Revision rhinoplasty is performed for the patients who have already undergone rhinoplasty but are not satisfied with the aesthetic and functional results though one year has passed after the surgery. During revision rhinoplasty, if available, breathing problems as well as the shape of the nose are corrected.
EVALUATION AND CONSULTATION PRIOR TO REVISION RHINOPLASTY
Patients of revision rhinoplasty are the patients who have already been disappointed once. All details concerning the correction surgery and to which extend the deformations can be corrected, should be shared in a realistic way. The result of the revision which the surgeon can achieve and the expectations prior to the surgery should match each other in order not to cause disappointment again.
Prior to revision rhinoplasty, the intranasal structures as well as the background of the deformation should be analyzed very carefully. For this reason, the intranasal structures and external structures are evaluated in detail. If necessary, computer tomography can be done in order to evaluate the bones and the cartilage in a better way.
If the nose is looked through, there can be typical deformities, which need revision. Such deformities are pinch nose, inverted v-deformity, saddle nose, aquiline nose and the rocker deformity. Every deformity needs a different surgical correction technique. The reasons and the solution processes for the occurred deformity are discussed in detail. The revision rhinoplasty is technically much more difficult compared to the first surgery. After the first surgery, there are deformities concerning the form and the thickness of bones and cartilages. The soft tissue is covered with scars, which heals more difficult. The natural anatomic structures are damaged. During these operations, an extra careful surgery must be applied.
SCHEDULING THE REVISION RHINOPLASTY
After rhinoplasty, the final results can be seen after 1 year. After 1 year, it cannot be expected that great changes will occur on the nose. The revision surgery can be done after one year when the tissues have healed completely.
STAYING AT HOSPITAL AFTER RHINOPLASTY
Your blood tests are done one or several days prior to the surgery. Our anesthesiologist checks your blood tests by examining prior to the surgery and informs you. It is sufficient to come to your reserved hospital room one hour prior to the surgery. In order to control your excitement prior to the operation, you can be given tranquilizer during the preparation phase. The surgery takes approximately 3 -4 hours. Sometimes it can be shorter and sometimes longer. During the surgery, the time is not restrictive. The surgery continues until the planned result is achieved.
According to the surgical procedure performed during the operation, you could stay one night at the hospital or if a smaller revision has been done, you can be released from the hospital in the same day.
FREQUENTLY ASKED QUESTIONS
WHICH TECHNIQUES ARE USED FOR REVISION SURGERIES?
For the revision surgeries, it can be chosen between the open and closed method according to the state of the deformity. If the cartilage on the nose tip is not deformed too much, I prefer the closed method without opening the nose skin again. When the cartilage on the nose tip is too much deformed and the cartilage structures must be shaped once again, then I prefer the open method.
If the septum cartilage has been removed during the first surgery and the cartilage for the correction is needed, cartilage has to be taken either from the ear or the ribs. The cartilage grafts, which are removed from the ear, do not leave behind any scars and does not cause any deformity. The cartilage grafts, which are removed from the rib, from a 3 cm cut under the breast line without causing any deformities.
THE PREFERRED ANAESTHESIA FOR REVISION SURGERIES
For smaller revisions, local anaesthesia together with sedative agents which forms a sleepy state with an open consciousness can be given. However in general, for revision surgeries general anaesthesia is preferred in order to ensure a bloodless surgery by controlling the blood pressure and also because the surgery takes longer.
THE POST-SURGICAL RECOVERY PERIOD
After the surgery, our nurses will explain to you in detail how you will perform your nose care at home and how you will take your medication. In the first 2-3 days, the edema control is very important. After this, the edema will regress very fast. In the first 2 days, we apply cold compressions on the forehead and cheeks. You should avoid bending etc. in order not to increase the blood pressure in the head. Sleeping in half-upright position or with 2-3 pillows in the first days will cause less edema. You can take short, lukewarm showers. The splint on your nose will not be affected due to short contact with water. Even immediately after the surgery, you can breathe very easily through your nose. On the 2nd or 3rd day, a control examination is done. If a silicon splint has been inserted, it will be removed. The inta nasal region is cleaned und the airway is controlled. Between the 7th and 10th days, the adhesive plaster and the splint on the nose are removed
WHAT SHOULD BE PAID ATTENTION AFTER THE SURGERY?
The patient should be careful about traumas, which the nose could experience after rhinoplasty. The nasal bones regain their stability approximately in 6 weeks. During this period of time, it is more appropriate not to wear any items like glasses which could constitute weight on the nose. You can wear contact lenses. If no bruise occurred, you can go to the sun. After 3 weeks, you can swim in sea. As soon as the splint is removed after revision surgeries, massage or new adhesive plasters might be necessary for a couple of days. Compared to the first surgeries, it will take more time until the swellings diminish.