Reoperation of the nose
Why reoperate on the nose?
It is done when the outcome of the previous rhinoplasty turns out to be unsatisfactory.
Generally speaking, it is best to reoperate 6 months after the previous surgery to allow the overall tissue to become softer. However, in the case of a simple nasal dorsum augmentation, then a reoperation is possible after 3 months. If inflamed, the implant should be removed and the inflammation should be dealt with first, before reoperating.
Tissue damage will be greater than the first operation, which requires much caution. Furthermore, excessive correction can lead to another reoperation. Therefore, it is necessary to consider the natural shape of the nose that is just right for each individual.
Scenarios where reoperation is necessary
1. Movement of graft
When the graft inserted to raise the dorsum of the nose does not stay in the centre and moves to one side or upwards, the nose appears bent and awkward.
Method of operation
The current graft is removed, and is replaced with another graft of the appropriate curvature and shape. The surgeon must also operate on the erroneous space where the initial graft was located.
2. Contracture
Contracture occurs when the site of initial rhinoplasty is infected and is not appropriately treated. Scarring occurs on the inside, and the nose hardens and contracts. If left untreated, the nose may shorten and stiffen.
Method of operation
First, the initial graft that caused the inflammation is removed, and an autologous tissue that is resistant to inflammation (dermis, fat, chest cartilage) or a new graft is used. The tip of the nose is often highly elevated, and therefore the tip of the nose must also be operated on using autologous nasal septal cartilage or chest cartilage.
3. Deformation of the tip of the nose due to L-shaped silicone
When the L-shaped silicone is located all the way up to the tip of the nose, pressure is exerted on the cartilage, and the skin reddens and becomes thinner. This results in the silicone becoming visible through the skin, and if severe may even protrude.
Method of operation
The L-shaped silicone is removed and an implant is inserted into the dorsum of the nose. The tip of the nose is repaired using autologous cartilage. The area where the skin is damaged is reinforced using skin graft or alloderm, since it may exacerbate if left untreated.
4. Inappropriately planned operation
If, without considering the overall balance, the glabella is excessively augmented, the tip of the nose is made too sharp, or the nose becomes too large relative to the face, etc. due to inappropriate planning, patients often go through reoperation due to unsatisfactory results.
Method of operation
During reoperation, precise design is crucial. The graft on the dorsum of the nose may be lowered, the starting point of the graft may be lowered, or the height of the tip of the nose may be appropriately modified. The possibilities are endless. The key is to plan the operation well.
5. Paraffin injections
Unlike Gore-Tex or solid silicone, liquid silicone, paraffin or Vaseline injections into the nose invade into the tissues, harden the skin, and move elsewhere to create a red and uneven nose.
Method of operation
Despite the difficulty of the operation, the inflammation caused by the paraffin, etc. must be completely removed before doing anything else.
Key information
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Duration: 1 hr - 1 hr 30 mins
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Anaesthetics: local anaesthetics
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Suture removal: 5 days after surgery
Caution
Common post-operational complications, such as bleeding, infection, inflammation, etc. may occur. This varies by individual, and patients are advised exercise caution before and after surgery.
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Ice pack massaging after surgery should be done immediately after surgery until swelling subsides.
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Do not drink alcohol or smoke for 3-4 weeks after surgery.
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Public baths and saunas should be avoided for about 3 weeks after surgery.
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Refrain from touching the operation site for a month after surgery. (You can wear glasses from one month after surgery.)