The second or more surgical interventions performed in cases such as anatomical problems such as bending and asymmetry in the nose that may occur after aesthetic nose surgeries, functional problems such as nasal congestion, or the visual result not being as desired are called "revision".
>The reason why rhinoplasty is among the most frequently revised surgical procedures is that the problems occurring on the nose, located in the middle of the face, are visible and noticeable.
The rate of occurrence of a problem requiring re-surgical application after aesthetic nose surgeries. Although the rates given about it vary widely, it is accepted that this rate is around 10-15%.
There are different factors that cause undesirable results or problems after the surgery, the most common of which are;
· Failure to fully determine the problems before surgery
· Not fully understanding the patient's expectations
· Mistakes made in surgical technique
· Structural features of the patient (very fine or thick skin, crooked nose, etc.)
· Problems experienced during the post-operative recovery period (trauma, infection, etc.).
Visual problems requiring revision can be divided into four different categories;
· Although there is no significant aesthetic problem, the patient's desired result is not achieved
· Minor problems: Minor irregularities on the back of the nose, slight asymmetries at the tip of the nose
· Moderate Severe problems: Asymmetry and irregularities that negatively affect nasal breathing
· Major problems: Severe asymmetries and deformities that can negatively affect nasal breathing along with loss or deterioration in cartilage or bone structures.
Nose. After the plastic surgery, the completion of the healing process and the final shape of the nose are included in the surgical intervention. Although it is accepted that it takes between 6 months and 1 year depending on the type of treatment, it may take even longer for the changes in the nasal skin to result. For this reason, it is generally recommended to wait at least one or one and a half years before performing a second surgery.
The biggest factor that plays a decisive role in the timing of revision surgery is the cause and content of the problem requiring revision.
In cases of mild irregularities, asymmetrical formations, thick skin structure of the patient, or problems caused by regional accumulation of excessive healing tissue, it is generally appropriate to wait for the healing to be completed (at least 1 year) and in the meantime, if necessary, to thin the thick and edematous tissues with cortisone injections. Depending on the graft technique used, one should wait 1.5-2 years before performing a second corrective intervention for the cartilage graft used to shape the back of the nose in the first surgery. In case of major problems affecting the nose or asymmetries and deformities resulting from blows to the nose after surgery, it is preferred to perform the second surgery without waiting for the healing process.
Although there is no significant aesthetic problem, the risk of third surgery is minimized in revisions due to the patient's expectations not being met. The best approach to lowering the nose would be to wait for the healing to be completed for at least 1 year.
Revision nose surgeries, defects in the tissue planes due to the previous surgery, adhesions formed between the skin and the cartilage or bone structure, and the cartilage or bone structure. These are interventions that involve significant surgical difficulties due to damage and deformities in bone tissues.
Therefore, in order to obtain a successful result in revision surgeries, existing problems should be evaluated very well and alternative approaches such as ear and rib cartilage removal that can be applied during the surgery should be planned in advance. Necessary preparations must be made and the surgeon who will perform the surgery must have sufficient knowledge and experience for such interventions.
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Nose Tip Aesthetics in Revision Rhinoplasty
The most common reason for revision nose surgery is that the tip of the nose is not as desired. So much so that the tip of the nose completely changes the person's profile appearance and determines the shape of the face. For this reason, in case of any problem at the tip of the nose or an undesirable result in the first surgery, nose tip aesthetics is performed within the scope of revision nose surgery.
During revision nose tip aesthetics; No intervention is made on the nasal bridge or septum; work is done on the cartilage and soft tissues at the tip of the nose. While this type of surgery is generally preferred for problems with drooping nose tip, it is also applied when there is asymmetry or wideness of the nose tip and it is excessively upturned. Revision rhinoplasty takes approximately 45 minutes and is usually performed under local anesthesia. The patient can be discharged 6 hours after the surgery.
Pre-Revision Rhinoplasty Surgery Interview
Revision rhinoplasty; It is applied in cases where the first surgery was not successful. Factors that cause a rhinoplasty surgery to fail: It can be determined as the failure to plan the surgery in a qualified manner, the doctor who will perform the surgery not being experienced and equipped, and the failure to provide proper nose care during the post-operative recovery period. However, if a result that the person undergoing nose surgery does not desire occurs, the functional properties of the nose are damaged, and breathing problems begin to occur, this means that the nose aesthetic surgery ends in failure.
Before the revision nose aesthetic surgery, the patient's psychological and physiological needs It is of great importance that the patient feels ready for a new operation process. For second nose surgeries, consultation with the doctor and surgery planning should be carried out much more carefully and in detail compared to the first surgery. For this reason, in addition to choosing a doctor who is specialized and experienced in his field, it is necessary to explain the complaints and the desired nose shape to the doctor in great detail.
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