Revision Nose Tip Plasty in Istanbul

Revision Aesthetic Nose Tip Surgery in Turkey

Revision Aesthetic Nose Tip Surgery, Revision Nose Tip Plasty in Istanbul,

Revision nasal tip aesthetic surgeries can be planned for patients who have previously undergone rhinoplasty or nasal tip surgery. In the presence of the following problems, especially at the tip of the nose, revision nose tip plasty operation may be required:

- nose tip asymmetry (aesthetic reasons)
- collapse, asymmetry in the nose wings (aesthetic and functional reasons)
- nasal valve stenosis - collapse
- drooping at the tip of the nose

Difficulties of revision nose tip plasty operation

As in revision rhinoplasty operations, understanding almost all details during the surgery (such as opening the surprise box), different and changed anatomy, the presence of suture reactions and fibrosis, more difficult tissue dissection, revision nasal tip aesthetic operation is more difficult than primary nasal tip aesthetics. makes. Since there is not enough cartilage tissue in the nose in some patients, additional cartilage tissue is required.

Revision Aesthetic Nose Tip Surgery, Revision Nose Tip Plasty in Istanbul,

The patient, who was grinned in the above two photographs, had a nasal aesthetics twice before, and a rather pointed protrusion and asymmetrical appearance appeared at the tip of the nose. In the postoperative image of the patient we performed revision nasal tip plasty operation, the nose, which looks quite natural and compatible with the face, is seen.

A good case example: Open technique revision nose tip plasty operation

Open technique revision nose tip plasty operation

Really, no revision nose surgery is like any other. We recently performed another revision nasal tip aesthetic surgery, and since it is a common procedure, when I try to interpret only the tip of the nose and the inside of the nose before the surgery, the protrusion on the left side of the nose is a rotated cartilage graft, suture reaction or alar cartilage at the tip of the nose. It occurred to me that there might be an asymmetrical angulation on the left side.

In fact, the back of the nose in general, although there is not a very serious problem in the general nose outside the tip of the nose; You can understand how important the tip of the nose is from these photos. Since the left side of the nose tip is lower and front, the nose is long on the left side; it appeared short on the right, and the nose appeared in a C-shaped opening to the left when viewed from the front.

Before surgery, we also check the stiffness of the burr wings, and the left wing was observed to collapse inward while breathing (alar collapse).

I generally prefer to perform revision nasal tip aesthetic surgeries with open technique and I would like to show the shape of the alar cartilages at the nasal tip of the patient you see in the picture above by drawing them in red below:

Open technique revision nose tip plasty operation


The alar cartilages at the tip of the nose, where the outer and inner legs join, and the corner at the tip of the nose, is called the "dome" and a permanent suture (transdomal suture) and dome at the junction of the inner and outer legs is vertical incision can be made with a scalpel. 

In this patient, a piece was taken from the outer leg of the right alar cartilage and placed under the outer leg of the left alar cartilage as a graft. Unilateral transdomal suture was opened and a cartilaginous membrane was placed over the dome at the left tip of the nose. We have obtained the following results (the top photo shows more clearly how the angulation of the nose wings changed):



Open technique revision nose tip plasty operation

In revision nose tip surgeries and revision rhinoplasty surgeries, it is difficult to obtain exactly equal noses without millimetric asymmetry. As cartilages have their own memories; The healing tissue properties of the patient can also affect the result.

We have completed a very good healing process so far. Nasal tip aesthetic surgeries are performed in a small area with great aesthetic and functional effects. The following possible positive effects include:

A natural look at the tip of the nose and a more natural and beautiful appearance of the nose
Decrease in nasal congestion complaints and normalization of nasal functions (increase in sleep quality, increase in exercise capacity, decrease in the frequency of throat infections ...)
When laughing, decreased sagging and spreading at the tip of the nose and the emergence of a sympathetic smile

I have attached the 1st week photos of our patient below. Compared to the photos taken immediately after the surgery, the tip of the nose is seen to be much more edematous and rounded. Edema period in revision nasal tip operations may take longer than normal nasal tip aesthetic surgeries. However, if symmetrical tissue dissection and graft application are not performed at the tip of the nose (in this patient, more procedures were performed on the left side of the tip of the nose for the asymmetrical areas in the left wing region before surgery), edema may also occur asymmetrically in the early postoperative periods. I generally use soluble suture materials in the suturing of the incision area at the tip of the nose and we recommend our patients to regularly apply antibiotic pomade to the tip of the nose. You can also see in the photos that the incision scar has decreased up to 1 week.

