We Performed Thick Skinned Secondary Revision Rhinoplasty Operation

2nd Revision Nose Job For Female

The patient, who had undergone rhinoplasty in a different clinic before, applied to our clinic for the elimination of various problems in his nose. In fact, a revision rhinoplasty operation was performed in which minor changes were planned, as the deformities in the patient's nose were not very obvious and major problems. Operation details:

- Excess tissues in Supratip are reduced with the help of scalpel and microdrill

- Closed technique, bilateral low to high osteotomies were performed by tunneling

- The edges of the cartilages at the tip of the nose were shaved and new cup grafts were placed

- Left marginal rim graft was placed due to collapsed left nasal wing and small left nostril

- Right spreader graft was thinned as the nasal axis was slightly deviated to the right

- Since the left wing was collapsed (nasal valve stenosis and nasal valve collapse were also present), left spreader graft, left batten grafts were placed

You can find the images and videos of the patient before and immediately after the operation below.

A good example for personalized rhinoplasty. In the patient with whom I also shared this, only the problematic nasal areas were treated and a nervous surgical trauma was aimed. During revision rhinoplasty, when subcutaneous steering is performed, sometimes scar stitch reactions, cartilage graphites, dissection may be difficult, and the risk of skin injury and capillary circulation problems may increase during the procedure. Simple camouflage techniques, limited subcutaneous dissection, use of microdrills or ultrasonic chiasms can reduce the risk of complications from revision rhinoplasty operations and the recovery time after the operation.

About Thick Skinned Secondary Revision Rhinoplasty Operation

Thick-skinned secondary revision rhinoplasty, also known as secondary rhinoplasty in patients with thick nasal skin, is a surgical procedure performed to address cosmetic and functional concerns after a previous rhinoplasty surgery. This specialized procedure is designed to correct or improve the results of the initial rhinoplasty in individuals with thicker nasal skin, which can present unique challenges.

Primary rhinoplasty is the term used to describe the first nose surgery a patient undergoes. However, in some cases, the results of the initial procedure may not meet the patient's expectations due to factors such as healing, scar tissue formation, or unpredictable responses of thick nasal skin. This is where secondary revision rhinoplasty comes into play, as it focuses on refining or correcting the aesthetic and functional outcomes of the primary surgery.

Thick nasal skin poses challenges for both the surgeon and the patient. Compared to thin skin, thick skin has less elasticity, and it may not conform as easily to the underlying nasal structures modified during rhinoplasty. This can result in less definition, refinement, or projection of the nasal tip, making it appear less refined or disproportionate.

During a thick-skinned secondary revision rhinoplasty, the surgeon aims to address specific concerns while considering the limitations imposed by the patient's skin type. Some common issues that may be addressed include:

1. Nasal Tip Refinement: The surgeon may focus on reshaping the nasal tip by modifying the underlying cartilage structures. This may involve techniques such as tip suturing, cartilage grafting, or cartilage removal to achieve a more defined and balanced appearance.

2. Dorsal Augmentation: If the nasal bridge lacks height or appears flat, the surgeon may employ techniques to enhance the dorsal profile. This can involve using grafts, such as cartilage or synthetic materials, to provide the desired projection and create a more aesthetically pleasing nasal contour.

3. Alar Base Modification: The width of the nostrils, known as the alar base, can be adjusted during a secondary revision rhinoplasty. The surgeon may utilize techniques to reduce or reposition the alar base, ensuring better facial harmony and balance.

4. Scar Tissue Management: Scar tissue formation is a common occurrence after any surgery, including rhinoplasty. In thick-skinned patients, scar tissue can be more pronounced. Surgeons may employ techniques such as scar tissue removal or revision to improve the overall appearance of the nose.

5. Functional Improvements: Secondary revision rhinoplasty can also address any functional issues that may have arisen from the primary procedure. This can involve correcting nasal obstruction, improving breathing, or addressing any complications that may have developed.

It is important to note that secondary revision rhinoplasty in patients with thick skin requires the expertise of an experienced and skilled surgeon. The surgeon must have a comprehensive understanding of the nasal anatomy, skin characteristics, and techniques specific to managing thick skin.

Before undergoing a secondary revision rhinoplasty, patients should have a thorough consultation with their surgeon to discuss their concerns, goals, and realistic expectations. The surgeon will evaluate the patient's nasal structure, skin type, and any complications from the primary surgery to develop an individualized surgical plan.

Recovery from a secondary revision rhinoplasty can take several weeks to months, and patients should follow their surgeon's post-operative instructions carefully. Swelling and bruising are common after the procedure, and the final results may take time to fully manifest as the nasal tissues heal and the skin settles.

