People seek a revision rhinoplasty for a variety of reasons. In my practice, there are 2 main reasons people come for a revision rhinoplasty consultation.

The top reason is that they have an aesthetic or cosmetic concern from their previous rhinoplasty. The nose is the focal point of the face and one of the first things that someone looks at when first meeting someone or looks at themselves in the mirror. Because of this, it should be no surprise that individuals notice certain irregularities and shadows that they may consider unsatisfactory. In many instances, a revision rhinoplasty can provide a refinement to these areas and improve the overall proportions and harmony that the nose has with the rest of the face.

Secondly, many will also present with the inability to breathe through their nose. This for me is much more of a problem because when someone’s breathing is affected, it becomes a persistent nuisance that cannot be fixed with medications. The main reason this happens is that many of the elements that provide structure to the nose have been over-resected. This frequently leads to breathing problems because much of the support has been altered.

Part of the treatment involves re-creating the structure of the nose to restore the integrity and function for improved breathing. This involves using cartilage grafts to rebuild the structure of the nose to give a new, aesthetic shape. This helps to withstand the inevitable contraction of the nasal skin that can occur over the course of many years. There is typically a paucity of nasal septal cartilage to use in cases of revision rhinoplasty. Because of this, cartilage needs to be obtained from either the ear or costal rib cartilage. The type of cartilage that is needed will depend on the deformity that needs to be corrected.

Regardless of the reason, I know that this can be an emotional time filled with anxiety and hesitation. The consultation takes as long as you need to feel comfortable and have all of your questions answered.

During the initial consultation, I use this time to really understand your motivation and expectations for a revision rhinoplasty. It is an opportunity to develop a mutual level of trust and understanding. A detailed physical examination is performed to determine the areas that will require correction in the nose to provide the best result and includes going over a thorough list of expectations and risks that are involved in surgery.

In my experience, the use of computer imaging is essential to provide a realistic potential outcome for the patients individual anatomy and expectations. I exclusively use the VECTRA 3D imaging system to create a realistic outcome that is in line with your needs and desires. I also think it is extremely helpful to explain the various structures in the nose, including bone and cartilage, and how sculpting these can alter the appearance of the nose.

Dr. Michael Somenek is a facial plastic surgeon in Washington DC and performs a full range of non-surgical and surgical facial rejuvenation procedures. He has a special interest in rhinoplasty and revision rhinoplasty procedures. He also offers BOTON injections and dermal fillers like JUVEDERM. For information on any procedure, please email our office call us at 202-810-7700, to schedule your cosmetic consultation.