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
Recovery From Revision Nose Surgery
Frequently Asked Questions

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.