this be fixed and if so, how? Should you always seek help from a plastic surgeon? And what to do if a similar problem appeared after the operation?

How does nasal asymmetry occur?

This condition (it should not always be called a defect) can be congenital or acquired:

• In the first option, the cause is the individual characteristics of the structure and development of the facial bones of the skull and cartilages, from minor to very serious, such as and/or. Most often, the nasal septum is to blame: it can grow faster than the outer bones of the nose, become deformed and displace all adjacent anatomical structures. Due to its curvature, nasal breathing is almost always impaired to one degree or another, differences in the size of the nostrils or wings of the nose are visually noticeable, and the back and tip may shift sideways from the center line.
• Acquired asymmetry can be a consequence of surgery on any part of the face, incl. rhinoplasty or septoplasty. Usually this is not a consequence of the surgeon’s mistakes, but only a temporary imbalance in proportions caused by swelling, which returns to normal after a few weeks or months. Another possible cause is mechanical injury. Here, everything often happens the other way around: the displacement of bone and cartilaginous structures is imperceptible in the first days and weeks due to swelling and bruises. And after a while, returning everything to its place will be much more difficult than immediately after the damage ( see also article « »).

Can this be fixed?

The only reliable way to correct defects of the septum, nostrils, wings and other nasal structures is plastic surgery - or rhinoseptoplasty. The first step here will be a face-to-face consultation, during which the surgeon will examine the problem area and make a decision on the advisability of intervention (we will talk about why such a decision is not always made “in favor of the patient” below). Next, the nature and causes of the problem are precisely determined and the most suitable technique is selected to eliminate it:

• If the asymmetry of the back, tip, nostrils and/or wings of the nose is caused by septal defects, work is carried out with it. Sometimes it can be relatively easily aligned and installed in a new position; in more complex cases, the curved areas are completely removed, which are then replaced with grafts - they are usually obtained from a piece of the patient's rib. It sounds scary, but in reality it is a relatively simple and low-traumatic procedure ( see also article « »).
• Sometimes the problem is associated with improper placement of the medial crus, a section of cartilage that laterally supports the columella. Its displacement to one side leads to the fact that the nostrils and wings look very different in size, and the tip may deviate from the midline. The correction in this case consists of a slight shift of the leg in the desired direction.
• More serious defects - consequences of injuries, congenital pathologies, etc., may require complex, sometimes multi-stage operations, during which not only the cartilaginous but also the bone structures of the nose are repositioned and the lack of tissue is compensated. There is no single technique here and an individual correction plan is developed for each patient.

Some surgeons allow it to be used to correct minor asymmetries. Typically, dense fillers based on calcium hydroxypatite, polycaprolactone, etc. are used for this, which are injected into the soft tissues and increase their volume. In this way, you can correct the unevenness of the tip and back, but it is not always possible to align the nostrils and wings. And, unlike surgery, the result will last only for 6-12 months, after which the procedure will have to be repeated.

There are also various devices for correcting the shape of the nose. Usually these are some form of clothespins that need to be worn on the face for a long time: supposedly, due to constant pressure, you can change the shape of soft tissues, cartilage and even bones. But, unfortunately, such devices cannot provide a noticeable aesthetic result even with constant use. But they give their owner a false sense of control over the situation, which is what determines the demand for them.

Photo 3 – results of rhinoplasty, nostrils of different shapes and sizes have been corrected:

Photo 4 – irregularities in the back and tip of the nose were corrected using fillers (without surgery):

Asymmetry after rhinoplasty

What could be worse than an initially crooked nose? Only irregularities left after the already performed plastic surgery, which the patient sees with surprise when the bandage is removed for the first time. And no matter how much the surgeons explain to the disgruntled ladies that everything will return to normal as soon as the swelling completely subsides (and this will happen no earlier than in six months), many rashly begin to prepare for a second operation a week after the first.

