Your nose is one of the most prominent focal points of the face. It balances out the structure and anatomy of the facial bones and brings together the symmetry on the face. It is one of the first things people notice about you.

Your nose not only serves to help you breathe, but also defines your character and ethnicity, makes you look more feminine or masculine, and can change shape as you age.

Rhinoplasty is one of the most requested surgeries in cosmetic surgery, and Rhinoplasty revision is even more popular. Many patients are having revisionary surgery 2, 3, even 5 times. Why is this?

There are two main reasons that can be addressed regarding nasal surgery.

1. Breathing
2. Cosmetic

Breathing issues are one of the main reasons that patients seek nasal surgery. If the septum is deviated, or curved, it can obstruct breathing. If the turbinates are enlarged, they sometimes need to be removed in order to breathe better. If in previous surgery, the cartilage has been aggressively removed, patients can have difficulty breathing and one or both sides can collapse.

Cosmetic reasons include a hump or bump on the nose, injury to the nose, a nose that is too wide, too short, enlarged nostrils, a flat nose, scooped nose, or a nose that droops at the tip with age. Many times it is a combination of cosmetic reasons and breathing difficulty that leads a person to choose Rhinoplasty as an option.

Patients seeking Rhinoplasty as a possible solution have many avenues on the internet to do their research. It is essential that when choosing a surgeon that he or she is properly Board-Certified preferably in Facial Plastics, ENT, or Plastic and Reconstructive Surgery. Physicians trained and boarded in these areas understand the internal anatomy of the nose, and are specialists in the functionality and preservation of the actual structure of the nose as well as artistic beauty of the nose.

Many patients seek revision Rhinoplasty when after the initial surgery, the nose has “collapsed” and breathing is impaired. This may be due to the internal structure not holding up as a result of the first surgery. It is important when seeking a surgeon for revisions to make sure that revision Rhinoplasty is routinely done by the surgeon.

Others seek revision surgery because they simply are not happy with the outcome and the result is not what they envisioned. This can sometimes be alleviated with computer imaging and communicating with the surgeon. Computer imaging allows both the patient and the surgeon to verbally and physically express what final outcome is desired. It is also important to remember that swelling after rhinoplasty can last up to one year, and revision surgery should not be attempted until after the one year mark.

Open vs Closed Rhinoplasty

Both techniques are routinely done and have wonderful results. It can be the preference of the patient and /or the surgeon. Open rhinoplasty does allow the surgeon to visualize the internal structures of the nose and make corrections, especially in revisionary surgery. Closed Rhinoplasty is an option when internal problems are not as severe and one does not require a complex rebuilding of the internal structure.

It is always stressed that research be done on the surgeons that you choose, and to have more than one consultation when deciding if surgery is the choice for you. Questions to ask would be:

How many revision Rhinoplasties do you perform per week?

How many Rhinoplasties do you perform per week?

Where is the surgery done?

What kind of anesthesia will I have?

Bring pictures with you and as always, ask many questions so that you feel comfortable with your choices.

Sylvia Silvestri, R.N.