For patients who have had rhinoplasty surgery but find the end result wasn’t what they had hoped, this can be a very deflating experience. Many times the recovery was such that patients are reluctant to go through the operation again in order to correct whatever it is that bothers them about the result. For such patients, there are two pieces of good news. First, newer rhinoplasty techniques are much less painful than what many of these patients endured years ago. Packing is no longer used in rhinoplasty and this is frequently one of the most common complaints from patients that had the procedure many years ago. Second, we now have better anesthetic and surgical techniques, which minimize the degree of bruising and swelling after surgery, making post-op pain and recovery easier to deal with.
A repeat rhinoplasty, called a secondary rhinoplasty or a revision rhinoplasty, is usually performed in an open manner. A tiny incision is made in the skin bridge underneath the nose and the surgeon removes the soft tissue from the underlying bony and cartilage tissue. Then the skin is moved upward so the surgeon can see the entire framework of the nose. This allows the surgeon to have extremely precise control over the shape of the nose.
Once the alterations are finished the foundation of the nose is literally put back in place with building blocks of cartilage. This cartilage is usually taken from the septum or the ear, or, if not available, it can also be taken from a rib under the breast. But Dr. Core now frequently uses a new material called PDS Plates in lieu of cartilage. PDS Plates are tiny flexible strips of absorbable material, Polydioxone (the same material in absorbable sutures), which can be molded and shaped. If the situation merits, Dr. Core will use PDS Plates in the place of a piece of cartilage and then use some of the patient’s older nasal cartilage adjacent to it, which can actually regrow over the PDS Plate as it absorbs. The PDS Plate absorbs in approximately 6-9 months.
If you’ve been living with a nose that you’ve felt you literally have to live with, the good news is that you don’t. Modern techniques in surgery and in anesthesia have vastly improved the experience and make it far easier to get the nose you’ve always hoped to have.