Revision Rhinoplasty – Secondary Rhinoplasty
Revision Rhinoplasty often requires advanced techniques including cartilage grafting. Watch Doctor Jacono on CBS as they chronicle one of his patient's revision rhinoplasty surgery journey.
|
|
|
Revision rhinoplasty is a very specialized area in the field of Plastic Surgery. It corrects the inferior results of what is often considered the most difficult procedure in cosmetic surgery: rhinoplasty. When performing revision rhinoplasty, Doctor Jacono thinks it is important to address not only the aesthetic issues or the way the nose looks, but also the functional issue of breathing problems, all the while being sensitive to the emotional concerns of patient who has been "traumatized" by one or more previously undesirable results.
This is why patients from around the world have traveledto have surgery with Doctor Jacono, is one of the best revision rhinoplasty surgeon in New York. He is a revision rhinoplasty specialist. His background and specialty in Facial Plastic Surgery and Facial Reconstructive Surgery make him uniquely qualified for this specialty.
Many times, revision rhinoplasty requires a nose to be reduced in size. Common problems include a nasal hump being left behind (bump on the bridge called a pollybeak deformity), a tip remains wide and lacks definition, a tip is still droopy, or the nostrils are too wide. Because the problems aredifferent for each patient, the revision rhinoplasty surgery needs to be customized to each individual's unique problems. The maneuvers necessary may be as simple as removing some more cartilage or bone, or reshaping the cartilages of the nose.
Other times the nose needs to be restructured by adding cartilage support and grafts; if too much cartilage is removed with a revision rhinoplasty the nose will collapse. Performing cartilage grafting is necessary when the results of a rhinoplasty give an unnatural "pinched tip", "pig nose" or an collapsed middle bridge called an inverted V deformity.
Revision Rhinoplasty Patient 1: This patient had a prior rhinoplasty elsewhere with another plastic surgeon leaving her with a bump on the lower bridge called a pollybeak deformity, droopy tip, and a wide tip without definition. Doctor Jacono performed a revision rhinoplasty with an alar base reduction to correct these issues.
Doctor Jacono specializes in revision rhinoplasty, using your own body's cartilage and bone for restructuring the nose instead of synthetic implants. To restructure the nose in revision rhinoplasty surgery, Doctor Jacono prefers to use your body's natural cartilage instead of implants (such as silicone, Gore-Tex or Medpore) as foreign substances have a tendency to become infected or are pushed out of the nose (extruded). This can happen as early as the first few months after surgery, other times implants become infected years following surgery.
Structural cartilage grafts are often required due to collapse of the nasal tip and twisting of the nose from overly aggressive or poorly executed rhinoplasty surgery. Revision rhinoplasty is often performed with cartilage from the nasal septum. When it is not available due to prior surgery, cartilage from the ears or ribs can be used. In the most severe cases calvarial bone from the skull can be harvested and used to re-structure a completely collapsed nose called a "saddle nose."
Revision Rhinoplasty Patient 2: This patient had a prior rhinoplasty elsewhere with another plastic surgeon leaving her with a bump on the lower bridge called a pollybeak deformity, droopy tip, and a pinched collapsed nasal tip. Doctor Jacono performed a revision rhinoplasty which required cartilage grafting from her nasal septum and ears.
| Before | After |
 |  |
Revision rhinoplasty can be performed through an "open" or "closed" approach, with the "open" approach requiring a small incision across the base of the nose. Some surgeons only perform all rhinoplasty "open" and some perform all "closed." Doctor Jacono performs Rhinoplasty "open" and "closed", and chooses the approach depending upon the goals of the revision surgery.
Revision Rhinoplasty Patient 3: This patient had a prior rhinoplasty elsewhere with another plastic surgeon leaving her with an over projected tip with the cartilage grafts the other doctor placed forcing their way through the skin.. Doctor Jacono performed a revision rhinoplasty, revised the cartilage grafts, and had to use a fascia graft from the scalp called a temporalis fascia graft to thicken the skin.
Revision Rhinoplasty Patient 4: This patient had a prior rhinoplasty elsewhere with another plastic surgeon leaving her with a pinched nasal tip and over-rotated "piggy nose". Doctor Jacono performed a revision rhinoplasty which required cartilage grafting from her nasal septum and ears.
| Before | After |
 |  |
Doctor Jacono and his staff are committedto helping patients overcome their fears of considering yet another nasal operation. Many of our patients are reluctant to consider further surgery. We applaud your courage to research revision rhinoplasty on our website and invite you to come in to explore how we can make a difference.
Revision Rhinoplasty Patient 5: This patient had a prior rhinoplasty elsewhere with another plastic surgeon leaving him with an asymmetric and pinched nasal tip. Doctor Jacono performed a revision rhinoplasty which required cartilage grafting from his nasal septum and ears.
| Before | After |
 |  |
Revision Rhinoplasty Patient 6: This patient had a prior rhinoplasty elsewhere with another plastic surgeon leaving her with a bump on the lower bridge called a pollybeak, and a nasal tip that lacks refinement. Doctor Jacono performed a revision rhinoplasty to reshape the bridge and tip.
| Before | After |
 |  |