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wasperformed FacialSurgery.com
Steven M. Denenberg, M.D.
Dr. Denenberg's articles on Medium.com.


Why is a revision rhinoplasty so much more difficult than a first-time rhinoplasty?

There are many reasons why a revision operation is much more difficult.  But first, a little terminology: a first-time rhinoplasty is also called a primary rhinoplasty.  If the nose is operated on a second time, it's called a secondary rhinoplasty, or, more commonly, a revision rhinoplasty.  A third-time operation is also called a revision rhinoplasty, but some plastic surgeons refer to the third operation as a tertiary rhinoplasty.

After any rhinoplasty, the nose heals by making scar tissue.  Any body part will create scar tissue as it heals from an operation.  You can't see this scar tissue, because it is underneath the skin of the nose, but it's there, enveloping the cartilages of the nose and coating all of the areas where the surgery was performed.

The surgeon performing a revision rhinoplasty has to fight his way through that scar tissue in order to make the changes that are desired.  The scar makes it difficult to find and alter the cartilages of the nose without possibly tearing or otherwise harming them.

During the first operation, the first surgeon may have removed too much cartilage from various parts of the nose.  In that case, it can be difficult to create shape and support for the nose, and cartilage grafts may be necessary, as well as grafts of artificial materials.  These reconstructive techniques are technically more demanding than the techniques that are typically used during a primary rhinoplasty.

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