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Revision Rhinoplasty - Corrective Nose Surgery at Silkwood Medical in Sydney

Dr. Warwick Nettle specialises in facial rejuvenation surgery and nose surgery and is one of the most experienced rhinoplasty surgeons in Australia. He frequently performs primary rhinoplasty and revision rhinoplasty at his Sydney practice and is often referred the most difficult cases to fix.  With strong training in ear, nose and throat (ENT) surgery and plastic and reconstructive surgery, Dr. Nettle is highly qualified to perform both primary and revision rhinoplasty.

Dr. Nettle trained in nose surgery in the USA with some of the most respected nose surgeons including Dr. Nicholas Tabbal, Dr. Jack Gunter, Dr. Sherrell Aston and Dr. Dean Toriumi.  Plus Dr. Nettle regularly visits leading surgeons in the USA to update techniques and share knowledge about rhinoplasty.

After extensive experience in revision rhinoplasty, Dr. Nettle is aware of the disappointment patients feel when primary rhinoplasty is unsuccessful and revision is necessary.  After rhinoplasty surgery, the need for revision occurs in approximately five to 10 percent of cases of primary nose surgery.  This is mainly because a few millimetres of difference on the nose can make a large aesthetic difference.  Closed rhinoplasty, as opposed to open rhinoplasty, generally has a higher incidence of negative results and the need for revision. In complicated cases of closed rhinoplasty, it may be difficult to properly view the underlying nasal bones and cartilages.  With most open rhinoplasty surgery, this is not the case.

Revision Rhinoplasty Procedure

Most revision rhinoplasty is performed by an open approach.  This involves a small incision on the columella (the skin on the central under-surface of the nose) that joins with incisions on the inside to allow the skin to be lifted off of the underlying cartilage and bone.  This allows complete vision of the underlying structural problems and scar tissue.

In almost all cases of revision rhinoplasty, extra material is needed for reconstructing elements that have been removed too aggressively or are not in the right place.  Extra cartilage may be taken from the septum (the midline cartilage of the inside of the nose) or if this is not available, cartilage may be removed from the ear.  This does not leave a visible defect on the ear as it is approached from behind.  Occasionally implants are used and these implants may be silicone, MEDPOR® or in unusual situations, GORE-TEX®, however Dr. Nettle prefers to use your own biologic material for nose surgery unless this is simply unavailable.  Temporalis fascia, which is a membrane overlying the temporalis muscle in the temple, is sometimes used as an overlay or to help build up areas of the nose as it is soft, pliable and easily obtained without any visible sign or functional deficit.

Packing is rarely needed for revision rhinoplasty but as with primary rhinoplasty, it may be used on rare occasions.  This should be fully discussed with you before your nose surgery.  After surgery, a thermoplastic (fibreglass) nasal splint is used and kept in position for approximately five to six days.  This is removed at the same time as the stitches on the under-surface of the nose.

Recovery from Revision Nose Surgery

Revision rhinoplasty has a similar recovery to primary nose surgery. The nasal splint and sutures are removed after five or six days, and you should generally be able to return to work after approximately 10 days.  Usually, the most obvious sign of nose surgery is bruising around the eyes, but in many revision rhinoplasties the nose does not need to be broken and therefore bruising is relatively minor.  It may take a few months before swelling subsides and breathing is at its maximum.

After revision rhinoplasty, it may take three to six months for the new shape of your nose to slowly emerge.  It actually takes approximately one and one half years for the final shape to be determined. Although relatively uncommon, even revisions of previous nose surgery sometimes need touch-ups to ensure the best possible result.

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Frequently Asked Questions

I am unhappy with my new nose after surgery. What can I do?

If you are unhappy with your new nose, the first step is to schedule a consultation at Silkwood Medical in Sydney to discuss further nose surgery. At your revision rhinoplasty consultation, we will discuss your medical history and evaluate your nose to determine what can be done. Rhinoplasty often involves modifying or removing parts of the natural cartilage, and certain goals may be unrealistic because they would compromise the structure of the nose. Each case is unique, and should be evaluated individually by Dr. Nettle.

What is revision rhinoplasty?

Revision rhinoplasty is nose surgery to correct problems with an unsatisfactory procedure. Though the majority of primary rhinoplasty procedures do not require revision, you may be unhappy with your nose after surgery. The main reason this happens is because small physical changes on the nose can make a large aesthetic difference.  A few millimetres of difference in the nose is much more significant than in other areas of the face. Revision rhinoplasty makes these fine adjustments possible.

How soon after my initial nose surgery can I undergo revision rhinoplasty?

After rhinoplasty, it is important to be patient. If you are dissatisfied with your nose a few months into recovery, it is important to remember that it can take many months, and sometimes more than a year, for all swelling to disappear and the final shape to be revealed. A new surgery should not be performed until you have fully recovered from the original procedure. The amount of time required will differ from patient to patient, and anyone interested in revision rhinoplasty should be evaluated individually.

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Schedule a Revision Rhinoplasty Appointment Today

The nose is extraordinarily important from a psychological, breathing, and self-identity point of view. Dr. Warwick Nettle at Silkwood Medical in Sydney has extensive training in revision rhinoplasty nose surgery procedures to help patients achieve facial harmony. Please contact Silkwood Medical to schedule an initial consultation at our practice. We also offer male rhinoplasty surgery to address the specific cosmetic needs of men.