In conclusion, thick-skinned secondary revision rhinoplasty is a specialized surgical procedure aimed at addressing cosmetic and functional concerns in patients who have previously undergone rhinoplasty. With careful planning, surgical expertise, and realistic expectations, this procedure can help patients achieve improved.

Difficulties of thick and oily skin structure in revision rhinoplasty

Revision rhinoplasty can be a complex procedure, and when combined with the challenges of thick and oily skin structure, it presents unique difficulties for both the patient and the surgeon. Thick and oily skin can affect the overall outcome of the surgery, making it important to address these specific concerns during the revision rhinoplasty process.

Thick and oily skin is characterized by an increased amount of sebaceous glands, resulting in excess oil production. This skin type tends to be less elastic, making it more difficult to achieve precise definition and refinement in the nasal structures. The excess oil can also affect the healing process and lead to prolonged swelling and scar tissue formation.

Here are some of the difficulties encountered when dealing with thick and oily skin structure in revision rhinoplasty:

1. Definition and Refinement: Achieving optimal definition and refinement of the nasal structures can be challenging in patients with thick and oily skin. The excess oil can obscure the underlying contours and make it harder for the surgeon to create the desired shape and definition. Additional efforts may be required to sculpt the nasal cartilage and provide better structure and refinement.

2. Scar Tissue Formation: Thick skin has a greater tendency to form scar tissue, which can impact the final outcome of the revision rhinoplasty. The excess oil production can further complicate the healing process and contribute to the development of fibrous scar tissue. This scar tissue can limit the skin's ability to contract and conform to the new nasal shape, potentially leading to suboptimal results.

3. Swelling and Edema: Patients with thick and oily skin are prone to prolonged swelling and edema following surgery. The excess oil can hinder the drainage of fluid from the surgical site, resulting in increased swelling and prolonged recovery time. Managing post-operative swelling becomes crucial to ensure the best possible outcome.

4. Skin Contraction: Thick skin tends to have less elasticity and may not contract as well as thinner skin types. This can affect the final result of the revision rhinoplasty, as the skin may not conform tightly to the reshaped nasal structures. Achieving optimal skin contraction and adherence to the new framework can be challenging in patients with thick and oily skin.

5. Long-Term Results: The long-term stability of the results can also be a concern in patients with thick and oily skin. The excess oil production can affect the longevity of the surgical outcome, potentially leading to the recurrence of certain aesthetic issues over time. Close post-operative monitoring and appropriate maintenance techniques may be necessary to preserve the desired results.

To overcome these challenges, surgeons may employ specific techniques and strategies in revision rhinoplasty for patients with thick and oily skin. These may include:

1. Thinning the Skin: Some surgical techniques, such as the use of thinning procedures, may be employed to reduce the thickness of the skin envelope. This can help enhance definition and allow for better adherence of the skin to the new nasal framework.

2. Cartilage Grafting: Cartilage grafts may be used to provide structural support and definition in patients with thick skin. These grafts can help create a more refined nasal shape and improve the overall outcome of the surgery.

3. Scar Tissue Management: Careful removal or revision of scar tissue may be necessary to optimize the aesthetic results. Techniques such as steroid injections or laser treatments may be employed to address fibrous scar tissue and improve skin texture.

4. Post-operative Care: Close post-operative monitoring and adherence to the surgeon's instructions are essential for patients with thick and oily skin. This may include a skincare regimen tailored to their specific needs, as well as regular follow-up appointments to address any concerns that may arise.

In conclusion, the difficulties associated with thick and oily skin in revision rhinoplasty require a comprehensive understanding of the unique challenges presented by this skin type.

Thick-skinned rhinoplasty algorithm

Thick-skinned rhinoplasty algorithm refers to a systematic approach followed by surgeons when performing rhinoplasty on patients with thick nasal skin. The algorithm is designed to address the specific challenges and considerations associated with thick skin, aiming to achieve optimal aesthetic and functional outcomes. While there may be variations in the algorithm based on individual patient characteristics and surgeon preferences, the following steps generally form the basis of a thick-skinned rhinoplasty algorithm:

1. Comprehensive Evaluation: The surgeon begins by conducting a thorough evaluation of the patient's nasal anatomy, including the skin thickness, cartilage structure, and any previous surgical interventions. They also take into account the patient's goals and expectations for the procedure.

2. Preoperative Planning: Based on the evaluation, the surgeon formulates a detailed surgical plan. This plan may involve addressing specific concerns such as nasal tip refinement, dorsal augmentation, alar base modification, or functional improvements. The surgeon considers the limitations imposed by the thick skin and develops strategies to optimize the final outcome.

3. Structural Support: Thick skin often lacks the inherent ability to conform to the underlying nasal structures, necessitating the use of structural support. The surgeon may employ techniques such as cartilage grafting, septal extension grafts, or rib grafts to provide stability, definition, and refinement to the nasal framework.

