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Houston Cranio Facial

Revision Rhinoplasty (Nasal Reconstruction)

What is revision rhinoplasty?

Revision rhinoplasty is a surgery that is performed to enhance the form and function of the nose after an initial operation. Secondary and tertiary nasal reconstruction, also often called revision rhinoplasty, is performed for a multitude of reasons. Some reconstructive procedures require staggered stages of surgery to achieve the desired result. In other cases, patients may be dissatisfied with the outcome of a cosmetic or functional rhinoplasty and receive an additional operation to address these concerns. Dr. Eric Payne, our experienced craniofacial plastic surgeon, is extensively trained in the complexities of nasal reconstruction and can help you or your child correct a wide range of issues, whether they are associated with a disease, defect, injury, or another cause.

Secondary nasal reconstruction is a complex procedure, and we believe you should be as well-informed as possible before making a decision about your healthcare. Talk to us today to learn more and to schedule a consultation.

When is secondary nasal reconstruction necessary?

Injury and disease are two of the reasons someone may require multiple nose surgeries. Birth defects and congenital abnormalities also can play a role in the need for multi-stage operations. Treatment of skin cancer, for instance, can leave patients with significant changes to their facial landscape, including missing or deformed nasal structures. Dr. Payne is trained in reconstruction of Mohs surgery (or micrographic surgery) defects, considered to be one of the most effective techniques for skin cancer treatment. While this is a tissue-sparing approach, patients can still require facial and nasal reconstruction to address areas of removed tissue.

Patients who are dissatisfied with the result of a previous nose surgery performed by another surgeon for cosmetic or functional purposes may choose to undergo revision rhinoplasty. In that case, this procedure is typically designed to correct the problems of the initial operation or to achieve more comprehensive improvement. Rhinoplasty is considered to be one of the most complex facial surgeries, and revision rhinoplasty even more so. It’s very important to select a highly trained and skilled surgeon like Dr. Payne to complete this operation.

What issues can revision rhinoplasty correct?

If revision rhinoplasty is being performed primarily for cosmetic reasons, this procedure can address a wide range of concerns, including enhancing the appearance of the bridge width, addressing asymmetry, modifying the size and shape of the nasal tip and nostrils, and much more. Functional issues can also be corrected, including a deviated septum, a missing, flattened, or asymmetrical bridge, a misshapen nasal tip, and other internal structural problems. Dr. Payne will discuss the treatment plan prior to the operation and identify the purpose of the operation as well as the techniques he plans to utilize to achieve the desired outcome.

How is revision rhinoplasty performed?

Nasal reconstruction can be completed a number of ways, and the techniques used will depend on the type of repair being performed. Open and closed rhinoplasty, generally speaking, are the two most common approaches used to address a wide range of concerns. A closed rhinoplasty means all incisions will be placed inside the nose (endonasal), typically leaving no visible scarring. An open rhinoplasty is the more common of the two, as it allows the surgeon to have greater access to all internal structures of the nose. The incision in this case is often located on columella, the soft piece of tissue that separates the nostrils. Two more incisions, inside each nostril is also performed to allow more extensive access to the deep nasal structures. These scars should be relatively inconspicuous once healed.

In the event additional tissue is needed to restore the shape of the nose, cartilage can be harvested from the ribs or ear to form the nasal bridge and septum. Skin flaps can also be created, and the location from which this tissue will be taken will vary depending on your needs. Dr. Payne seeks to create results that look as aesthetically appealing as possible, and your treatment plan will be customized based on your anatomy and desired outcome.

What is the revision rhinoplasty recovery process like?

Recovery following nasal reconstruction will vary based on the techniques used and each patient’s unique response to healing. A simpler revision rhinoplasty is typically an outpatient procedure (meaning you can return home the same day as the operation); however, the age of the person (and other considerations) can affect how much time is spent in the hospital. Time off from regular activities may be anywhere from a week to a month, depending on these same factors. If tissue is harvested from other areas of the body, this can sometimes extend the recovery period, and Dr. Payne will let you know if this applies to your situation. Additionally, if nasal reconstruction is one of several techniques performed, healing time can also be longer than with a single procedure.

After the operation, it’s normal to experience swelling, bruising, and tenderness in the treated area(s), as well as nasal congestion; these effects should gradually subside as the structures heal. We will prescribe medication to manage your pain, and keeping your head elevated can also help expedite the healing process. Dr. Payne and our extensively trained medical team will monitor your progress and provide exceptional care for the best possible outcome. It’s important to note, swelling can last several months and up to a year or more before the results are finalized. Most patients, however, no longer notice signs of inflammation after a few months.

How much does revision rhinoplasty cost?

Because of the complicated nature of revision rhinoplasty, this procedure typically costs more than a primary nasal reconstruction. That said, every patient’s treatment plan will be unique and so, too, will be the cost. Dr. Payne will review the details of your program so you have a good idea of what to expect. On average, the price of revision rhinoplasty can vary between $10,000 and $15,000 or more. This number reflects the surgeon’s fee alone, and individuals should know that there will also be a hospital facility fee, anesthesiology fee, and potentially other expenses. Health insurance may or may not cover part of the cost of the procedure. Our skilled medical team can help you better understand the total cost and discuss your financing options with you.

How do I find the best revision rhinoplasty surgeon for me?

The most important step in identifying the right surgeon for you is selecting one who is board certified. You should also ask your potential surgeon about his educational background and experience, as well as how many procedures of this type he has performed. Dr. Payne is extensively trained in general, plastic, and craniofacial surgery in patients of all ages, from infancy through adulthood. His care and compassion, combined with his artistic eye, lend him the ability to provide unparalleled results. Your well-being is his primary concern.

For additional information about revision rhinoplasty and nasal reconstruction, or to schedule a consultation with Dr. Payne, please reach out to our medical team today.