What is a Secondary Rhinoplasty?

Rhinoplasty is what is commonly known as a nose job. Secondary rhinoplasty is an operation performed on a nose that has already had a rhinoplasty. Occasionally the patient is not happy with the result of the first operation on his nose, or the first operation goes wrong. The patient can then opt for secondary rhinoplasty to correct any mistakes or any undesirable features left by the first procedure. A secondary rhinoplasty is also known as revision rhinoplasty.

Secondary rhinoplasties are more complex operations than primary rhinoplasties. As well as altering the structure of the nose, the surgeon must deal with any abnormalities caused by the first operation. Problems with a previous nose job can affect the skin, the soft tissue of the nose, the cartilage of the nose or the bone of the nose. Scarring also complicates the procedure. Depending on the severity of the problem, surgeons can make the nose more aesthetically pleasing or restore function lost during the first procedure.

People undergoing secondary rhinoplasty operations may need skin grafts or cartilage grafts. Implants are also commonly used to restore shape to the nose. Cartilage for the procedure may be harvested from the ear, the rib or other areas of the nose.

Surgeons use one of two approaches to operating on the nose, depending on the severity of the problem. The endonasal technique involves work being done inside the nose without cutting the outside of the skin. The open technique involves the surgeon lifting the skin off the cartilage and bone of the nose.

There are several types of primary rhinoplasty problems that make secondary rhinoplasty desirable. The nose can have protrusions of bone or cartilage that are not spotted until swelling goes down after the initial surgery. These protrusions can be rasped down relatively easily. Minor depressions in the nose can be filled in with cartilage grafts.

A saddle nose deformity, in which the hump of the nose is depressed because of too much removal of tissue, can be fixed with a cartilage graft or an implant. A too-flat nose can be corrected by reinforcing the internal support structure of the nose with cartilage grafts. The tip of the nose may be too big, asymmetrical, or too flat. Tip issues can be fixed through removal of excess tissue or addition of cartilage or an implant. Noses that are too short are complicated to correct, but cartilage grafts can be used to extend the nose if the existing skin is not too scarred to adapt to the longer structure.