What's really going on? The blood supply to the face is fundamentally different from other parts of the body. Significantly more blood flows to the head per unit volume of tissue. This, on the one hand, promotes rapid healing, but, on the other hand, the same rapid increase and long-term (up to 6-8 months) persistence of edema, the “behavior” of which is sometimes quite unpredictable:

• it can move to different parts of the nose, causing its back or tip to deviate in one direction or the other from the midline;
• often intensifies at certain times of the day, for example, in the evening;
• may go away relatively quickly in one area of ​​the nose, but persist for a long time (several months) in another.

Thus, nasal asymmetry after rhinoplasty is normal. At first, the nostrils may be different, and the wings and back often look not quite even, and the tip - too large or displaced. But until the swelling subsides completely, it is absolutely inappropriate to draw conclusions about the aesthetic results of the operation - and, moreover, to plan a repeat one.

Why are such operations not performed on all patients?

For most people, the presence of a slight disproportion is not just the norm, but a part of their individuality that shapes their unique appearance. This is evidenced by numerous studies in which scientists compared images composed of the double left and right halves of the face of one person. Even the recognized beauty Marilyn Monroe was no exception.

As it turns out, the criterion of beauty is often not the mathematical correctness of facial features, but their overall harmony and balance. And its important component can be the asymmetrically located nose, which is slightly shifted towards the narrower half. If such a “defect” is corrected (for example, surgically), then the entire delicate relationship will be disrupted, and the aesthetic result will be unsatisfactory.

Another important factor is our tendency to be overly critical of our own appearance. We are talking about those cases when there is no noticeable cosmetic defect, but a slight displacement of the back or tip of the nose is given “universal” significance. As a result:

• a person is ashamed of his own face;
• believes that this imperfection is noticeable not only to him, but also to others;
• is embarrassed to be photographed or chooses head positions for the photo so that the asymmetry is not noticeable;
• worries a lot about this, up to the appearance of more serious psychological problems, difficulties with communication, being in society, etc.

It is extremely difficult to carry out an operation that would completely satisfy a patient with such complexes. In this case, the initial dissatisfaction with oneself and one’s appearance is usually transferred to the result of plastic surgery, in which minor “irregularities” and “inconsistencies with the ideal” will certainly be found (psychologists call this condition dysmorphophobia).

• American plastic surgeon Ronald V. DeMars has an interesting way of helping patients realize the real extent of their alleged problem. “When a person comes to me for a consultation with a request to remove minor asymmetry of the nose or other part of the face, I give him a glossy magazine and ask him to show me 5 photographs of the most attractive, in his opinion, celebrities. We then look at their faces close up and on each one I point out at least 5 asymmetrical areas. This is not difficult to do, since not a single person in the world has perfectly equal proportions.”

Thus, before looking for ways to correct an existing deficiency, you need to honestly answer the question of why exactly this is needed. Objective reasons for seeking help from a plastic or ENT surgeon are:

• violation of nasal breathing caused by incorrect position of the septum or other osteochondral structures;
• a serious external defect of the nose, which is clearly visible from the outside, clearly distorts facial features and leads to objective difficulties in communicating with people.

The desire to perform an operation to harmonize the face and make it more attractive, if a person understands that rhinoplasty alone cannot correct all the problems in life, is also a very good reason. In other situations, rhinoplasty is unlikely to give the desired result.

Experts' opinions:

leading plastic surgeon at Frau Klinik: Initially, nasal asymmetry is a physiological feature that only intensifies over the years. The operation should be performed if there are problems with nasal breathing or if the proportions are disturbed: the septum, the osteochondral part of the external nose, etc. are bent, and therefore the person experiences discomfort. Today, I consider microrhinoplasty to be the safest and most effective method for correcting this problem. It allows you to carefully perform all surgical procedures in an extremely short time (from 50 minutes to 1.5 hours), maintain natural proportions, and minimize injuries to blood vessels and nerve endings. This approach helps not only the surgeon, but also the patient himself - the rehabilitation period is much faster and easier (there are no bruises or hematomas), and you can return to your normal lifestyle within a few days. As for asymmetry that occurs after surgery, this happens quite rarely and depends on the following factors: how significantly the proportions of the nose were initially disrupted; quality of the surgeon's work; the process of scarring, which is associated with the individual characteristics of our body (hormonal levels, skin type, etc.). If you feel like “something has gone wrong,” you need to contact your plastic surgeon to take preventive measures.

