Today I would like to talk about the revision rhinoplasty (reoperation nose job). Many people are having revision rhinoplasty from JW Plastic Surgery Center Korea and there are few types who needs to have revision nose rhinoplasty or types of who would like to have revision rhinoplasty.
For the types of revsion rhinoplasty are:
1. Complications (side effect) from an implant
2. Deformated nose tip or complications (side effect)
3. Nasal bone has grown back after having “humpectomy” or “osteotomy” (lateral osteotomy and medial osteotomy)
4. Functional complications (runny nose, rhinitis after having rhinoplasty)
5. Personal dissatisfaction
Now I will explain further more about these complications as I have mentioned above
1. Complications (side effect) from an implant
- Infection
- Deviated implants (goretex, silicone, etc.,) or movable implants
- Skin redness
- Too noticeble of an implant that has been used for rhinoplasty
- Exposure of an implant
How to solve these problems?
- Infection can be controlled:
by performing of “infection control”, removal of an implant, infected skin and fat tissues control - Deviated implant or movable implants can be controlled:
by “Capsulotomy & implant mobilization” - Redness can be controlled:
by an implant wrapped with alloderm or use dermofat graft
Usually there are 4 types of exposured of an implant (Visible implant margin)
1) Wide implant.
2) Narrow implant.
3) Too pointy implant.
4) Skin thinning.
Why “Contractured nose surgery (contractured rhinoplasty)” is hard to solve?
- Scar tissue is sticked to the skin.
- Difficulty with skin stretch (skin do not stretches as much as primary case).
- There are not enough of cartilages to use (Limited cartilage that we can use).
How are we going to solve “Contractured Nose”?
- Removal of scar tissue.
- Detachment of scar tissue from the skin.
- Enough of adhesioned skin.
- Secure the enough of cartilage to be grafted.
If Case is not that bad for the revision rhinoplasty, we can perform:
1) Septal Extension Graft (extending the nose by using of septal cartilage)
2) Derotation Graft (extending the nose by using of ear cartilage)
3) Rhinoplasty by using of rib cartilage
- Shaved rib cartilage to make your tip lengthened
- Diced rib cartilage wrapped with fascia to make your tip lengthened
Autologous tissue that can be used for the nose bridge
- Temporal fascia
- Rib cartilage
- Dermofat (Skin and fat layer from your buttocks)
- Diced Cartilage