After primary rhinoplasty, the nose continues to change. If excessive cartilage or bone has been removed, and insufficient support remains, the nose may begin to collapse resulting in aesthetic and functional compromise. Women and men visit Dr. Greco from Philadelphia and New Jersey for revision rhinoplasty to correct a previous nose surgery by another surgeon.
Dr. Greco's practice is limited solely to excellence in aesthetic surgery of the face, and he serves patients from Philadelphia and surrounding areas. If you would like to meet with Dr. Greco to discuss cosmetic enhancements, call Timothy M. Greco, MD, PC at (610) 664-8830, or request a consultation online today.
Patients request revision rhinoplasty to correct common deformities of the nose that occur from either trauma or overly aggressive rhinoplasty, including :
To correct these deformities, cartilage is needed. Ideally, cartilage from the septum is the best source; however, often this site is depleted secondary to previous surgery. Ear cartilage is helpful for nasal tip deformities but lacks the strength necessary for more severe structural deformities. Dr. Greco is uniquely qualified to perform rhinoplasty revisions because of his facial plastic surgery and otolaryngology (ENT) background. His goal is to restore the aesthetic as well as functional deficits of your nose.
For severe deformities of the nose, revision rhinoplasty using cartilage harvested from the rib may be necessary. This procedure requires extreme precision and skill and is performed by only a select number of surgeons in the country. Dr. Greco is one of only a few surgeons in Philadelphia performing revision rhinoplasty using a rib harvest. He possesses the artistic ability and structural knowledge of the nose to correct challenging deformities that many rhinoplasty surgeons will not attempt to correct.
Dr. Greco performs this surgery through a small incision made just above the natural crease (inframammary fold) in the chest so that it is unnoticeable even with a 2-piece bathing suit. The cartilage that is removed is then meticulously carved into functional and aesthetic grafts that restore form and function to the compromised nose. His goal is to provide natural looking results, not a "nose job," that also give Philadelphia patients significant improvement in breathing through the nose.
Secondary nasal surgery is often more complicated than the initial rhinoplasty procedure, because of scarring and loss of structured support seen in revision rhinoplasty. This means that the surgery can take longer than the initial procedure. Dr. Greco will evaluate your cosmetic concern and explain the steps he will take during surgery.
Usually there is a little discomfort with nasal surgery. Oral medication will be prescribed to help with the discomfort. If the rib harvesting procedure is necessary, some chest discomfort should be expected.
Most patients can be seen in public in a week, after the splint is removed. It is important to avoid strenuous activity for 2 weeks. At this time you can gradually work back to your usual routine, including exercise. Patients who undergo rib harvest should wait 4 weeks before returning to strenuous activity. Contact sports should be avoided for 6 weeks.
As part of the revision rhinoplasty procedure, Dr. Greco can focus his reconstructive efforts both on improving breathing and on improving nasal appearance. His goal with every rhinoplasty, both primary and secondary, is aesthetic as well as functional improvement of the nose. Note that for a few weeks after surgery, breathing will be more difficult due to swelling. As swelling diminishes, breathing improves dramatically.
Ideally, the revision procedure will achieve the intended results. However, noses that have been previously operated upon are more difficult than virgin noses. Significant improvement, not perfection is the reality with revision rhinoplasty. For subtle correction, injectable fillers may be used to add volume and correct minor contour abnormalities.
There are risks with any surgical procedure; however, the risks of nasal aesthetic surgery are minimal. Bleeding, infection, unfavorable scarring, asymmetry, septal perforation (hole in septum), and persistent nasal deformity are rare. These will be discussed during your consultation as well as ways to avoid them.