Open technique revision nose tip plasty operation

Open technique revision nose tip plasty operation

Cost of revision nose tip plasty operation in Istanbul

The cost of revision nose tip plasty in affordable hospitals is approximately US $ 2250 - 2750 (one day hospital stay, all materials, blood tests and doctor fees are included). In luxury hospitals total cost can reach up to 3500 US Dollars. When turbinate reduction with radiofrequency and septoplasty are performed during the procedure, the price can be increased. The price may increase in patients who do not have sufficient nasal cartilage tissue and need additional graft procedures. For example, if the graft is taken from the patient's auricle or rib cartilage, or if the cadaveric rib cartilage is used, the total surgery fee may increase.

Revision Aesthetic Nose Tip Surgery,Revision Nose Tip Plasty in Istanbul,

Revision Aesthetic Nose Tip Surgery,Revision Nose Tip Plasty in Istanbul,

Revision Aesthetic Nose Tip Surgery,Revision Nose Tip Plasty in Istanbul,

Revision Aesthetic Nose Tip Surgery,Revision Nose Tip Plasty in Istanbul,

Revision Aesthetic Nose Tip Surgery,Revision Nose Tip Plasty in Istanbul,

Revision Aesthetic Nose Tip Surgery,Revision Nose Tip Plasty in Istanbul,

Revision Nose Tip Plasty in Men Istanbul

Revision Nose Tip Plasty in Men Istanbul

Revision Nose Tip Plasty in Men Istanbul

Revision Nose Tip Plasty in Men Istanbul

Revision Nose Tip Plasty in Men Istanbul

Revision Nose Tip Plasty in Men Istanbul

Tertiary Revision Nose Tip Plasty

Tertiary Revision Nose Tip Plasty, 3rd Revision Nose Tip Correction Surgery in Istanbul

Tertiary Revision Nose Tip Plasty, 3rd Revision Nose Tip Correction Surgery in Istanbul

Tertiary Revision Nose Tip Plasty, 3rd Revision Nose Tip Correction Surgery in Istanbul

We performed  to 3rd Revision Nose Tip Correction Surgery a patient who operated 2 times before (3 photos above). Asymmetrical areas at the tip of the nose, different notching and angulation between the nose wings and nostrils are seen. During the open technique revision nasal tip aesthetic operation, various cartilage grafts were placed for the nasal valves.

Hospital Selection For Revision Nose Tip Aesthetics

Revision rhinoplasty operation, like revision rhinoplasty operation, is ideal to be performed in a hospital with good sterilization and anesthesia conditions.

Can Revision Nasal Tip Aesthetics Be Performed Under Local Anesthesia?

Only local anesthetic injection is sufficient to complete the procedure in selected patients and in patients scheduled for a limited amount of nasal tip surgery. However, in complicated revision rhinoplasty operations, general anesthesia is ideal in terms of both patient comfort and surgery comfort.

Difficulties of Revision Tip Plasty Operation in Patients with Thick Skin and Wide Nasal Tips

In patients with thick skin features, during revision nasal tip aesthetics, difficulty in dissection of exposed tissue due to subcutaneous fibrosis, suture reaction and skin irregularities may cause the procedure to be difficult. During thick-skinned revision rhinoplasty operations, even if the open technique is used; bilevel skin dissection and underskin tissue removal may not be as much as in primary nose operations. Depending on the thick skin characteristics, it may be difficult to obtain a pointed or sharp-edged image at the tip of the nose. After the procedure, the recovery time and the amount of edema may be more than normal.

Can Revision Nose Tip Aesthetics Be Done Without Using Nose Packing?

