Revision rhinoplasty involves re-operating a nose to improve a previous poor result and can be one of the most difficult surgeries to perform in plastic surgery. Revision rhinoplasty can take two forms. The first is the small “touch up” revision of an acceptable previous result. The patient may be happy with the overall appearance of the nose, but may wish a small and slight improvement. For example, a small tiny bump was left on the bridge or a small visible edge on the tip. Revision rhinoplasty in this case is usually a less involved operation. The patient is typically content with having the surgery performed by the original surgeon since trust was not lost. Patients are typically not emotionally upset.

The second form is when the revision rhinoplasty is performed to reconstruct a previous poor result. A failed rhinoplasty can be one of the most devastating experiences a patient undergoing plastic surgery can have. Patients that undergo rhinoplasty have usually thought about the surgery for several years. When the result is a nose that is worse in appearance than the original nose, the patient can become extremely disappointed. Self esteem and confidence may decrease and affect the person’s social activities. I have a deep and personal understanding of the emotional distress that patients undergoing through this feel and I am committed to helping them.

Rhinoplasty, also known as “nosejob”, is a surgical procedure that is performed to permanently change the shape and size of the nose. The surgery is done by reshaping nasal skeleton, which is made of bone and cartilage. The skin of the nose is not altered, but when the underlying structures are changed, the skin conforms to the new shape of the nose.

Revision rhinoplasty is performed with either an open or closed approach, much like a primary rhinoplasty. When using the closed approach, minimal additional scarring will occur since the incision is place inside the nose. When correcting results of prior surgeries it may be necessary to use an open approach with the incision placed across the skin between the nostrils. This open technique allows for better visibility for the surgeon to see and access the problems. The specific techniques that will be used are dependent on the aim of your surgery. For example, bone and cartilage are removed when treating a hump that has formed. If a depression is in need of raising, cartilage grafts will be needed to build it up.

Revision rhinoplasty is a very specialized area in the field of Plastic Surgery. It corrects the inferior results of what is often considered the most difficult procedure in cosmetic surgery: rhinoplasty. When performing revision rhinoplasty, thinks it is important to address not only the aesthetic issues or the way the nose looks, but also the functional issue of breathing problems, all the while being sensitive to the emotional concerns of patient who has been "traumatized" by one or more previously undesirable results.

Bad nose jobs can be repaired with a revision Rhinoplasty surgery, The incisions for revision rhinoplasty can be made on the inside of the nose (closed rhinoplasty), or on the underside of the nose between the nostrils (open rhinoplasty). Closed rhinoplasty has the advantages of being less traumatic and invasive to the tissues because the surgeon only uncovers the areas that need correction, whereas the open approach involves a wider dissection and more disconnection and reconnection of supporting structures. The closed approach may be safer if you have scarring from earlier nose surgeries, but some surgeons prefer the open approach for the exposure that it provides, or to better understand and visualize complicated cases. If you are unhappy with your previous nose job, setup a consultation with Dr. Kassir to see if he can repair your poor rhinoplasty with his 

Increased Confidence

The nose is a central feature of the face and can have a profound effect on a person’s overall appearance. The majority of patients experience an enhanced self-image and significantly increased confidence after improving this influential facial characteristic.

A Trusted Expert

Revision rhinoplasty expert and has studied this procedure in depth. It is he who other nose specialists often ask for advice. Dr. Pearlman uses his expertise to achieve significant improvement for his patients, and he has lectured around the world to educate other surgeons on ideal surgical techniques.

Your nose may have one or more of the following:

	Pinched tip
	Pulled up nostrils (notched)
	Deep creases above the nostrils
	Tip "knuckles" (bossae)
	Upturned nasal tip (pig nose)
	"Scooped out" profile
	Collapsed bridge
	Narrow bridge
	Crooked nose
	Nasal length discrepancies
	Difficulty breathing
	Other abnormalities

Recovering from revision rhinoplasty is similar to recovering from the initial procedure. You will need to take one to two weeks off from work or your usual activities. During the week after your procedure, you should keep your head elevated, even while sleeping.

For the first few days after surgery, your nose might feel stuffed up, and you may have to breathe through your mouth. You may also notice that your nose is sore, swollen or bruised, and the bruising may continue into the eye area, contributing the look of “black eyes.” However, many patients are pleasantly surprised with the lack of bruising and swelling, thanks to surgical techniques. Note: It takes about one year for any residual swelling to subside completely.

If you experienced an extensive degree of scar tissue after your first surgery, it may take longer to realize your final results than it did with your initial procedure.