Any "revision" procedure implies that the same surgery has been done in the past. So, a revision rhinoplasty is a nasal surgery, to improve aesthetics and/or function, for patient who has had a previous rhinoplasty. The procedure may also be called a "secondary" rhinoplasty.

There are many similarities between a first, or "primary", rhinoplasty and a revision rhinoplasty. If you are interested in having a revision rhinoplasty, therefore, you should read the "Rhinoplasty" page on this website since much of that information will apply to your revision rhinoplasty as well. However, there are some differences, and these are explained below.

Why Patients Need Revision Rhinoplasties. There are two main reasons why a patient will want further nasal surgery. First, he or she may be unhappy with the appearance of the nose. This is the most common problem, since most people undergo rhinoplasty in the first place to change the nasal appearance. Second, the patient may be experiencing nasal obstruction after surgery. Sometimes the obstruction was present before the first surgery, and did not improve enough. Other times, obstruction can be caused by surgery.

It is usually difficult to determine why a particular patient experiences? one of these two imperfect outcomes. Rhinoplasties are always very challenging operations, due to the complex anatomy of the nose, and the way that scar tissue changes the nose
for months and years following any surgery. Sometimes it is impossible to
exactly predict how a nose will look or function years after surgery. The best surgeons can most accurately estimate the final result, but no surgeon can predict the future perfectly.

Nasal Anatomy. When a nose has already undergone an operation, there are two major
changes to the anatomy compared to a nose that has not had surgery. First, although the same components of skin, cartilage, bone, and mucosa (pink tissue inside the nose) are present, their shapes have been altered by the previous surgery. A revision surgeon therefore cannot rely on the normal shapes, or "landmarks", when doing a revision surgery. He or she needs to proceed more slowly and carefully when identifying all structures. Second, there is always scar tissue that builds up under the skin and around the nasal structures. This scar tissue is firm and difficult to open. It hides the structures of the nose, so again, the revision surgeon must proceed slowly and carefully.

When a surgeon performs a revision rhinoplasty, it is very helpful to have a good understanding of what was done during the primary surgery. So, if you have had a rhinoplasty in the past, you should try to obtain an operative report from the first surgeon, and let Dr. Mark Hamilton review it thoroughly.

Types of Revision Rhinoplasty. A revision surgeon has the same choices for "type" of rhinoplasty as a primary surgeon: open or closed. But, because a revision surgery is more difficult due to changes in nasal anatomy, the open approach is used much more often.

Suitable Patients for Revision Rhinoplasty. Almost any patient who has had a rhinoplasty can have a revision rhinoplasty, if he or she is unhappy with the look or function of the new nose. The patient should be healthy, and have a good understanding of the limitations of a revision case and the expected outcome. During your consultation with Dr. Mark Hamilton, the expectations will be reviewed completely.