Unfortunately there are a number of reasons for why rhinoplasty can fail. These can include failure to follow the instructions of the patient as well as incompetency technically on the part of the surgeon. What results can be an unholy apparition where the person’s nose is out of alignment or contour. This can take an average person’s facial appearance and make it into something decidedly unnatural which causes emotional pain and embarrassment.
Worse than this, a failed nose surgery can cause a real deformity of the nasal cavities and passages that negatively impacts the function of the person’s nose. Disappointment and anger are natural reactions to problems like these, along with bitter regret for have opting to have the surgery in the first place. In the end, many disappointed rhinoplasty patients will look for a reliable and dependable surgeon who can fix the damage and rebuild the horribly misshapen nose.
Repairing Unnatural Damages from a Previous Rhinoplasty Is Possible
It requires a high degree of medical, technical, and artistic skills to fix a surgically ruined nose. In fact the challenge is far more difficult than the original surgery should have been. There are several reasons for this. Delicate, thin components of the shape have to be recreated in a three dimensional picture. Twisted, collapsed, and shredded remains must be worked over into the new and improved shape.
Every fabricated section will need a true mirror image to mimic the opposite part. The final product has to be correctly and optimally aligned in such a way that the nose looks straight to the casual observer. Joints and seams have to be invisible after the surgery heals. The whole nose structure needs to be correctly proportioned so that it appropriately fits in with the rest of the person’s face. Not only does the outer appearance have to look nice and be smooth. The interior air passages have to be sufficient in size so that a comfortable quantity of airflow is permitted.
Differences Between First Time and Revision Rhinoplasty
The revision form of rhinoplasty requires a great deal more surgery time. This surgery is far more complex and easily needs a minimum of four to five hours of operative time. The recovery period turns out to be far longer as well, thanks to pre-existing damage to tissue and the longer surgery time. Those patients who possess healthy but thin skin could need a full six to twelve months to see complete results and healing. It could even take two years for optimal recovery and results to appear for those who possess thicker skin that is more prone to scarring.
Revision rhinoplasty also needs something besides merely extended treatment and recovery times. It practically always needs graft material for the surgery to be successful. This living material it wants comes from cartilage that the surgeon will have to harvest from somewhere else in the patient’s body. This is then applied to replacing the damaged nose tissue. The human organism only possesses three ample supplies of extra cartilage. This is why the results with the grafted cartilage will range widely from one patient to another.
The three types of cartilage employed for this revision rhinoplasty are from the septum, the ear, or the ribs. The best source is always from the septum because it is straight and comes from the nose itself. Next best choices are the ear and rib cartilage.
Cartilage from the Nasal Septum (Septal)
This cartilage comes from the dividing barrier which differentiates between the left and right nasal passages. The septum proves to be approximately the dimensions of a credit card. The cartilage beyond the outer perimeter of the septum is safely removable for grafting purposes in nose reconstruction.
There are so many benefits that septal cartilage offers surgeons. The only downside to it is that the excess supply of the material is highly limited. A great number of patients may not be able to take advantage of this excellent source of spare cartilage. Those suffering from prior septoplasties, intense septal deviation, or septal cartilage that has been damaged in the past will simply lack an excess supply with which to reconstruct a nose that was badly damaged in the prior surgery.
Cartilage of the Ear (Conchal)
Within the external ear is a bowl-shaped part that is on the other side of the ear canal. This conchal bowl may be harvested via a tiny incision hidden behind the postauricular crease. For most people, the cartilage a size of a quarter can be taken out without changing the look of the outer ear.
The downside to this ear cartilage is that it is curled, thick, and likely to crack under shaping or stress. It does resist infection effectively as well as resorption and warping. Yet the thickness, unworkable shape, and limited amount cause it to be less than optimal as nose grafting material. Yet there are scenarios when the cartilage from an ear can be effectively deployed to improve a nose surgery gone bad.
Cartilage of the Rib (Costal)
Most people think of the rib cage as primarily built out of bone. Yet in the places next to the breast bone (sternum), the ribs are comprised entirely of cartilage. Every person’s ultimate shape, strength, and thickness of the cartilage varies considerably. .Yet obtaining a length of cartilage that is two to three inches long is possible for aiding with nasal surgery reconstruction.
The upside is that this material is often widely available in sufficient quantities. Getting to it is difficult, takes time, and can be dangerous. Besides this, the cartilage from one’s nose has a tendency to be too brittle and weak when the surgeon thins it to the necessary thickness for the nose surgery. It often warps or curls up in only the months, weeks, or even days after surgery too.
This means that noses which a surgeon reconstructs using rib cartilage can be bulky or bigger than desired so that the thin grafting is not necessary in the procedure. This works for men who want a strong nose, but not well for those looking for delicate and shapely noses as these will all too easily warp. Yet for those whose nose jobs were badly botched, using cartilage from the rib can many times prove to be the only practical means of treating the issue.
If you’re thinking of undergoing a rhinoplasty or a revision rhinoplasty in the Beverly Hills area, you may look for or contact Dr. Andrew Frankel. Dr. Frankel is a board certified surgeon in Facial Plastic and Reconstructive Surgery & Otolaryngology-Head and Neck Surgery. Dr. Frankel performs a wide variety of facial & neck area procedures.
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