Rhinoplasty is a commonly performed operation, but sometimes the results don’t turn out the way they were planned. This can be frustrating as you already underwent a nose surgery, but now there is hope for patients unhappy with their previous rhinoplasty result to get the nose they want.
Rhinoplasty is a commonly performed, but difficult operation because the nose must not only look good, but also function for breathing and smell. Unfortunately, the results don’t always turn out the way they were planned. Most people inquire about revision rhinoplasty for one of two issues: “My nose doesn’t look good” or “I can’t breathe through my nose.” This can be frustrating as you already underwent a nose surgery, but there is hope for patients unhappy with their previous rhinoplasty result to get the nose they want. Dr. Compton is highly qualified and experienced in complicated revision rhinoplasty cases. Don’t let his young face fool you, he has performed thousands of nasal surgeries and specializes in complex and revision rhinoplasty for both appearance and breathing issues.
Many plastic surgeons have not had the extensive rhinoplasty training and experience that Dr. Compton does and it is this expertise that is vital to a successful revision rhinoplasty case. Just as important is finding a surgeon who will take the time to find out what your goals are and formulate your personalized surgery. It is normal to feel some anxiety about a revision rhinoplasty and Dr. Compton will take the time to ensure you feel comfortable and all your questions are answered. Dr. Compton provides all of his cosmetic surgery patients his email address for routine questions and his cell phone number to call in case of an emergency. He is a warm and caring doctor, who will ensure you are well taken care of, while pursuing the nose you were always meant to have.
The nose is a complex three-dimensional structure that is in the very center of our face and therefore your identity. Each component of the nose has subtle curves and depressions that give the highlights and shadows that define the nose. Minor variations can create large aesthetic and functional differences. An experienced hand is required to correctly balance these structures. Poor rhinoplasty results can occur from a variety of things, some are surgical errors and some are the result of poor healing. Since the final result is a complex interplay between all of the structural components of the nose undergoing inflammation and scarring, occasionally irregularities arise during the healing process. Many times these minor issues can be corrected in the office with minimal discomfort under local anesthesia. Often though, poor results occur due to poor surgical techniques.
Whether that was overly aggressive removal of cartilage or under correction of a pre-operative problem both can lead to similar dissatisfaction. If the problem was not adequately addressed in the first operation, then repeat surgery will need to be performed aimed at appropriately correcting that issue. This could range from a small incision inside the nose, to open rhinoplasty approach. The approach is less important than the final outcome being as good as possible. If the problem is from too much cartilage having been removed, a larger surgery will likely be required to correct the nasal deformity and breathing issues. Over-resection rhinoplasty (too much cartilage removed) generally results in an irregular appearing nose with a knobby tip, retracted nostrils, over-narrowing of the nose and nostril collapse. In this situation, Dr. Compton likes to use an open approach for structural grafting using your own cartilage.
Dr Compton would prefer to use cartilage from the nose/ septum if available, but often times this has been removed previously. In this situation, Dr Compton prefers to borrow a 4-5 cm cartilage segment from one of your ribs to rebuild the nose, as it is a very strong material. For less structural problems, he will use the cartilage from your ear. In women, the rib is removed through a 3 cm incision under the breast, where your underwire sits. On gentlemen the incision is generally a little lower. A pain pump is then inserted to numb the chest wall for 72 hours which removes much of the pain from the process. When removed, most people comment that it only is sore when they cough.
The reason rib grafts are so useful is that rib cartilage is very strong and can be shaved very thin while still maintaining its strength. This allows it to be placed into the nose to strengthen it without adding excess bulk. As the larger piece of rib is cut into smaller pieces, some of the grafts are straight and some are curved. This natural curve works great to support the nostrils and the straight pieces for adding strength/ straightening the middle of the nose. Other pieces can be used to add height to the tip or bridge of the nose, tip definition or really any other application. It is very versatile. Dr. Compton always soaks the rib graft in an antibiotic solution as he is working on it to reduce the incidence of infection on the graft.
Use of this type of donor rib graft in the nose has been done for many decades is very well accepted as a safe method, with an excellent success rate. Many of the revision rhinoplasty patients pictured in the photo gallery have been corrected with this technique.
In select cases, Dr Compton may use a cadaveric donor rib graft. While this presents less pain for the patient, this graft has a higher rate of resorption and is technically more challenging to carve. Dr. Compton only uses donor grafts from the leader in this field, Musculoskeletal Transplant Foundation WWW.MTF.ORG. They only accept 3% of donors due to their very strict criteria and then thoroughly test and process the graft for blood-borne pathogens, including HIV, Hepatitis, and many others, most of which the general public has not even heard of.
Recovery from revision rhinoplasty will not necessarily be worse and the experience is often times better than the first surgery. Patients do tend to have a longer duration of recovery though due to the scar tissue present from the previous operation as well as the larger amount of work that is required. Initial bruising and swelling are similar to primary rhinoplasty with most patients able to return to work in 1 week with bruising resolving in 2 weeks. Swelling is improving by the end of the first week and is 80-90% gone by 1 month but the remaining swelling may take up to a year to gradually resolve. This process may be longer in multi-revision cases. Dr. Compton will follow up with you on multiple visits for at least 1 year after surgery then on an annual basis after that. These visits are all included in the surgical fee for most patients. It is important to monitor the healing process as it is occurring and intervene when at the appropriate time.
Revision rhinoplasty cases are significantly more challenging than primary cases and require much more demanding techniques. Rebuilding the missing and damaged pieces generally takes more than 3 times longer than removing them. Unfortunately, insurance only pays 2 rhinoplasty codes, neither of which are weighted for the extra time required for revision cases. This as well as the need for graft material will translate to a higher out of pocket cost. Depending on the insurance, the nose and the work needed, this could range from a cosmetic surgeon fee of $2500- $6000 not including anesthesia or facility fees. Most revision cases require a $2500-3500 surgeon cosmetic fee on top of the insurance reimbursement. Remember though, all surgeons and all rhinoplasties are not created equal. The only thing similar to the previous surgery is that it is a surgery on your nose. Dr Compton is a master at creating a well balanced, aesthetic nose that breathes well. As he likes to put it, “It’s just what I do.”
Dr Compton approaches every surgery, that this will be your last and best nose surgery.
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"My experience with Dr. Compton was outstanding. Dr.Compton always made me feel like I was the only patient he had. Our consultations were never rushed like other Drs. He took his time to explain the process, address any concerns, make sure my needs/wants will be meet, and that me and him were aligned."