Understanding the Types of Cases Requiring Revision Rhinoplasty

The nose is located at the center of our face and, as such, significantly influences our overall facial impression.

If you have a complex about the shape of your nose, you might consider plastic surgery at some point and look at many cases. Seeing how even a slight change in shape can bring about a big transformation,

you might feel inspired to try plastic surgery yourself.

Nose surgery is a method to improve noses with various unflattering names, such as ‘pig nose’ or ‘hump nose.’

It involves inserting an implant into a low nose to make it prominent, correcting a deviated shape, or reducing wide nostrils,

thereby creating a beautiful line through correction.

While even a slight change can alter one's image, the nose is made of cartilage, not bone,

and contains small, delicate blood vessels. Therefore, if done incorrectly, there is ample room for problems to arise,

such as side effects, or dissatisfaction leading to revision rhinoplasty because the surgery was performed without considering the proportions with the forehead and lower face, or the overall harmony with the facial features.

The ideal nasal angle, when viewed from the side, should be approximately 95-105 degrees between the philtrum and the columella, and the angle between the forehead and the nasal bridge should be approximately 115-135 degrees.

If the angle between the nose and forehead falls below approximately 115 degrees, the area around the eyes may appear sunken,

and the forehead might seem to protrude. If it's above 135 degrees, the forehead may appear flat, making the nose look low,

and the face may lack dimension. Let's explore the types of cases that require revision rhinoplasty.

First, there are cases where the nasal bridge or tip is crooked. If approached only through a non-open technique from one side, the implant

may shift inward. It is crucial to create a new space to prevent the previously created pocket from being biased to one side.

Furthermore, not only implants but also structural elements like cartilage can be affected by a crooked implant and settle in a deviated position, requiring careful correction through revision rhinoplasty.

Next are cases of an upturned nose. For individuals with a naturally short or upturned nose,

lengthening can be achieved with septal extension graft. A contracted nose is a phenomenon where the nose shortens and turns up due to inflammation. This is a difficult case, requiring complete removal of the capsule caused by inflammation, sufficient skin dissection to secure the skin, and lengthening using cartilage that can act as a support.

Afterward, autologous cartilage, such as ear cartilage, septal cartilage, or costal cartilage, is needed for revision rhinoplasty to prevent the lengthened nose from rising again.

The next type of revision rhinoplasty is for a low or high nasal bridge. If the nasal bridge is too low or excessively high,

or if a hump nose remains where the middle of the nasal ridge appears raised, the hump part can be further shaved down or

corrected with an implant suitable for the nasal bridge. Next are cases where the nasal tip droops and appears long.

If the nasal tip support is low, ear cartilage can be used to raise the tip. In cases where it is very low,

the basic structure must be rebuilt and the tip framework strengthened to prevent it from drooping.

Next are cases where the nasal tip is crooked and the nostrils are asymmetrical.

If the tip is excessively raised, the columella may lean in one direction and the nostrils may become asymmetrical.

If the septum is leaning to one side, it should be corrected. If the alar cartilage is also deviated, it should be dissected and

repositioned through revision rhinoplasty. Next are cases where problems have arisen due to implants.

Many places use silicone. However, unlike autologous tissues such as cartilage or dermis,

implants are artificial chemical substances, and thus your skin tissue recognizes the implant as a foreign body,

which can lead to a foreign body reaction. In such cases, there may be no initial problems, but gradually over time,

the surface may become red, silicone may show through, or contracture with inflammation may occur, necessitating revision rhinoplasty.

Since each individual has different bone thickness, skin elasticity, and cartilage fat layers, considering the overall facial harmony and

proportions to naturally raise the height of the nasal bridge and design the height and shape of the nasal tip and nostrils to match the bridge height is essential to create an ideal form. Revision surgery is generally best performed approximately 6 months after the initial surgery.

This is because it is desirable to perform the surgery after the overall tissues have recovered, softened, and stabilized.

However, if inflammation occurs, we recommend controlling the inflammation first, such as by removing the implant inserted into the nose,

and then considering revision rhinoplasty once the symptoms subside.

Most importantly, the appropriate timing can vary depending on the tissue condition, surgical situation, and degree of recovery, so it is advisable to adjust the timing through consultation and examination with an experienced specialist. Revision rhinoplasty is more difficult and complex than the initial surgery, as changes in shape may occur differently from before, and each person may have different problems. Therefore, the skill of the revision rhinoplasty medical team is crucial.

Just as individuals have preferred face shapes, people also envision a desired look when undergoing plastic surgery.

However, if revision rhinoplasty fails to enhance one's individuality,

it may not look natural, leading to low satisfaction.

Therefore, at our clinic, detailed examinations are conducted to enhance your strengths and unique features, ensuring a natural and attractive outcome. Each person has a unique impression,

and even faces that are considered similar can evoke different feelings.

Since everyone's thoughts and standards regarding appearance are different, and their desired improvements vary,

it is advisable to meticulously examine the individual's perceived deficiencies and desired aspects to provide care for a satisfactory revision rhinoplasty. Our dedicated specialists, with extensive clinical experience and accumulated know-how, will do their best to ensure you are satisfied with a natural transformation.

** Please be informed that this post is a promotional post written by Diva Plastic Surgery in compliance with the Medical Advertising Act. **

Frequently Asked Questions

What types of cases require revision rhinoplasty?

Various types of cases require revision rhinoplasty. These include a crooked nasal bridge or tip, an upturned nose, a low or excessively high nasal bridge, a drooping or elongated nasal tip, a crooked nasal tip with asymmetrical nostrils, and problems arising from implants.

When is the most appropriate time for revision rhinoplasty?

Generally, it is best to perform revision surgery approximately 6 months after the initial surgery. This is because it is desirable to proceed when the overall tissues have recovered, softened, and stabilized. However, if inflammation has occurred, revision surgery should be considered after controlling the inflammation and once symptoms have subsided.

What is a contracted nose and how is it corrected?

A contracted nose refers to the phenomenon where the nose shortens and turns up due to inflammation. The capsule caused by inflammation is completely removed, the skin is sufficiently dissected and secured, and then cartilage that can act as a support is used to extend the length. Afterward, autologous cartilage may be needed to prevent the lengthened nose from rising again.

What should be done if problems arise due to implants?

If problems arise due to implants, revision rhinoplasty is necessary. Artificial implants can be recognized as foreign bodies, leading to redness on the surface, visible silicone, or contracture accompanied by inflammation. In such cases, inflammation control, including implant removal, should be performed first, and then revision surgery should be considered.

What are the ideal angles for the nose?

The ideal nasal angles, when viewed from the side, should be approximately 95-105 degrees between the philtrum and the columella, and approximately 115-135 degrees between the forehead and the nasal bridge. If these angles deviate, the area around the eyes may appear sunken, or the nose may look low, resulting in a face that lacks dimension.

Is autologous cartilage always necessary for revision rhinoplasty?

Yes, it may be necessary. Especially in cases of a contracted nose that is upturned, it is mentioned that using autologous cartilage, such as ear cartilage, septal cartilage, or costal cartilage, is important to support the lengthened nose and prevent it from rising again. The necessity and type of cartilage may vary depending on the individual's condition.