plastic surgeon, rhinosurgeon, Sharm clinic: The causes of nasal asymmetry can be congenital (genetic) - they can appear both immediately and during the process of growing up, or acquired - when, due to an injury in childhood, the development of one half of the face could lag behind. In the first case, a violation of proportions is usually associated with different volumes of tissue on the right and left sides of the nose, when the length of the cartilage or wings, the height of the bones are noticeably different, or the septum is curved. Also, a combination of asymmetry with a cleft palate and “cleft lip” is possible. If such a condition causes aesthetic discomfort in the patient, creates complexes, worsens the quality of life, or interferes with breathing, the problem must be solved only surgically. For example, if deviations of the tip of the nose are caused by different lengths/widths of its cartilages, then it is necessary to excise the excess volume and apply special sutures to build a new symmetrical frame. Open rhinoplasty allows you to perform this as accurately as possible. The asymmetry that arises after rhinoplasty is a direct complication, but its likelihood is extremely low; most often the culprit is ordinary swelling, which gradually goes away. If the problem persists for a year, corrective surgery may be required.

plastic surgeon, Arbat Aesthetic clinic: There is no absolute symmetry in any face. Differences between the right and left sides are often noticeable at the level of the wings of the nose, in the shape of the nostrils, etc. It is not always possible to completely rid the patient of such a “flaw”. After all, the bone structure of the skull also matters here, which, like our soft tissues, is also not perfectly smooth. This can only be an indication for surgery if the difference is visible to the naked eye, and not only to the patient in the mirror or in a selfie at a certain angle and lighting (which is most often the case), but really to everyone. This mainly occurs as a result of injury, or is a congenital defect - and in addition to aesthetic problems, it is also accompanied by impaired breathing.

Sometimes nose enhancement surgery does not solve problems, but adds new ones. In this case, secondary rhinoplasty is performed. The intervention will help restore the attractiveness of the face and free breathing for the patient.

Read in this article

Reasons for revision rhinoplasty

Sometimes patients are simply dissatisfied with the results of the first nose correction surgery, and there are no objective reasons for carrying out a new intervention. But there are clear criteria that make it necessary:

The fact that the patient needs correction of the result of the first rhinoplasty is indicated by changes in the color of the skin of the operated area, severe bleeding, an inflammatory or infectious process.

The culprits of problems requiring secondary intervention are:

• surgeon errors;
• patient ignoring doctor’s recommendations during the rehabilitation period;
• complications;
• injuries received after surgery.

Sometimes the measures necessary to improve the appearance of the nose are deliberately divided into 2 stages. And some problems are solved during the first operation, while others are eliminated during the second operation.

When can the procedure be done?

To correctly assess the consequences of your first rhinoplasty, you need to wait six months. Only then can we say with confidence whether it was a success or not, and decide on the need for repeated intervention. But if it is obvious that it is really needed, it is better to carry out the operation a year after the first. In this case, there is a greater chance of success and less likelihood of complications.

Difficulties of the process

Repeated surgery requires great skill from the surgeon. After all, it will be much more difficult to carry out than the first one. Problems are created by several factors:

This may lead to the fact that he will be dissatisfied with the effect of secondary rhinoplasty, even if it was carried out brilliantly and has an objectively good result.

• Technically, performing a repeat operation may be complicated lack of own cartilage, changes in their structure and the need to use implants, the presence of a large volume of scar tissue. The latter is characterized by low elasticity.

Difficulties are also created by the fact that the surgeon works almost by touch, since the subcutaneous areas could have changed significantly after the first intervention. Complications, such as necrosis, add to the problem.

