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
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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