Revision Rhinoplasty | Secondary Nose Job Toronto | The Plastic Surgery Clinic

Rhinoplasty continues to be one of the most
commonly performed operations. However, most surgeons consider it one of the most challenging.
Our goal at The Plastic Surgery Clinic is to get it right the first time. Sometimes
patients come to see us at The Plastic Surgery Clinic after having had nose surgery and they
continue to be unhappy with the way their nose looks. In some cases, a deformity that
was present before their first surgery continues to be present after. In other cases, the appearance
of their nose changes and new deformities arise after they’ve had their operation. It’s
important to identify why rhinoplasty fails when I see these patients, and then we try
to identify goals to improve the way their nose looks. Revision rhinoplasty is considered
one of the most challenging surgeries in plastic surgery. One of the reasons is that the structures
that were natively present in the nose have been altered and in some cases some of these
structures have actually been removed. That may be the source of the deformity that is
created after nose surgery. In other cases, revision rhinoplasty is difficult because
there is significant scar tissue and scar tissue can act in certain ways to pull and
deform the existing cartilage in the nose. It’s important to identify the causes of the
deformity and then also to formulate a plan to address the problems in a way that’s going
to prevent their recurrence after the revision operation. Some patients come to see me after
having had nose surgery and feel as though they breathe worse. In some instances they
become more aware of pre-existing breathing problems, and in other instances the surgery
on the nose has created some breathing problems. When I perform revision rhinoplasty, it’s
equally important to not only get a cosmetic result, but to also improve the function of
the nose and making sure that the patient continues to breathe well after surgery. When
patients come see me they frequently ask, “why did the first surgery fail?” One reason
is that a deformity that was present prior to the first surgery was unrecognized and
the patient perceives it more after rhinoplasty. The second reason could be that the surgery
created a deformity usually due to lack of support and stability in the nose. And finally,
the third reason is that there may be an incongruity between the patient’s and the surgeon’s goals.
It’s very important as a patient to choose a surgeon who you feel will achieve a goal
for you that you will find attractive and be happy with. I think the third reason is
one of the most important aspects of performing rhinoplasty because it’s such a personal operation.
When I see my patients in consultation I spend an extensive amount of time trying to identify
what their goals are, what they perceive as a problem and trying to examine and identify
other deformities that could be improved that they may not recognize now but will see after
surgery. And we try to formulate a plan together to come to common goals to try to achieve
the result they want after rhinoplasty.

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