Revision Rhinoplasty

Revision Rhinoplasty

Revision rhinoplasty is always a big decision that tends to carry a fair amount of emotion. The disappointment from the first procedure is very tough for some. As a revision rhinoplasty specialist, Dr. Michelle Cabret-Carlotti spends a tremendous amount of time with the patient discussing their goals and examining the nose both clinically and at times with various imaging technology.

As Wikipedia nicely explains, Rhinoplasty (Greek: ῥίς rhis, nose + πλάσσειν plassein, to shape), a nose job, is a plastic surgery procedure for correcting and reconstructing the form, restoring the functions, and aesthetically enhancing the nose, by resolving nasal trauma (blunt, penetrating, blast), congenital defect, respiratory impediment, and a failed primary rhinoplasty.

In the surgeries — closed rhinoplasty and open rhinoplasty — an otolaryngologist (ear, nose, and throat specialist), a maxillofacial surgeon (jaw, face, and neck specialist), or a plastic surgeon, creates a functional, aesthetic, and facially proportionate nose by separating the nasal skin and the soft tissues from the osseo-cartilaginous nasal framework, correcting them as required for form and function, suturing the incisions, and applying either a package or a stent, or both, to immobilize the corrected nose to ensure the proper healing of the surgical incision.

The non-surgical rhinoplasty procedure corrects and modifies slight defects of the nose by means of subcutaneous injections of biologically inert fillers; the results tend to be relatively transitory, in comparison with the results of nose surgery.

In an effort to functionally and aesthetically enhance the nose, various steps can be taken. The below example is of a woman that had suffered trauma as a young adult but while addressing that trauma desired the otolaryngologist/ Facial Plastic Surgeon to also reduce the dorsal hump of the nose in her primary rhinoplasty.

The functional aspect of that surgery was reasonably successful but the dorsal hump was clearly under-reduced and hence deemed a failed primary rhinoplasty, particularly because the patient desired a smaller, swooping affect to the dorsal or bridge region. Years later, the patient suffered a second trauma hitting a glass door causing a left-sided depressed nasal bone fracture and a soft tissue scarring of the skin just above the tip of the nose.

After careful consultation with Michelle Cabret-Carlotti, MD, DDS, a double doctorate board certified (ABOMS) Maxillofacial, Reconstructive, and Cosmetic surgeon, this patient opted to move forward with a revision rhinoplasty that included osteotomies (bone cuts/breaking the nasal bones to narrow them), tip refining, and a more aesthetic reduction of the dorsal region.

The scar tissue in the skin just above the tip will be addressed with a CO2 laser resurfacing procedure at a later date as Dr. Michelle Carlotti advised that it should be delayed by a minimum of 3-6 months postoperatively.

This 40 something-year-old female underwent the revision rhinoplasty at The Carlotti Center is now and pictured at 3 months postop. Dr. Michelle Cabret-Carlotti counsels all rhinoplasty results that subtle swelling should be expected from months to up to two years.

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Posted in: Rhinoplasty

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