Revision rhinoplasty, also known as secondary rhinoplasty is the procedure used to correct the results from an original surgery that were unsuccessful or not considered optimal. This is not to be confused with the minor corrections or touch ups that are required in 5–15% of procedures performed, which are usually performed by the original surgeon. A revision rhinoplasty is required when the corrections required are more severe, and a more complex surgery is required in order to restore a more natural look to the nose. Some procedures may result in the nose looking unnatural or having artificial transitions between features and the corrections made through this procedure can soften these transitions, incorporating a more harmonious set of facial features. Ongoing breathing problems can also result from an unsuccessful rhinoplasty, and further surgery may be required as a correction.
When considering revision rhinoplasty, it is important to consult with a surgeon who specializes in Facial Plastic Surgery, rather than a general plastic surgeon who performs surgery on all areas of the body. A thorough understanding of the complex facial structure is required in order to ensure that results are corrective and aesthetically pleasing. Dr. Torgerson is uniquely positioned to perform this surgery due to having attained the highest level of accreditation in Canada. He has obtained an M.D, a PH. D as well as a FRCSC (Fellow of The Royal College of Physicians of Canada). Dr. Torgerson performed his residency training in Otolaryngology, which is Ear Nose and Throat surgery, and went on to train in facial surgery through the University of Toronto’s elite fellowship program. He also serves as an associate faculty in the division of facial plastic surgery at The University of Toronto. By having a specialized knowledge of facial structure, Dr. Torgerson is able to ensure functionality as well as an aesthetic harmony of features. Since establishing his private practice, Dr. Torgerson has built one of the highest reputations as a top facial surgeon and performs revision rhinoplasties on a regular basis.
– Nasal airway obstruction – Collapse of cartilage or nasal bones – Artificial or cosmetic appearance to nose in relationship to other facial features – Internal and external nasal valve collapse – Worsened asymmetry and/or appearance – Over reduction or inadequate reduction of dorsal height (bridge height/hump) – Incomplete shaping / insufficient result – Excessive or inadequate tip projection – Excessively narrowed/pinched nasal tip – Excessive internal and/or external scarring (thickened scar tissue)
Many factors are involved in revision rhinoplasty and, through consultation, it is necessary for the patient to express their concerns and dissatisfaction as well as for the surgeon to determine the extent of the required corrections. The nature of the surgery will be determined by the thickness of the skin, the degree to which the original tissue has already been altered and the degree of re-building required. Dr. Torgerson uses a VECTRA 3D imaging system which produces a 3D picture from which the expected results can be simulated and discussed. A unique expertise is required in order to understand the underlying anatomical causes of the dissatisfactory results and the complications they may cause. The need for revision rhinoplasty may be functional, aesthetic or both, and Dr. Torgerson will ensure that the patient is comfortable and confident with the expected outcome.
Revision rhinoplasty is a highly complex surgery in that it mirrors the initial surgery but requires many additional techniques depending on the degree to which the underlying framework must be sculpted. A degree of precise craftsmanship is required to restore a more natural look to a nose perhaps looks too long or small, too pinched or too incongruous with the rest of the face. The additional requirement of repairing impaired breathing may also require a degree of reconstruction or repair. The need to rebuild a corrective structure is complicated by the degree of tissue originally removed and by scar tissue created from previous surgeries.The surgeon will have to work with existing bone and cartilage that has been previously altered and subsequently affected by scar tissue. One of the most common requirements for revision rhinoplasty is that too much tissue has been previously removed and the use of grafts may be required to strengthen and support the structure of the nose as well as to refine its shape. These grafts may be naturally obtained from the nasal septum, ear cartilage or rib cartilage but synthetic graft materials are also available and widely used. Patients will be required to wear a nose cast for one week and the swelling and bruising generally subsides within one to two weeks. It will take several more weeks for the internal nose tissue to settle and subtle, progressive changes may occur over time as the recovery process continues.
Revision Rhinoplasty is one of the more complicated and challenging surgical procedures yet its results can be the most satisfying. Once the areas of weakness have been strengthened, prominent inconsistencies have been repaired and a natural shape has been restored, the patient emerges with a renewed sense of confidence. Corrected breathing functions enhance an overall sense of well being, and additional health concerns are alleviated. Dr. Torgerson has performed many successful revision rhinoplasty procedure and, as a top facial plastic surgeon devoted to head and neck procedures, patients can be confident that by choosing Dr. Torgerson, they are in hands of a highly accomplished and skilled expert.