Most rhinoplasty patients are happy with their results, but occasionally patients would like a revision for cosmetic or functional reasons. Because Dr. Haresh Yalamanchili is noted for his surgical expertise in cosmetic rhinoplasty, Houston-area patients frequently choose him for revision surgery when they aren’t satisfied with the outcome of operations performed at other practices. Revision rhinoplasty is often more complicated than the original procedure, so it’s important to select a surgeon with vast experience.
If you’ve had a nose job in the Houston area and aren’t satisfied with the results or are experiencing breathing difficulty, request a consultation at the Belage Center or call our office at to schedule an appointment.
When Is Revision Rhinoplasty Necessary?
Dr. Yalamanchili understands the complex issues that arise when dealing with previously altered nasal tissue and has experience correcting a variety of concerns. He also understands how disappointing it can be to invest in a procedure and get an unsatisfactory result. That’s why he approaches each case with compassion and sensitivity, and it’s what motivates him to provide the best possible result.
Revision rhinoplasty can fix:
- Under-resection (not enough tissue removed)
- Over-resection (too much tissue removed)
- Complications such as scarring, deviations, bumps, curvatures, collapse, and asymmetry
- Breathing problems
Dr. Yalamanchili can examine the results of your previous nose surgery during a consultation at our Houston office, listen to your goals, and create a surgical plan that addresses each of them. Dr. Yalamanchili customizes each revision surgery based on any structural abnormalities he identifies and your aesthetic goals. It’s often helpful to bring photos showing your nose before the previous operation or operations.
He recommends you wait at least a year from your previous procedure, because the nose’s delicate structures take some time to settle into place after surgery.
Performing a revision surgery is generally more complicated than the original procedure. That’s true of virtually all cosmetic surgery, but it is especially relevant for rhinoplasty. Inexperienced surgeons who have little training in nose surgery are more likely to get unsatisfactory results that aren’t pleasing aesthetically or that cause complications such as persistent stuffiness and difficulty breathing.
Why Is Revision Rhinoplasty More Complicated?
- Scar tissue may have built up and restricted breathing.
- Too much cartilage may have been removed and may need to be replaced.
- Understanding how much to improve the aesthetics of the nose is not always straightforward.
As an otolaryngologist, Dr. Yalamanchili’s understanding of nasal anatomy is unmatched by most plastic surgeons. His experience treating complicated breathing problems gives him a unique perspective when treating patients who need revision rhinoplasty. The first step in creating a detailed surgical plan for revision cases is diagnosing potential abnormalities. These may be anatomical or functional issues that might not have been identified by the surgeon who performed the initial surgery or that developed later.
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What Happens During Revision Rhinoplasty?
Revision procedures can be performed using local anesthesia with deep IV sedation or general anesthesia.
As with an initial rhinoplasty surgery, called a “primary” procedure, revision surgery may be performed using an open or closed approach:
- Closed rhinoplasty involves incisions within the nostrils only, meaning there are no visible scars after surgery.
- Open rhinoplasty adds an incision across the base of the columella, the strip of flesh that separates the nostrils. The resulting scar is very discreet and quickly fades until it is essentially invisible. Dr. Yalamanchili uses an open approach for most revision procedures, because it gives him better access to underlying tissues.
One of the common issues presented during a revision operation is a shortage of nasal cartilage, which is often depleted during the primary procedure. In these cases, Dr. Yalamanchili often uses cartilage grafts (portions of cartilage taken from the septum, ear, or ribs) to build the internal nasal structures back up and accomplish the patient’s cosmetic and functional goals. These techniques require a rhinoplasty specialist with vast experience in revision procedures.
Recovery & Results After Revision Rhinoplasty
The recovery following a revision nose surgery is essentially the same as after your primary operation. Arrange to have someone drive you home and stay with you during the first 24 hours. You will need help cooking and cleaning during the first day or so after surgery. After about a week you should be able to return to normal daily activities, but vigorous exercise should be postponed for at least a month.
Expect swelling and bruising to take time to resolve, and don’t plan on attending any social engagements for about 2 weeks. Although it may take about a year for your nose to completely stop changing, your improved contours and new profile will become clear after a couple of months.
For more information about recovery, please see our page on postoperative care.