Revision rhinoplasty is a surgical procedure that revises or corrects a primary nose job. The revision procedure is much more complicated than the primary rhinoplasty. It requires a sophisticated understanding of the nasal structure and expert surgical technique, which the best-in-class nose plastic surgeon in New York City Dr. Linkov possesses.
City Facial Plastics, located in Manhattan, NYC, has an enormous history of performing rhinoplasty with phenomenal results. When needed, we can also repair a previous nose job through a rhinoplasty revision procedure to help our patients finally enjoy the benefits of a beautiful, functional nose.
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What Is Revision Rhinoplasty?
Secondary rhinoplasty is a surgical procedure aimed to rectify any deformities or abnormalities that occurred because of a botched primary rhinoplasty. It is a highly delicate procedure that requires a facial plastic surgeon to possess exceptional surgical skills, precision, experience, and expertise.
Prior to committing to surgery, Dr. Linkov always ensures your goals for surgery can be met. Only then can he enact the successful and natural outcomes he has always been known for. Dr. Linkov spends enough time with every patient, examining your anatomy, medical history, and the results of a primary procedure.
Patients seeking revision rhinoplasty in NYC are apprehensive. They have already undergone a complex facial procedure and have been disappointed with its outcomes. Therefore, Dr. Gary Linkov is especially attuned to the needs of these patients. His workmanlike job has attracted international intention and has made him arguably the best revision rhinoplasty surgeon not only in New York but across the United States.
What Are the Reasons for a Secondary Nose Job?
People seek out rhinoplasty surgery to improve their nose, assuming it will be the only procedure on their nose. But sometimes a person might find that the results of the rhinoplasty do not meet their cosmetic needs. They might still have breathing problems afterward, or even new breathing problems.
Often the reason for these problems is an overly reductive initial rhinoplasty that took too much supportive tissue away leaving the potential for many problems behind. People who are unhappy with the results of their first rhinoplasty will sometimes seek out rhinoplasty tip revision, either with the same surgeon or with a different surgeon.
Am I a Candidate for the Procedure?
Your health and safety are the top priorities for City Facial Plastics. Hence, your medical history will be thoroughly examined to determine if revision rhinoplasty in NYC will be safe for you.
You are the right candidate if:
- You experience breathing difficulties after the initial procedure
- You are gravely disappointed with the appearance of your nose
- It has been at least one year since your primary nose job
- Your nose structure has collapsed because of the lack of structural support
- You can meet all the medical requirements for surgery and anesthesia to be safe for you
If your initial rhinoplasty surgery did not produce the desired results, you do not have to live with it for the rest of your life. Fortunately, you have access to the service of Dr. Linkov who has the experience and competence to painstakingly correct the work of less skillful surgeons.
What Is the Recovery From Revision Rhinoplasty?
Thanks to the meticulous planning and precise surgical methods of Dr. Linkov you can expect a swift and healthy recovery. To instill confidence and relief, Manhattan revision rhinoplasty patients are normally given a frank, educational roadmap of the recovery process.
Recovery from a revision rhinoplasty can be divided into time from surgery, such as:
- First 48 hours – Oozing from the nose is possible. Wear a drip pad under the nose to catch the spots of blood. Pain is usually mild to moderate and can usually be managed without narcotics.
- 1-2 weeks – Primary swelling and most bruising resolve in the first two weeks. Splints, casts, and sutures are removed typically at one week. Nasal stuffiness slowly improves.
- 8-12 weeks – The redness of the external incision, if used, diminishes. Tip swelling improves and can be aided by steroid injections.
- 3mo – 1 yr – Tip swelling continues to improve and eventually resolves to leave you with a final revision rhinoplasty result.
Dr. Gary Linkov cares for every patient. Hence, he is always on hand to support and guide you throughout the recovery process. Only by strictly following the recommendations of your surgeon can you enjoy all the benefits the best revision rhinoplasty in New York has to offer.
Are There Any Potential Risks and Complications?
To guarantee patient safety, Dr. Gary Linkov performs every procedure under the most stringent safety protocols. Even though all the necessary precautions are taken to avert possible complications, any surgical intervention still carries a certain degree of risk. Prior to surgery, Dr. Linkov will inform you about the potential risks that can occur.
Some of the most distinguishing risks and complications of a secondary nose job include:
- Bleeding – Major bleeding is rare but oozing in the first few days after surgery is common.
- Infection – Rare if the body’s own tissues are used, but the rate increases if foreign substances are used during the procedure (other than suture).
- Poor scarring – Primarily refers to the external incision if performed. If closed in an inverted-V or stair-step fashion poor healing is rare.
- The undesirable aesthetic result – It is always possible that the patient will be unhappy with the cosmetic appearance of the revision nose job. This risk can be mitigated with careful planning and superb communication between the best revision rhinoplasty doctor and the patient.
- Upper dental numbness – Extensive dissection or cautery at the nasal spine or along the nasal base may result in temporary upper dental numbness which usually resolves in weeks to months.
- Asymmetry – The nose often has asymmetric features that rhinoplasty may fail to address.
- Bossae (tip irregularities) – With swelling the nasal tip may appear symmetric and uniform in the early months but eventually various pressures on the nasal tip can result in certain tip irregularities and prominences.
- Overrotated tip – Failure to control the rotation of the tip will result in a “piggy” appearance with an increased nostril show from a frontal view.
