Dr William Portuese will like to learn about your goals and expectations at your initial meeting. He wants to get to know you as a whole person. He will utilize a state-of-the-art imaging tool to show you how your nose will look after surgery after taking some time to get to know you. Patients frequently have no idea how much rhinoplasty can alter their profile. The ability to see this is a significant tool that can aid in the deciphering of your objectives.
Revision rhinoplasty is a procedure that involves a second operation on the nasal anatomy and structure in order to improve the nose’s appearance even further. In addition to the skin soft tissue envelope and the nasal septum, the nose is made up of two nasal bones, two upper lateral cartilages, and two lower lateral cartilages. A revision rhinoplasty entails making the necessary alterations to the nose in order to achieve a natural-looking result for the patient. Due to the presence of scar tissue and previous modifications to the architecture of the nose, rhinoplasty is far more difficult than a primary rhinoplasty. Those modifications are frequently undetectable to the surgeon until the treatment is carried out. Before placing this patient under general anesthesia, experienced rhinoplasty surgeons normally have a surgical strategy planned. For patient safety and comfort, all rhinoplasty surgeries at The Seattle Cosmetic Surgery Center are conducted under general anesthesia by Board certified physician anesthesiologists.
While the before and after photos below show excellent cosmetic results from revision rhinoplasty, patients should keep in mind that Dr. William Portuese considers the whole picture—despite the fact that most patients are concerned with the appearance of their nose, he is also sensitive to the functional aspect.
Patients who have one or both nasal bones that have wandered outwards from previous surgery and need to be straightened or narrowed with osteotomies may need a revision rhinoplasty.
A slight dorsal hump may remain in some patients, which can be shaved down using a rasp. The irregularities over the bridge line might be made of cartilage or bone, and they are the most prevalent anomalies after a primary rhinoplasty treatment, particularly in patients with thin skin. Spreader grafts are put under the concave upper lateral cartilages in the mid-section of the nose when patients have a concave upper lateral cartilage or an inverted V. deformity. When a patient has an inverted V. deformity, spreader grafts are inserted on both sides of the nose, or solely on the concave side when a crooked nose is present. Because the tip cartilages of the nose can be asymmetric following rhinoplasty, cartilage grafting procedures are used as an onlay graft or sutured onto the tip cartilages. Suture procedures applied to the lower lateral cartilages at the tip of the nose diminish the breadth of the tip, resulting in a less bulbous nasal tip.
Significant reduction in the breadth of the tip of the nose is impossible due to thick skin and substantial scar tissue. An alar rim graft is used to restore the architecture of the alar rim and prevent the nasal rim from collapsing during inspiration in individuals who have alar rim collapse. A dangling columella is another obvious indication of rhinoplasty surgery. A nose with a dangling columella seems “bottom heavy.” Incisions are made on each side of the interior region of the nose, and excess cartilage and skin are shaved away in that area to decrease a hanging columella
Female Cosmetic Rhinoplasty – Revision
In addition, depending on where the skin and cartilage are removed, the tip of the nose can be turned upwards or downwards. When there are still large nostrils after a primary rhinoplasty, an alar-plasty is performed. To narrow the nostrils, an alar-plasty involves removing a wedge of skin from the base of the nostrils. Depending on the surgeon’s preference, revision rhinoplasty can be performed using an open or closed rhinoplasty method. All of the incisions for a closed rhinoplasty are made on the inside of the nose to have access to the tip, bridge, and nasal bones to perform the necessary adjustments. The same incisions on the inside of the nose are used as well as an external incision across the columella in an open rhinoplasty.
Cosmetic Rhinoplasty – Bulbous Tip
Dr. William Portuese has complete control over nasal functionality in every revision nose surgery he performs as a board certified facial plastic and reconstructive surgeon. He can even improve a patient’s breathing by fixing a deviated septum or another functional fault in specific situations. Patients typically enjoy the valuable secondary benefit of smooth, comfortable breathing, even if their primary concern is the appearance of their nose. Patients sometimes come to Dr. Portuese because their breathing has gotten worse after a previous rhinoplasty.
Breathing Difficulties Out of the Nose (Nasal Obstruction)
Dr. Portuese can enhance the nasal airway without changing the look of the nose in this situation. Shortcuts are never good, according to one of Dr. Portuese’s main practice principles.
His technique is extensive and thorough after examining the particular issue, guaranteeing that the favorable effects endure a lifetime. If a previous nose work has left you unable to breathe correctly through your nose, it may be time to see Dr. Portuese for revision rhinoplasty.
Crooked Nose Revision