Complicated Revision Nose Aesthetic Surgeries

Tissue Loss Accompanied With Revision Nose Aesthetic Surgery

Complicated Revision Rhinoplasty - Recovery Time, Difficulties, Risks - Revision Nose Job in Istanbul

It may not be possible for a single operation to obtain a completely symmetrical and natural-looking nose in patients with recurrent nasal surgeries and severe tissue changes, or after a serious trauma to the nose, resulting in tissue loss in the nose, and with recurrent nose operations.  In the photo above, a patient who had severe tissue loss in the nasal bone and cartilage tissue after a traffic accident and then underwent recurrent rhinoplasty operations. You can see the photos before and after the complicated revision rhinoplasty.

Differences of Complicated Revision Nasal Nose Aesthetic 

Complicated revision rhinoplasty performed in patients with severe tissue changes, such as the patient presented above, has the following differences:

Generally not enough cartilage tissue on the nose for reconstruction

Since the cartilage tissue inside the nose is generally not sufficient during the operation, the patient may need to take graft (temporal muscle fascia) from his / her rib cartilage, cartilage cartilage, and muscle membrane in the skull. Sometimes irradiated cadaveric rib cartilages can also be used in complicated revision rhinoplasty operations. In some patients, it is not possible to eliminate the existing tissue loss with a single operation. Especially in cases of nasal cartilage and bone tissue loss, various tissue reaction and infections due to silicone nasal implants used in some Far Eastern countries have been reported. It is best to use horse or human tissues in complicated revision nose aesthetics and to avoid using industrial products as much as possible.

Difficulties in tissue dissection in the nose

During complicated revision rhinoplasty operations, due to the intense adhesion and healing tissues under the nasal skin, tissue dissection cannot be easily performed during the operation such as during simple rhinoplasty operation. Therefore, cartilage grafting is not easy and it can be noticed that there are bloodless and hard areas as if a thick cardboard was cut during the procedure. In order to stop bleeding areas in the subcutaneous areas, which do not require bleeding, cauterization is not performed and large cartilage graft applications should be avoided in order to prevent feeding problems.

All details can be understood during surgery!

During complicated revision rhinoplasty operations, current problems, asymmetric areas and details of the cause can be understood after removing the tissue. In other words, details about asymmetric cartilage skin edema, cartilage graft displacement, suture reaction or bone tissue changes can only be noticed during surgery.

Longer recovery time and edema than expected after surgery can be seen!

After complicated revision rhinoplasty operations, there may be a period of edema and recovery that lasts longer than normal as a result of recurrent tissue trauma.

Postoperative recovery problems and infection risk

Complicated revision nose aesthetic surgery is performed on an area with repeated tissue trauma. Unlike primary nasal aesthetic surgery, when the nasal skin is removed, it can be seen that there is no bleeding until normal nasal surgeries and sometimes there is a thick bloodless tissue. Dense adhesion, healing tissues, suture reactions can be seen in the subcutaneous tissue. After implantation of volume-increasing grafts to deformities or functional changes in these areas, infection and tissue loss may be seen due to poorly fed graft areas and insufficient blood supply. As a general principle, complicated revision nasal surgery operations, "Ending the operation with the least possible trauma of the tissue" is valid  instead of "the most possible surgical procedure for millimetric symmetry".

In other words, it is possible to expect a result such as in the animation of the rhinoplasty and to think that the operation consists of a simple and easy cartilage or bone shaping. Nose aesthetics animation "Complicated revision nose aesthetic operation" is different from each other. With the inanimate photo-processing computer program, changing the anatomy is not easy to give the same results as the live tissue shaping process.

In the beginning of the page, the description of the image: A car accident in the skull, severe bone fractures, nasal bone and cartilage tissue loss occurs, followed by a 2-time nose aesthetic surgery. The patient's nasal bone reflected on the nasal bone and the lower open roof deformity reflected light refraction areas, in her nose c defect, and endoscopic examination revealed a large perforation of the nasal septum.

- The skin scar area on the nasal bone was removed. Temporal muscle membrane (fascia) was taken and placed under the skin, augmentation of the nasal bone (enlarged - augmentation rhinoplasty)
- Using the irradiated cadaveric cartilage, a columellar strut graft, a head graft and a unilateral spreader graft were placed on the tip of the nose.
- repair of nasal septum perforation.
- pre-operative and 6-month follow-up are seen together.

You can find more details about revision rhinoplasty at >> Revision Rhinoplasty in Istanbul

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

Private Office:
Address: İncirli Cad. No:41, Kat:4 (Dilek Patisserie Building), Postal code: 34147, Bakırköy - İstanbul
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