- Alar retraction – Nasal tip maneuvers need to be balanced or else alar retraction can occur which is most visible from a profile view.
- Septal perforation – This can occur from the septoplasty portion of the procedure if there is an improper dissection of the tissue around the septal cartilage.
- Saddle nose (bridge collapse) – Overaggressive removal of septal cartilage can result in the bridge collapsing in.
- Pollybeak – This can result from an under-resection of cartilage or from a droopy tip.
- Nasal valve collapse – Both the internal and external nasal valves which are critical for proper nasal airflow need to be well supported to avoid collapse and airflow obstruction.
- Inverted -V deformity – If the midvault of the nose, or the middle third, is collapsed, the nasal bones can become more prominent, giving the appearance of an upside-down V. This is usually from lack of support in the middle third of the nose and a reduction of the nasal bones.
- Deviated nose – The nose may appear straight in the early period of healing but can sometimes deviate over time since cartilage tends to have “memory” and may try to return to its original shape.
- Rocker deformity – Inaccurate bony osteotomies (cuts) may lead to the upper part of the nose still appearing wide.
- Open roof deformity – If a nasal hump is removed additional grafts or bony cuts need to be made “to close the roof” and limit the chance of the bridge of the nose appearing “open” with visible shadows of underlying structures.
- Dorsal irregularities – As bone and cartilage are manipulated at the bridge, edges and contours must be smoothed or else they may show through, especially in thin-skinned individuals.
- Damaged skin – Each time the nasal skin and soft tissue are dissected off of the underlying structures, blood supply may be altered and result in changes to the skin integrity.
Dr. Linkov always encourages his patients to voice their deepest concerns and questions prior to surgery. Rhinoplasty revision surgery is a highly delicate procedure that requires strong cooperation between a patient and a surgeon.
Why Should I Choose Dr. Linkov to Perform My Secondary Nose Job?
Choosing the right surgeon has always been of the utmost importance. Given the complex 3-dimensional anatomy of the nose and the psychological effect this procedure has on a patient, revision rhinoplasty is deemed one of the most challenging surgeries a facial plastic surgeon performs. Dr. Linkov is an ideal specialist who can address all the abnormalities that could arise as a result of a poorly-performed primary rhinoplasty.
Dr. Linkov is proud to be among the leading NYC revision rhinoplasty surgeons who has extensive experience treating all conditions of the nose. He is the Chief of Otolaryngology and Facial Plastic Surgery for the Veterans Hospital in Brooklyn, NY, where he operates on complex nasal deformities on our country’s veterans.
Dr. Linkov’s private practice in Manhattan’s Upper East Side focuses on cosmetic and functional rhinoplasty. Are you still doubting? You can view before and after photos of Dr. Linkov’s patients below.
Revision Rhinoplasty Before and After
Frequently Asked Questions
What Are the Common Rhinoplasty Problems?
A successful nose job should look natural and blend with the rest of the facial features. When rhinoplasty is overdone, poor techniques are used or healing does not go as planned, the results are often noticeable.
Some of the common complaints from poor nose job recipients include:
- A pinched appearance
- Collapsed or saddle nose
- Upturned or twisted nose tip
- Bumpy, deviated, or twisted bridge
- Nasal valve collapse
When Should I Undergo a Secondary Nose Job?
After your primary rhinoplasty, it is best to wait a full year before planning for revision rhinoplasty. Sometimes a decision can be made a few months earlier, such as at 10 months, but that is on a case by case basis. The reason to wait this long before having a tip revision rhinoplasty is that the swelling, especially at the nasal tip, can take many months to improve.
Surgery done too soon may be unnecessary. Also, it is best to allow the tissue to heal before retraumatizing it and tissue planes may be more difficult to find and dissect if revision surgery is done sooner. Board-certified plastic surgeon in Midtown, Manhattan Dr.Linkov will walk you through the most appropriate timing for your procedure.
Is Revision Rhinoplasty Worth It?
Whether a revision nose is worth the added downtime, risk, and expense depends on many factors. The revision rhinoplasty specialist should be able to explain to you what may have gone wrong during the first surgery and have a concrete plan on how to fix these issues. The patient, on the other hand, needs to have a specific idea of what they want to have corrected and understand the challenges of, and the extended recovery for, a revision rhinoplasty.
Is Revision Rhinoplasty in NYC Free?
There are two scenarios to consider. The first is that a surgeon performs rhinoplasty and the patient is unhappy with the result. If that surgeon and patient decide to pursue a revision rhinoplasty then they must decide the cost. Often, for these types of cases, the surgeon’s fee is waived but anesthesia and facility costs may apply.
Another factor to consider for the first scenario is how long after the primary rhinoplasty is the revision requested. If a patient returns after five years requesting a revision nose job it may be a different financial situation compared to stating disappointment and requesting a revision after a few months.
The second scenario is if a patient, who has previously had a rhinoplasty elsewhere, comes to a surgeon seeking a revision procedure (secondary rhinoplasty). Often, in this scenario, the surgery will cost more than primary rhinoplasty because of the complexities described above. Keep in mind that every surgeon approaches his or her own revision rhinoplasty fees differently.
While rhinoplasty revision is complicated, Dr. Linkov, as a top-rated facial plastic surgeon in New York, has the experience and skills to help patients who are unhappy with their previous nose job results. If you want to explore rhinoplasty revision, contact City Facial Plastics in UES, Manhattan to schedule an appointment with Dr. Linkov.