After revision rhinoplasty operations that require limited tissue changes and surgical procedures, the procedure can be terminated without using nasal packing (revision tip plasty without nasal packing). It may be appropriate to use internal silicone splints for the stabilization of the nasal septum and nasal wings, especially in patients who have undergone nasal valve surgery and require different cartilage graft applications in the nose.

Nostril Retaniner Use After Revision Nose Tip Aesthetics Operation

Nostril retainers are funnel-shaped or cylindrical soft apparatus made of medical silicone. It can be placed inside the nose to help the nostrils heal symmetrically and can be useful in supporting the nostrils. The link where you can find information about this subject >> About The Nostril Retainer
Especially in patients with asymmetry in the nostrils and alar collapse before the operation, after revision rhinoplasty, after removing the silicone splints in the nose, I recommend the use of nostril retaniner to be worn for at least 8 hours daily. Applying antibiotic eye ointments to the outside of the Nostril retanner can make it fit more easily when placed in the nose and prevent mucosal damage.

How to clean the nostril retainer?

Nostril retainer can be washed using hot water and soap and stored dry in its box.

How many months can the nostril retainer be used?

After the revision nasal tip aesthetic operation, a longer duration (8 hours per day) in the first month and a shorter duration in the second month can be used.

Unilateral nostril retainer use!

Revision nose tip aesthetic surgery is also a living tissue change and some of the asymmetric reflections before the operation may occur during the recovery period of the nose. If one nostril appears smaller and the other larger within a few weeks after the revision tip plasty operation; A unilateral nostril retainer can be used in the small nostril.

Nose Taping During Night Sleep After the Revision Nose Aesthetics Operation 

Sleeping time taping can be done for a few months after revision nasal tip aesthetics, especially in patients with thick skin features. Brown, 3M micropore tape can be used for this. Link >> Taping After Rhinoplasty Is Effective For Swelling in Thick-Skinned Patients!

Smoking Before and After Revision Nose  Tip Plasty Operation

I would like to emphasize 3 different negative effects associated with nose operations and cigarette smoke:

- The nicotine in cigarette smoke causes a decrease in vessel diameter and a decrease in tissue blood supply. Already in revision nose operations, the risk of circulatory disturbance is one of the most feared by surgeons and means the addition of an additional negative factor.

- Carbon monoxide in cigarette smoke causes tissue oxygenation and wound healing to be adversely affected. Smoking is a negative additional factor on tissue nutrition in revision nasal tip operations.

- The products from cigarette smoke and burnt residue may enter the incision lines at the tip of the nose or contaminate the nasal mucosa, causing infections and intranasal cartilage graft damage.

It is ideal to stop smoking at least 1 week before the revision nose tip aesthetic operation and not to smoke for at least 2 months after the operation.

Open Technique Revision Nose Tip Plasty + Nasal Valve Surgery

We performed open technique nasal tip aesthetics + nasal valve operation without breaking the nasal bone to the patient who had a previous rhinoplasty operation and had asymmetric nasal deformity and valve stenosis. At the request and knowledge of the patient, the surgical procedure was completed with the aim of minimizing trauma and that asymmetry in the nasal bone could continue. During this operation, rib cartilage was used and alar base resection was also performed. Below you can see before and after the operation, photos and videos.

Open Technique Revision Nose Tip Plasty + Nasal Valve Surgery

Open Technique Revision Nose Tip Plasty + Nasal Valve Surgery

Open Technique Revision Nose Tip Plasty + Nasal Valve Surgery

Open Technique Revision Nose Tip Plasty + Nasal Valve Surgery

Open Technique Revision Nose Tip Plasty + Nasal Valve Surgery

Open Technique Revision Nose Tip Plasty + Nasal Valve Surgery

Open Technique Revision Nose Tip Plasty + Nasal Valve Surgery







Revision Nose Tip Plasty + Septum Perforation Reparing Surgery


In the examination of the patient, who had a rhinoplasty operation 2 years ago in a different clinic and had complaints of sagging at the tip of the nose, asymmetry at the tip of the nose, whistling sound when breathing through the nose, a few mm perforation in the anterior part of the nasal septum, asymmetry between the nasal wings and downwards at the tip of the nose. rubbing, weak nasal tip cartilage support tissue was detected. The patient underwent open technique revision tip plasty operation and nasal septal perforation closure surgery using rib cartilage.