• It is impossible to predict the result in advance. During the first operation, the surgeon keeps in mind a computer-determined model of the new nose and works towards this shape. During secondary rhinoplasty, his task is not to make things worse, but to remove functional and aesthetic defects as much as possible. Sometimes it is impossible to correct all errors. And the doctor has to look for safe methods of correction directly during the operation.
• The risk of complications increases. After all, living tissues that have already undergone changes can behave unpredictably during the operation. Their healing is slower. General anesthesia, which the patient receives over a short period of time, also does not contribute to ease of recovery.

Complications that may occur

Re-intervention is characterized by problems that can arise after the first rhinoplasty:

• unnecessary damage to bones, cartilage, skin;
• heavy bleeding;
• loss of nasal sensitivity;
• divergence of seams.

There may be even more serious complications. Methods for eliminating them are chosen by a specialist.

Nose asymmetry

A crooked nose after secondary intervention can become due to:

• swelling;
• insufficient removal of tissue from one of its sides;
• the desire of the cartilage to return to its previous uneven position;
• displacement of the components of the nose;
• varying degrees of tissue scarring during the healing process.

Significant asymmetry is considered a complication. A small one does not require correction.

Droopy tip

The drooping of the lower part of the nose is an aesthetic drawback, but a significant one. It occurs as a consequence of excessive tissue removal. The cause of the defect can also be an open method of surgery with dissection of the columella. Excess scar tissue forms in this area, making it larger. Sometimes the tip of the nose droops because postoperative swelling subsides.

Scarring

Scars protruding above the skin will negate the overall effect of an improved nose shape. They can form due to prolonged healing, improper care of sutures, and body characteristics. Scars can also be internal. In this case, they provoke not only external defects of the nose, but also problems with its functioning.

Bleeding

Copious bleeding from a postoperative wound occurs due to rupture of large vessels. This is more likely with revision rhinoplasty. After all, it is more difficult to detect areas that need to be bypassed due to deformations of the nose and other changes provoked by the primary intervention. The cause may also be weakness of the vascular walls, or the composition of the patient’s blood.

Tissue necrosis

The dieback may affect cartilage, bone, or skin. This is caused by errors in the operation, when excessive tissue excision and cauterization occur. Provocateurs of necrosis are deterioration of the blood supply to the area and the development of infection in the wound. The problem is solved surgically.

A) Thinning of the skin after secondary rhinoplasty, which led to increased sensitivity and constant irritation of the skin; B) Infection of the dorsal implant

Implant rejection

During revision rhinoplasty, the patient's own tissue taken from other parts of the body is used to achieve an acceptable aesthetic result. But even “native” material can be rejected by the body. The reasons include incorrect fixation of the implant, failure to maintain sterility during surgery, and a “rebellion” of the immune system. But more often allografts or artificial materials are rejected.

Methods of revision rhinoplasty

The secondary intervention, like the first, is carried out under general anesthesia; it can last even longer - up to 4 hours. Based on the characteristics of the problems, the surgeon will choose:

• Open way. It is made through incisions at the base of the nose and, if necessary, near the nostrils. The skin and soft tissue are then removed. During a repeat operation, the surgeon still has to remove the scar component to get to the cartilage. With the open method it is easier to do this, but there is still a risk of damaging the osteochondral frame.

But the method allows you to more completely eliminate defects and protect tissue from additional injuries. The recovery period after such an operation is longer, which means the risk of complications is high.

• Closed method. Indicated when necessary to correct minor defects. The incisions in the closed method are located in the internal structures of the nose. Healing will go faster and there will be no noticeable scars. But the likelihood of additional damage to soft tissues and bones is greater, so the risk of nasal asymmetry and other deformities increases.

To learn how closed secondary rhinoplasty is performed, watch this video:

Recovery after

The success of revision rhinoplasty largely depends on how the rehabilitation proceeds. The patient must follow the rules:

• protect your nose from anything that can cause damage;
• sleep on your back for several weeks;
• At first, do not eat too hot or cold food;
• stop playing sports;
• do not wear glasses, but replace them with lenses;
• do not overheat, that is, postpone visits to the solarium and the beach, baths, replace the hot bath with a warm shower;
• do not eat salty, spicy, fatty foods, preferring lean meat, fish, vegetables and fruits to this food;
• give up alcohol, coffee, smoking;
• avoid colds.

