2021년 6월 15일 화요일

Revision Rhinoplasty

Revision Rhinoplasty


Dr.Kyungho Ko from Banobagi Plastic Surgery Clinic said “As the nose is in the center of the face, so surgery should be performed considering of overall ideal ratio.”

Among various plastic surgeries, many people consider undergoing ‘nose job’ because it can improve the overall appearance, impression, and image with just a slight change in mm. As nose is in the center of face, surgery should be performed considering the ideal ratio to achieve satisfactory results harmonizing with the facial features.

Sometimes the nose becomes even shortened and inflamed with contracture when implant is forcibly inserted to raise the nasal bridge higher. Then revision rhinoplasty will be needed. The nose is very small in size, but the internal structure is complicated with bones, cartilage, and soft tissues intricately mixed in it. So rhinoplasty is a difficult surgery dealing the complicated internal structure of the nose, and revision rhinoplasty is even more difficult since structural and tissue changes already occurred from the previous surgery. Therefore, it is essential to thoroughly analyze the reason of revision surgery and the cause of side effects before diagnosing surgical plan.

Rhinoplasty revision cases can be classified into problems with nasal tip, nasal bridge, and implants. In the case of nose tip problem, the tip of the nose raised through surgery become gradually lower over time. The symptom appears when the cartilage is weak and the length of the collumella is short, and revision is required to extend the nasal septum itself or to strengthen the collumella. If the tip of the nose is lifted due to contracture, it is a side effect due to inflammation after nose job. After sufficiently removing the problematic tissue, the remaining tissue should be released and corrected. Revision can also be performed for the case that nasal tip is still dull even after the previous nose job by collecting or trimming cartilage again.

Revision is needed if the nasal bridge is too high, the width of the bridge feels too wide or narrow, and the bridge looks crooked. Just because the bridge of the nose is high doesn’t mean pretty at all, it may rather look too plastic. If you are dissatisfied with the height, it is necessary to correct it to an appropriate height in consideration of proportion with overall features. The width and shape from the front view should be determined according to the ratio from the starting point of the eyebrows and should be symmetrical.

A typical implant problem is when the implant is visible. If the skin is thin or the implant placed is too thick, it may be seen through the skin. Occasionally, some patients complain discomfort as they feel the implant moving on the bridge of the nose. This is because the implant inserted does not match the shape and line of the nose bridge, so it should be inserted in the correct position or replaced. Also when cartilage inserted at the tip of the nose is crooked or visible, it can be corrected using autologous tissue.

As indicated above, there are different cases that require revision rhinoplasty. It is essential to thoroughly analyze the cause, determine the cause of the side effects or dissatisfaction, and diagnose suitable surgical method. So it is important to choose a clinic and specialist with abundant know-how in rhinoplasty as the surgical method and materials used differ depending on the individual’s condition, even for similar cases.

 

Original Article link: http://kpenews.com/View.aspx?No=1586270




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