The term rhinoplasty refers to plastic surgery of the nose, often known by most people as a “nose job.” A secondary rhinoplasty is corrective nasal surgery that serves to alter the form and/or function of the nose after a previous rhinoplasty. Secondary aesthetic and reconstructive nasal re-shaping is indicated for cosmetic or functional deformities not properly treated or made worse from the primary operation. Some also refer to secondary rhinoplasty as “revision rinoplasty.” This broader terminology can apply to rhinoplasty required beyond a secondary operation, such as a third or fourth operation.
Common Problems that Require Secondary Rhinoplasty:
- Nasal airway obstruction
- Collapse of cartilage or nasal bones
- Artificial cosmetic appearance to nose (“Overdone nose job”)
- Internal and external nasal valve collapse
- Worsened asymmetry
- Over reduction or inadequate reduction of dorsal height (bridge height/hump)
- Incomplete shaping (not enough of a cosmetic change)
- Excessive or inadequate tip projection
- Excessively narrowed nasal tip (“pinched tip”)
- Excessive internal and/or external scarring (thickened scar tissue)
The changes necessary in secondary rhinoplasty can be done through a “closed” or “open” approach. Typically, if there are major structural changes required, and open approach may be preferred. Minor contour corrections can be performed via a “closed” technique. Closed rhinoplasty is when only internal incisions (endonasal) are made for access to the nasal structures. Open rhinoplasty refers to the addition of an incision in the skin bridge between the two nostrils (columella) in order to lift up the nasal skin for more direct visualization of the structures to be altered. The decision to use either the closed or open approach in revision rhinoplasty is based on surgeon preference and each technique has its pros and cons.
Dr. Ridenour believes in the principle of structure rhinoplasty. In structure rhinoplasty, there is minimal excision of bone and cartilage. Instead, the nasal cartilages are contoured with sutures and with additional pieces of cartilage used to create the desired shape. Soft tissue grafts are used more frequently to prevent visible irregularities from occurring from beneath the skin. The result is a nose with improved shape that looks natural but is strong enough to resist change over time.
Dr. Ridenour is a board-certified surgeon with vast experience in primary and secondary (revision) rhinoplasty. He performs both open and closed rhinoplasty techniques depending on the needs of the patient. He is fortunate to have been mentored by some of the great rhinoplasty surgeons of the modern day and he is known for his natural and realistic results.