Under such conditions, the patient will have to live for at least a month. The sutures are removed a week after the intervention, before which they are cared for using the means prescribed by the doctor. Swelling can last up to several months. Therefore, we can talk about the results of secondary rhinoplasty only after six months or later.

Why might a doctor refuse surgery?

Sometimes the results of the first aesthetic surgery cannot be corrected surgically. There are several reasons for this:

• insufficient amount of time has passed since the previous rhinoplasty;
• too much scarring of the operated area;
• irreversible changes in nasal structures (cartilage, bones, skin);
• poor health of the patient.

More often, the listed obstacles arise after two or more unsuccessful operations. But it always makes sense to contact several doctors, choosing serious specialists. It is possible that one of the surgeons refuses because he does not have sufficient ability to correct the mistakes of others. But there are cases where revision rhinoplasty was successful after 6 interventions.

If all doctors claim that a secondary operation is impossible, you should come to terms with this. Defects in appearance will have to be corrected using cosmetics or fillers.

When deciding on secondary rhinoplasty, the patient must understand that it may not be possible to make it look the way they want. Its goal is to minimize the consequences of a previous intervention and restore the functions of the organ. And yet, according to statistics, the majority of repeated operations lead to satisfactory results.

Useful video

For information about why a doctor may refuse a patient surgery, as well as other answers to questions about secondary rhinoplasty, watch this video:

Revision rhinoplasty is an operation designed to correct errors, defects and unsatisfactory results after the first rhinoplasty.

It’s worth noting right away that secondary rhinoplasty is not a panacea and cannot always correct all the mistakes made during the first procedure.

For example, correcting a crooked nose after reconstructive rhinoplasty is not always possible, since technically it is a very complex operation with frequent use of implants. You also need to distinguish between a truly unsatisfactory result and simple patient dissatisfaction.

Differences between primary and secondary rhinoplasty

Primary rhinoplasty, for the most part, is aimed at solving problems associated with the patient's dissatisfaction with the shape or size of his nose. Most often these are problems of a purely aesthetic nature.

The secondary one is aimed at solving a wide range of problems that were a consequence of the first operation (often carried out incorrectly).

Its principles are fundamentally different from the principles of the primary one, and the surgeon is forced to operate in very limited conditions. The specialist is faced with the client's disappointment, fear and anger, lack of a complete picture of the previous operation and lack of information and is forced to navigate his way almost blindly, since the subcutaneous components change greatly as a result of the procedure.

There are several commandments to revision rhinoplasty:

• do no harm (that is, do not make it worse than it is);
• make an accurate diagnosis;
• create realistic expectations for the patient (do not promise exorbitant results, because this is impossible);
• correct functional deficiencies (dips, depressions, poor breathing, septal displacement);
• limit surgical dissection, which can lead to even more disastrous results and poor healing;
• Don’t take on something that can’t be fixed.

When can rhinoplasty be considered truly unsuccessful?

You can talk about success or failure after an operation no earlier than six months after it is performed, since this time is occupied by the final, formative stage of the entire procedure.

Before performing rhinoplasty, the doctor must not only conduct a series of studies related to the general health of a person, but also determine his psychological readiness to receive results and motivation. If the latter is absent, then the patient will in any case be dissatisfied with the result of the plastic surgery.

Rhinoplasty can be called unsuccessful if the surgeon made serious mistakes that led to the following:

• curvature of the nasal septum;
• breathing complications;
• partial or complete loss of smell;
• opposite results (for example, instead of a thin tip of the nose, a thick one is obtained);
• excision of a large amount of cartilaginous tissue, which leads to depressions and unevenness on the nose.

Signs of failed rhinoplasty are the following:

• skin pigmentation;
• profuse nosebleeds;
• abscess;
• inflammation of soft tissues.

Determining and making an accurate diagnosis

Before going under the surgeon’s knife again, it is necessary to conduct a diagnosis, which includes the following nuances:

Photo: deviated nasal septum

• determination of nasal flexibility;
• determination of mobility;
• determination of skin thickness;
• determination of scar changes;
• determination of changes in the skin and subcutaneous complex.

