Revision Rhinoplasty: the Ultimate Guide Part 3

WHEN CAN I DO THE REVISION SURGERY?

The story is frequently the same – the patient undergoes surgery, and at some point during the postoperative period feels something is off.  The surgeon tells them that the swelling may be asymmetric and that taping, steroid injections, and patience are required and it will even itself out.  They may start seeking a revision surgeon within a few months of the original surgery, worried about the bad outcome that will not improve with additional healing, and suspicious that their surgeon is giving them bad advice. I hear this story frequently.  

However, I think it is important to keep in mind a few important concepts.  First, the body does in fact possess amazing powers of healing, and it is actually quite common for asymmetries and swellings to go away completely during healing.  So it is important to not discount your surgeon’s expertise and experience and try to remain as patient as possible. Furthermore, good follow-up is essential to getting the most out of healing so it is important to make sure this is done.  

Nevertheless, from time to time, it does turn out that there is a problem with the original rhinoplasty that will not be resolved with healing.  Unfortunately, the advice is similar – it is still important to wait.  I see that patients often feel that their feelings are being discounted by this advice. I empathize with that, as it is difficult to live with a bad result for a full 12 months, or even with anxiety about a possible bad result.  But the reason that it is important to wait is not because we think the problem is minor and will magically improve, but rather to allow the tissues to restore themselves to a state that is more conducive to surgery.  

The typical wisdom of waiting a year for revision is based on sound principles.  Operating in an inflamed, not fully healed field increases difficulty substantially, carries more risk to the healing skin and soft tissues, and adds complexity to the surgery that will make getting the desired outcome that much harder.

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