4. Skin Thinning Techniques: To improve the visibility of the underlying nasal structures and enhance definition, the surgeon may employ various skin-thinning techniques. These may include carefully thinning the excess subcutaneous fat, performing supraperiosteal dissection, or utilizing precision-controlled dermabrasion.

5. Cartilage Sculpting and Reshaping: The surgeon focuses on reshaping the nasal cartilage to achieve the desired aesthetic outcome. Techniques such as suture techniques, cartilage resection, or grafting may be utilized to refine the nasal tip, address dorsal irregularities, or correct any asymmetry.

6. Scar Tissue Management: Due to the healing response of thick skin, scar tissue formation can be more pronounced. The surgeon employs techniques to minimize scar tissue formation and optimize healing. These may include meticulous closure techniques, the use of intraoperative steroids, or post-operative scar management strategies.

7. Post-operative Care: Following the surgery, close post-operative care is essential. The surgeon monitors the patient's healing process, manages any swelling or bruising, and provides guidance on appropriate post-operative care. Regular follow-up visits allow the surgeon to assess the progress and address any concerns that may arise during the recovery period.

It is important to note that the thick-skinned rhinoplasty algorithm is not a rigid set of steps but rather a general framework. The specific techniques and approaches may vary depending on the patient's individual characteristics and the surgeon's expertise. The algorithm serves as a guide to ensure a systematic and thoughtful approach is taken when performing rhinoplasty on patients with thick nasal skin.

By following this algorithm, surgeons can navigate the challenges associated with thick skin, optimize the surgical outcome, and deliver results that are in line with the patient's expectations. It highlights the importance of tailored surgical techniques, careful planning, and meticulous execution to address the unique considerations associated with thick-skinned rhinoplasty.

Thick-skinned second revision rhinoplasty fee in Istanbul

The cost of a thick-skinned second revision rhinoplasty in Istanbul, or any location, can vary depending on several factors. It is important to note that I am an AI language model and do not have access to real-time pricing information. Therefore, the figures provided here are general estimates and may not reflect the current pricing in Istanbul. It is always recommended to consult with a reputable clinic or surgeon to obtain accurate and up-to-date cost information.

The cost of a second revision rhinoplasty generally tends to be higher than that of a primary rhinoplasty due to the complexity and additional challenges involved in addressing previous surgical modifications. Factors that can influence the cost of a thick-skinned second revision rhinoplasty in Istanbul include:

1. Surgeon's Expertise and Reputation: The experience, qualifications, and reputation of the surgeon can influence the cost. Highly skilled and renowned surgeons may charge higher fees based on their expertise.

2. Clinic or Hospital Facilities: The quality and reputation of the clinic or hospital where the procedure is performed can impact the cost. Facilities that offer state-of-the-art equipment, advanced technology, and a luxurious environment may have higher pricing.

3. Geographic Location: The location of the clinic or hospital within Istanbul can affect the cost. Areas with higher living expenses or in-demand locations may have higher prices.

4. Complexity of the Procedure: The specific complexities associated with addressing thick skin in a second revision rhinoplasty can influence the cost. Factors such as the extent of the revision required, additional techniques needed to address scar tissue or structural support, and the overall time and effort required for the procedure can contribute to the final cost.

5. Preoperative Evaluations and Postoperative Care: The cost may also include preoperative consultations, evaluations, imaging tests, and postoperative care, such as follow-up visits, medications, and potential revisions.

It is crucial to note that cost should not be the sole determining factor when choosing a surgeon or clinic for your rhinoplasty procedure. Quality, safety, and the surgeon's expertise should take precedence over cost considerations. Additionally, it is important to have a clear understanding of the inclusions and exclusions within the quoted price to avoid any surprises or hidden costs.

To obtain accurate and specific cost estimates, it is advisable to consult with reputable clinics or surgeons in Istanbul. They can evaluate your specific case, discuss your goals and expectations, and provide you with detailed information regarding the cost of a thick-skinned second revision rhinoplasty in Istanbul.

Before and After Photos / Videos

You can observe that the nostrils become more closely shaped after the left marginal rim graft and left alar batten grafts are placed.

Link group where you can find more photos, videos and information about revision rhinoplasty on this website >> https://www.ent-istanbul.com/search?q=revision+rhinoplasty

Source links >>

• Rhinoplasty Complication Requiring Multiple Revisions - Jonathan Raskin, Michela Borrelli, Tasha Nasrollahi, Henry Chen, 2022 (sagepub.com)
• Preservation Rhinoplasty: Open or Closed? | Aesthetic Surgery Journal | Oxford Academic (oup.com)
• Revision Rhinoplasty in Asians - Clinics in Plastic Surgery (theclinics.com)

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon

Private Office:

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