If the nose is crooked, then it is necessary to determine the anatomical components that create it. The doctor must also determine the presence or absence of septal cartilage and the need to use implants.

What should the doctor do?

The goal of rhinoplasty: primary or revision, is to make the patient satisfied and happy, so the right attitude is one of the most important factors for success. In order to understand what a person really wants, it is necessary to ask him about it in detail and immediately inform him of what of his desires is possible and what is not.

Photo: before and after nose surgery

Promising a patient a perfect nose, especially in the case of revision rhinoplasty, does not make sense, because the most important task of the surgeon will be to eliminate the primary problems: curvature, inability to breathe, etc. And only in second place will be giving the desired shape of the nose. In order for a person not to be disappointed, the plastic surgeon must give approximate forecasts.

Moreover, an experienced and attentive surgeon must inform the patient that revision rhinoplasty of the tip of the nose or the entire organ is often unpredictable, so any predictions given before the operation are not a 100% guarantee. This largely depends on the fact that subcutaneous scar tissue changes the “skin topography”, which can change significantly when tissue is cut.

Photo: scar tissue removal

Therefore, the first stage of the operation is precisely the removal of scar tissue to search for lateral cartilages. It should be immediately noted that this is not so easy to do, because it fits tightly around the cartilage and it is likely that you will not find it, but accidentally damage it.

In practice, cases of accidental cartilage removal during revision rhinoplasty are not common, but do exist. Since the surgeon does not have complete information, the operation is slow and shallow, otherwise there is a possibility of causing irreparable harm to the patient.

Rhinoplasty is considered a very complex operation and much more complicated than a simple eyelid lift, lip augmentation and similar procedures, so only an experienced and knowledgeable doctor can handle such an intervention.

What should the patient think about in advance?

1. After rhinoplasty, at least a year must pass before you can begin a second operation. This is due both to the load on the body (both primary and revision rhinoplasty are performed under anesthesia) and to the scar tissue, which must heal completely in order to be able to withstand additional intervention without even more disastrous results.
2. The rehabilitation period after repeated surgery lasts even longer than after regular surgery. Accordingly, the procedure must be carried out during vacation or holidays, because the patient will not be able to immediately begin work or study.
3. The choice of a surgeon is also not the least important decision. The doctor who performed the first operation is not always necessarily bad or inexperienced. Often, especially when it comes to reconstructive rhinoplasty, its capabilities are very limited and it takes a lot of time and effort to achieve ideal results. Consider and weigh the pros and cons before going to another specialist. Unlike a new doctor, the surgeon who has already performed the operation is aware of how the procedure was performed, what difficulties arose, how much tissue was excised or what implants were used, and this is a definite plus.

Video: Consultation with a plastic surgeon

When agreeing to a nose job, you need to understand that unsuccessful rhinoplasty operations are not fiction, but reality. It is also worth considering that complications are possible. All the details are in the article.

On the one hand, it is easy to decide on otoplasty, because it is a fairly safe procedure. Find out how much ear surgery costs.

Indications for secondary rhinoplasty

Statistics confidently state that in twenty-five percent of cases, patients require another operation after rhinoplasty.

This happens due to the following factors:

• surgeon errors;
• non-compliance with recommendations during the recovery period;
• complications that arose during the rehabilitation period.

Revision rhinoplasty is performed in the following cases:

• dissatisfaction with the size and shape of the nose, which differs significantly from what the patient wanted;
• the appearance of headaches and difficulty breathing, which could arise due to improper healing;
• visible scars;
• dips, depressions;
• the appearance of a hump that was not there before the operation;
• curvature of the nasal septum.

The essence of the procedure

Photo: progress of rhinoplasty surgery

The secondary rhinoplasty procedure is not much different from a regular nose job, except that it is technically much more difficult. The patient also undergoes tests, adheres to the usual rules before the operation and does not feel pain during the procedure itself, because he is given anesthesia.