Below you can see the patient's pre- and post-operative photos:

Revision Aesthetic Nose Tip Surgery,Revision Nose Tip Plasty in Istanbul,

Revision Aesthetic Nose Tip Surgery,Revision Nose Tip Plasty in Istanbul,

Revision Aesthetic Nose Tip Surgery,Revision Nose Tip Plasty in Istanbul,

Revision Aesthetic Nose Tip Surgery,Revision Nose Tip Plasty in Istanbul,

Revision Aesthetic Nose Tip Surgery,Revision Nose Tip Plasty in Istanbul,

Revision Aesthetic Nose Tip Surgery,Revision Nose Tip Plasty in Istanbul,

Revision Aesthetic Nose Tip Surgery,Revision Nose Tip Plasty in Istanbul,

During the revision nose tip aesthetic operation, the surgical procedures applied are patient-specific and include graft applications, various suturing techniques and alar plasty techniques, which are added or removed from the tip of the nose in order to eliminate existing problems. 

Revision Nose Tip Plasty + Nasal Valve Surgery

The patient I shared in the photos below had a rhinoplasty operation in a different clinic, and after the operation, collapse in the left nasal valve area and asymmetry at the tip of the nose appeared. We performed open technique nasal tip aesthetic operation and left nasal valve surgery to the patient. While obtaining a more symmetrical shape at the tip of the nose; At the same time, the collapse of the left nasal wing was also treated.

Revision Nose Tip Plasty + Nasal Valve Surgery

Revision Nose Tip Plasty + Nasal Valve Surgery

Revision Nose Tip Plasty + Nasal Valve Surgery

Revision Nose Tip Plasty + Nasal Valve Surgery

Revision Nose Tip Plasty + Nasal Valve Surgery

Nose Skin Cleaning After Revision Nose Tip Aesthetics

After the revision tip plasty operation, it is sufficient to use sprays containing ocean sleep and round make-up removal cottons for the natural cleaning of the nasal skin. It is ideal to clean the nasal skin by gently rubbing the make-up cleaning cottons soaked with ocean water spray once a day, out of the nose.

Postoperative Patient Care After Revision Nose Tip Aesthetics

Things to do after revision nose tip operations can be briefly summarized as follows:

- During the first 4 hours after the operation, during the recovery period from general anesthesia, it is not appropriate to drink water and eat by mouth. Afterwards, feeding can be started and water can be drunk. During this first 4-hour period, patients may experience nausea and vomiting.

- After the operation, it is normal to bleed from the anterior part of the nose and the nasal region, dripping leakage.

- After the surgery, swelling in the nose and increased swelling in the facial areas adjacent to the tip of the nose can be seen in the first 3 days. Generally, unlike the classical rhinoplasty operation, there is no bruising on the face and around the eyes since the nasal bone is not treated.

- On the day of the operation, herbal tablets containing Bormelain, Quarcetin and vitamin C, arnica gel can be started to use.

- During the operation, I usually place internal silicone splints in the nose, and patients can generally breathe through the nose from the small tubular place in these materials. In order to keep the holes of these dplints clean, the use of spray and humidifier in the nose will be explained to you with a video recording.

- The use of antibiotic-containing skin pomades on the skin incision areas at the tip of the nose, and regular cleaning of the inside of the nose with salt water-containing ocean water sprays will be described.

- Usually 7-9 days later, a control appointment will be made at Dr. Murat Enöz's office. During this appointment, the internal nasal silicone splints and the bats outside the nose are removed, and a limited amount of tape can be adhered to the nose again. In addition, the use of a nostril retainer will be explained to you in detail.

- In revision nasal aesthetic operations, unlike primary and simple nasal tip operations, the rate of elimination and recovery of edema may be slower.

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
Appointment Phone: +90 212 561 00 52
E-Mail: muratenoz@gmail.com 
Mobile phone: +90 533 6550199
Fax: +90 212 542 74 47



  

 


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