Rhinoplasty - "nose job" - is a cosmetic surgical procedure which is usually performed by either an Otolaryngologist, Maxillofacial Surgeon, or Plastic Surgeon in order to improve the function and/or the appearance (cosmetic surgery) of a person's nose. Rhinoplasty is also commonly called a "nose job". Rhinoplasty can be performed to meet aesthetic goals or for reconstructive purposes to correct birth defects or breathing problems. It can be combined with other surgical procedures such as chin augmentation to enhance the aesthetic results.
Revision rhinoplasty is a nose operation carried out to correct or revise an unsatisfactory outcome from a previous rhinoplasty. It is also known as secondary rhinoplasty or tertiary rhinoplasty. There are two main reasons for performing secondary or tertiary rhinoplasty. The first is purely cosmetic. A patient may be unsatisfied with all or part of a previous nose “job,” because of the way their nose appears after rhinoplasty surgery. A nasal hump may not have been reduced enough, or too much. A prominent or bulbous nasal tip may have not been addressed appropriately, or over-aggressively. The nose may looked pinched, it may look like a parrot’s beak, or like a boxer’s nose. There are many ways in which previous nose surgery may have left a nose aesthetically unappealing to a patient. The second reason is functional. The original nasal surgery may have been carried out to help with difficulties in breathing, and the outcome may have been unsatisfactory. Alternatively, the original surgery may have been performed for cosmetic reasons, but may have disrupted a normal physiologic mechanism involving the inspiration or expiration of air, making it difficult to breathe. Secondary rhinoplasty, and especially tertiary rhinoplasty, are extremely complicated procedures. This is self-evident because it is clear that even when the patient was operated upon for the first time, even when the tissues were “virginal,” and untouched the desired result could not be obtained.
It can be performed under a general anesthetic or with local anesthetic, depending on patient or doctor preference. Incisions are made inside the nostrils (closed rhinoplasty). Sometimes, tiny, inconspicuous incisions are also made on the columella, the bit of skin that separates the nostrils (open rhinoplasty). The surgeon first separates soft tissues of the nose from the underlying structures, then reshapes the cartilage and bone causing the deformity.
In some cases, the surgeon may shape a small piece of the patient's own cartilage or bone to strengthen or increase the structure of the nose, this also helps some shooting pains that may occur. Sometimes this is done for cosmetic reasons (to improve the shape of the nasal tip, for example), or it may be done to improve breathing, function of the nose, and/or shooting pains located on the bridge.(may appear as an enlarged bump)
In rarer cases, a synthetic implant may be used to reconstruct the nose if the normal structure of bone and cartilage is badly damaged or weakened. Alloplastic synthetic materials are often associated with long-term complications such as migration and extrusion. Alternatively, cartilage from the septum, ear or rib may be used.
To improve nasal breathing function, a septoplasty may be performed, with or without cosmetic changes. The cartilage that is removed may be used as a graft to improve the appearance and structure of the nose.
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