In general, it lasts several hours and in some cases, the specialist may need implants, which are taken from the patient himself (most often a very small part of the auricle cartilage is taken, which in no case leads to the loss of its previous shape).

After all the manipulations, stitches are also applied and a long recovery period is required. The final results are assessed no earlier than seven months after the test.

Complications

The operation does not exclude complications, which may result in the following:

• ruptures of blood vessels;
• displacement of the nose to the side;
• increased scarring;
• the presence of edema, tumors and hematomas (these side effects are normal).

Rehabilitation

Rehabilitation after revision rhinoplasty lasts longer than after the first operation. The stitches are removed after a week, but bruises and swelling can last up to three to four weeks.

After the procedure, the patient is given the following recommendations:

• for the first few weeks sleep exclusively on your back;
• eliminate wearing glasses and replace them with lenses;
• exclude physical activity;
• avoid going to solariums, the beach, and beauty salons;
• eat right and avoid drinking coffee, alcohol, cigarettes, salty and heavy foods;
• Take care of your health and avoid colds and runny noses.

Prices

Revision rhinoplasty is much more complicated and, accordingly, more expensive. On average, its cost is about 220,000 rubles without expenses during the rehabilitation period. However, very often surgeons undertake to correct their shortcomings for free, but this is not practiced in all clinics and not all specialists. Moreover, if the recommendations after the operation were violated, then all the blame for the unsuccessful operation falls on the shoulders of the patient and there can be no talk of a free re-operation.

Nose job (all inclusive)	Price, rub.
Plastic surgery of the nasal septum	60 000
Plastic surgery of the tip of the nose	110 000
Repeated nasal tip surgery previously performed in another institution	130 000
Nose reduction with osteotomy (full rhinoplasty)	150 000
Rhinoseptoplasty	170 000
Repeat surgery to correct a crooked nose previously performed in another institution	180 000
Repeat surgery to correct a crooked nose, using implants or cartilage, previously performed in another institution	215 000
Bilateral vasotomy	50 000
Rhinoplasty	40 000
Nose hump resurfacing	40 000

Frequently Asked Questions

What can cause a failed operation?

There are several such factors: it could be a mistake by an inexperienced doctor, non-compliance with postoperative requirements, or simply unforeseen complications after the procedure.

Are there other options to fix the errors?

If we are talking about non-surgical rhinoplasty, then it has very limited possibilities. With the help of fillers (fillers), you can get rid of a small hump, unevenness or tighten the tip of the nose, but it cannot correct curvature or difficulty breathing.

People resort to this operation for various reasons. More often these are obvious aesthetic problems, or arisen functional difficulties. The cause could be an injury, individual complaints about one’s appearance, etc. The result of all the reasons is the same - a person decides to. But ?

Consequences of such an operation

Rhinoplasty is an expensive, complex, and sometimes necessary operation. What do you need to know about the consequences?

When deciding on such an operation, you should be aware that the procedure is fraught with complications. The point is not that natural difficulties arise, which are inevitable during any operation; they pass after a certain time. These include: hematomas, bruises under the eyes, difficulty breathing, impaired sense of smell, temporary asymmetry, numbness.

But problems may be unforeseen, which depend on each individual case. Such nuances are directly related to a person’s individuality, the characteristics of his body and the qualifications of the surgeon. The probability of these unforeseen changes is 30%. But these are not complications; such “unforeseen events” can easily be corrected. Problems begin when there are obvious complications.

What could be the reason for this?

• Violation of training rules and behavior during the recovery period,
• Individual characteristics of a person.

The final result becomes known only after a year, sometimes a little later. No doctor can predict it for sure.

This video will tell you about the sad consequences of rhinoplasty:

Complications after rhinoplasty

Complications after rhinoplasty can be classified as:

• Aesthetic,
• Functional,
• Psychological.

The last point stands somewhat apart; it follows from the previous two. However, sometimes it is singled out especially since it can occur in a complex form, which depends on the level of the main complication and the psyche of each individual person. Likewise, functional complications can leave their mark on point 1 (aesthetic), since all functional disorders also have external manifestations.

Consequences of rhinoplasty

Frequency of occurrence

Complications arise throughout the operating room and. They can be divided into 4 time periods:

• Directly during surgery, most often there is severe blood loss,
• Immediately after the operation,
• During the recovery period,
• At the end of the rehabilitation period.

In addition to bleeding, complications include rough scars, adhesions, damage to bone tissue, airway obstruction, bruises, etc.

Expected and inevitable complications disappear after 2 weeks. The danger comes from “unexpected” complications:

• infection,
• Tissue necrosis (skin, cartilage, bones),
• Dehiscence of seams (easiest to eliminate).

Let's look at some complications in more detail.

Species

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Swelling after rhinoplasty is a natural phenomenon. It would be a mistake to call it a real complication. Swelling appears in the operated area and under the eyes. Immediately after the operation it is clearly visible. It subsides within about two weeks. Swelling may be present longer - up to six months. The reasons for the duration and quality of edema are strictly individual.

Callus

If during surgery a violation of bone structures is required, then the formation of a callus cannot be avoided. Her appearance is the norm. A complication is hypergrowth of bone tissue. This complication entails deformation of the nose and a violation of harmony. Sometimes, as a result of the operation, only the appearance may appear, which is not a pathology.

The formation of callus after rhinoplasty is a natural process of protecting the body from external influences. This is the process of bone tissue regeneration. First, new connective tissues appear, then thin bone fibers are formed, and finally, bone tissue completely replaces soft tissue. The surgeon's task is to prevent the intensity of this process.

Nose crooked to the side

What was the purpose of the operation? If the cause was the elimination of the curvature of the nose, then the immediate result after the operation can be pleasing; the curvature goes away. However, by the end of the rehabilitation period it may return, since nasal tissues have no “memory”. In this case, correction will be required.

But the cause of curvature can also be swelling. In this case, it is a natural complication that will disappear at a certain time. Here again individual characteristics play a role. For some it will be 2 weeks, for others it will be a month, two, three. In any case, such curvature will be the norm. We can't talk about it until a year later if the problem remains.

Nose can't breathe

Impaired nasal breathing after rhinoplasty can be caused by blockage of the nasal passages. This usually happens during the rehabilitation period. The cause of the complication is allergic or reactive rhinitis. This requires drug treatment. Surgery is only necessary if treatment is ineffective.

With delayed complications (which occur after a long time), a narrowing of the nasal passages may be observed, which also leads to difficult nasal breathing. This causes a feeling of discomfort. In this case, reconstructive surgery is required, since the cause of the complication is an increase in the amount of tissue on the inside of the nostril. It needs to be cut off.

Terrible complications after rhinoplasty are discussed in the video below:

Nose sank

This complication is called “hollow”. The cause is deformation due to a fracture of the cranial bone at the time of osteotomy, when it is not possible to center the fragments. Excessive tightness in the nose may also be the cause. Corrected only by repeated osteotomy.

Unpleasant smell

An unpleasant smell in the nose after rhinoplasty is a natural phenomenon. It is not a complication and is acceptable during the entire first year after the operation.

Temperature

After rhinoplasty, body temperature rises, which is normal. It lasts no more than 3 days. In other cases (higher temperature, prolonged period of time), you should consult your doctor.

Other complications

After the operation, the sense of smell is impaired, which is quite natural. Gradually it will return to normal. have a reddish or pink tint. Not only that, they tend to grow.

To eliminate them, you must fulfill all the surgeon’s requirements that are necessary during the recovery period:

• Treatment of sutures with the drugs prescribed by the doctor,
• For keloid scars, corticosteroids are required,
• In some cases, corrective surgery may be prescribed.

Rhinoplasty is a serious, although quite common, operation. Not only the experience of the specialist matters, but also your attitude towards the procedure. Negligence is unacceptable. You must completely trust the surgeon and fulfill all necessary requirements. Of course, the qualifications of a specialist should not be in doubt.

The consequences of the operation are described in this video review: