Revision rhinoplasty is an operation that everyone wishes they did not have to go through.
The disappointment and anxiety that came with your primary nose job make you long for a repair or fix, but, at the same time dread the process and fear another bad result. Who wants to go through the inconvenience, discomfort and expense of yet another surgery to achieve the similar original goals?
To increase the likelihood that you won’t have to go through the rhinoplasty experience again, you need a revision rhinoplasty specialist who will work with you throughout the entire process from the planning stage prior to your surgery, through the technical demands of the actual rhinoplasty procedure and throughout your entire healing process.
You should take your time and choose your surgeon with care for the very best revision rhinoplasty result. Here we’ll discuss how to find just the right plastic surgeon and rhinoplasty expert to partner with you for success.
Your Primary Rhinoplasty: What Went Wrong?
Your prior rhinoplasty surgery may have failed because your surgeon was not experienced enough or because your surgeon did not deliver on your wants and needs. Your surgeon may have had different artistic taste than you and may have created a nose that he or she liked, instead of what you thought you were getting.
Maybe the nose you wanted was not possible and your surgeon did not tell you in advance. Sometimes a failed nose job is technically and structurally well done, but not to your taste. In some cases, there was a complication or it was not handled properly by your previous rhinoplasty surgeon.
What Makes Rhinoplasty (even Primary Rhinoplasty) Challenging for Your Plastic Surgeon?
Rhinoplasty is one of the most difficult-to-perform and exacting of all aesthetic surgeries. Many plastic surgeons will avoid offering nose jobs.
Even among rhinoplasty surgeons, there are but a few who do complex reconstructive nasal surgery. Many plastic surgeons don’t get into this type of surgery because it’s a challenge to excel in rhinoplasty.
It’s a challenge partly because the evidence of your surgical work sits right in the middle of the patients’ face. Even further complexity is involved because, even when a patient only wants a small bump removed, the surgeon must strengthen the whole delicate structure of the nose and breathing function must always be preserved or enhanced.
When your surgeon performs revision rhinoplasty (a second rhinoplasty surgery) in that same delicate area of the body, things are naturally more complicated. Even on the biggest guy, the male patient’s nasal anatomy is a delicate structure.
It consists of arches and tunnels of cartilage and bone surrounded by soft tissue, which can be easily damaged. A second surgery, on any part of the body that has been previously operated upon, gains complexity. That’s because your NJ rhinoplasty surgeon is dealing with already traumatized tissues and scar tissue.
Secondary Rhinoplasty: Why is it so Complex?
Revision rhinoplasty to correct problems not fixed in the primary nose job (or new problems brought on by that first rhinoplasty surgery) requires meticulous and careful technique.
These skills and deep anatomical knowledge are honed over years in practice as a plastic and reconstructive surgeon. In a second rhinoplasty, your revision rhinoplasty specialist also needs quick, accurate judgment to handle previously damaged nerves and tissue. (Damaged nerves can lead to numbness and impaired function in any area of the body.)
In most cases, a graft is needed to shore up inadequate cartilage left from the first surgery. Successful grafting must be sturdy and strong.
Surgeons must avoid excessive damage to the blood supply of the nose to ensure proper healing and healthy skin. (All of your body’s tissues need an adequate blood supply, bringing them nutrients and oxygen, to survive.) And, of course, everything about the nose must look smooth and elegant.
In the hands of a skilled, experienced revision rhinoplasty specialist, consistently great results can be expected.
The Right Surgeon Makes a Big Difference
As you can see, you must choose your NJ-area surgeon carefully when considering a second rhinoplasty. A true rhinoplasty expert will help ensure that the complicated surgery is planned thoroughly and handled skillfully for the quickest healing possible and a stellar outcome.
If complications occur, as they sometimes do in a complicated case, an expert rhinoplasty surgeon will know how best to deal with it, to produce the very best outcome for you. We work hard to get that smile that will be coming after splint removal, in a week or so!
When Is Rhinoplasty Revision Needed?
If anything bothers you about the look or function of your nose after a nose job, you could be a candidate for a revision rhinoplasty.
You will never know if you don’t initiate the process.
Complaints or dissatisfaction with a primary rhinoplasty often falls into the following categories:
- Grafts or implants that have moved out of place.
- Obstructions in the nose that cause difficulty breathing.
- Poor tip projection where the tip droops, sometimes becoming a parrot-like polly beak deformity.
- Too little tip definition, leaving a broad, shapeless or bulby tip.
- Too much tip definition, making the nose look too sharp or too pointy.
- Hanging columella where the skin/cartilage dividing the nostrils hangs down toward the lips, making nostrils visible from the side.
- Overly wide bridge and flat profile.
- Overly narrow bridge.
- Unnatural look.
- Saddle deformity where the nasal bridge has collapsed or looks overly scooped.
- Collapsed nostril on one or both sides.
- Asymmetry.
- Noisy breathing, mouth breathing or other breathing problems.
- Unsatisfactory appearance, nose shape that differs significantly from goals discussed before surgery.
- And more.
Revision Rhinoplasty: Enhancing Form and Function
With revision rhinoplasty, it’s never “just” about aesthetics, it’s about both of the crucial aspects: the cosmetic enhancement and breathing function. Both outcomes must be superb for a successful surgery and happy patient.
I take these responsibilities very seriously with all my patients and I’m not happy until they are. I truly enjoy helping patients by providing information about options, providing expert advice and helping to improve lives.
Even if patients never have surgery, (occasionally it’s just not the right choice or the right time for some) – even then, I love helping patients learn about their possibilities and options. No matter what, they have taken a step forward in their journey.
Clarify Your Goals for Your Revision Rhinoplasty: An Expert Surgeon Can Help
Although every revision rhinoplasty patient is different, they typically have certain basic and important goals in common for a successful outcome, including:
- Most patients want their nose to complement the rest of their facial features, which is the general definition of attractiveness. Everyone wants an attractive result and the details are different for each person.
- Most patients want a nose that functions properly. We all need to breathe easily and hope not be limited by nasal airway problems.
- Most patients want a natural-looking nose that does not look “done”. You don’t want a nose that would only look good on your favorite actor or actress’ face, although your aesthetic taste may mean that you DO like certain traits that you can point out in other noses. Don’t get your heart set on anything overly specific to retain your own unique look, but improved. This is often the fallacy of preoperative computer imaging or thumbing through magazines for noses you may like.
- Most patients want to look like themselves, only better.
Why Realistic = Happy in Revision Rhinoplasty (and Any Aesthetic Surgery)
Patients wanting to look “perfect” or “exactly like their favorite actor” are heading for disappointment. This goal is not humanly possible (because your anatomy is unique) and should not be attempted by any responsible surgeon. This can be especially true for revision rhinoplasty.
There may be limits to what is possible while still maintaining the function and the structural integrity of your nose. Actually, this is what makes revision rhinoplasty most compelling and rewarding to me and my realistic patients.
Be ready to hear the truth. This is where an expert revision rhinoplasty specialist surgeon can help most in the pre-surgery phase. Make sure you understand what to expect from your revision rhinoplasty. The more informed you are about the details of the surgical plan, the more likely to are to be happy with your results.
Don’t be discouraged in your quest to find an experienced rhinoplasty specialist will provide and become as informed as necessary before planning your revision rhinoplasty.
The Revision Rhinoplasty Specialist
1. Top credentials – Board certification and surgical privileges:
A Board Certified Plastic Surgeon is an expert with at least 5+ years of training focused exclusively on plastic surgery. (Look for many more years in your specific surgeon, but this gives you a baseline of training and experience.)
Board certification must be recognized by the American Board of Medical Specialties (ABMS). Don’t accept any kind of “cosmetic surgeon” certificate – this is NOT a recognized specialty board of the ABMS.
Both Dr. Cohen and I are board certified in both general surgery and plastic surgery, with privileges at Hackensack University Medical Center. I have specialized in rhinoplasty for over 15 years.
Becoming an ‘expert’ in rhinoplasty not only requires the requisite training and experience but also that the surgeon is keenly interested in rhinoplasty and devote a significant part of their practice to nasal surgery and be willing to do the most difficult cases.
2. Experience and expertise:
A true rhinoplasty specialist is an expert who doesn’t just dabble in rhinoplasty. This subspecialty of plastic surgery requires precise technique and superior surgical judgment which is molded from practice and refinement over years. Your surgeon must have the skill to repair both the physical form (the look) and the function of your nose. Look for someone with reconstructive experience for the deepest knowledge of facial anatomy, because…
Revision rhinoplasty challenges include:
- Scar tissue.
- Shortage of bone and nasal cartilage/compromised structure or fragile nose.
- Grafts may be needed from the nasal septum, ear or ribcage.
- Presence of implants.
- The patient may be stressed or traumatized from their first rhinoplasty.
3. Artistic sense:
Rhinoplasty requires excellent technical skills – it’s a science, but also an art. Make sure your surgeon shares your good aesthetic judgment through a discussion about facial balance and looking at photos. One of the things Dr. Cohen and I love about plastic surgery in general (and that I love about rhinoplasty in particular) is the artistry involved.
That’s the reason I chose this specialty. I truly enjoy the mix of science and art. In this field, a blend of talents helps the patient achieve the results they truly want. Every nose I repair and every patient I work with is unique. There cannot be any cookie cutter surgery, especially in rhinoplasty.
Your surgery will be tailored to the needs of your anatomy and your wishes for a result that brings harmony to your face and enhances your facial features.
4. Honesty and communication:
Your revision rhinoplasty specialist should be able to explain the strategy to repair your nose in a way you can understand. Choose a surgeon you feel comfortable talking to and one who you feel is listening. Your surgeon should talk with you about risks and complications. Although these are rare, especially with an expert surgeon, complications do occur.
If you surgeon denies ever having seen any complications, he or she is not being honest or lacks experience. Your surgeon should have the experience and judgment to handle any complication. As a rhinoplasty specialist, I always ensure that patients understand their individual risk profile and explain how I deal with and prevent complications.
This helps my patients go into surgery confidently.
5. Dedication:
Your revision rhinoplasty specialist must be concerned about your needs and well being. If you feel like the surgeon is “selling it” during your consultation or wants you to commit immediately, these are bad signs. Look for a revision rhinoplasty specialist that partners with you as an individual for the success of your rhinoplasty procedure.
At Cohen/Winters, we feel that surgery as our calling and we get tremendous satisfaction from patients who are happy and do well. In fact, we are never happy unless you are. Much of my practice is dedicated to rhinoplasty and reconstructive or revision rhinoplasty.
I enjoy the moment the splint comes off and the patient first sees their new improved nose about as much as anything else I do.
Risks of Revision Rhinoplasty: Can Surgical Experience Help?
Another reason to ensure you choose a true revision rhinoplasty specialist for your surgery: reducing risk. There are extra risks with a revision rhinoplasty surgery, as with any secondary surgical procedure on body parts that have been operated upon previously. Your chosen NJ surgeon should reveal the percentage of corrective rhinoplasty patients that suffer complications. As with any surgery, some risk goes with the territory. Risks and challenges of secondary rhinoplasty include:
- Infections
- Prolonged inflammation
- Excessive blood loss
- Scars and excessive scar tissue
- Skin death
- Weakened nasal structure
- Temporary loss of smell
- Complications from anesthesia
- Continued nasal problems, aesthetic or functional
- And more complications specific to your revisional nasal surgery
It’s important that you understand and take the risks seriously. Do what you can to mitigate potential problems, risks and complications by choosing a top expert revision rhinoplasty specialist. An expert reconstructive surgeon is deeply familiar with nasal and facial anatomy and can plan around some surgical obstacles and risks. Part of being an expert surgeon is knowing how to protect patient health should something go wrong. Experts cannot ensure that nothing ever will go wrong in a surgery. However, expert Bergen County rhinoplasty surgeons help keep minor issues from becoming a big complication through experience, superior surgical judgment and technique.
Traveling to NJ for Revision Rhinoplasty
When you find the best NJ surgeon to perform your revision rhinoplasty, don’t be daunted if you’re not from around here.
Sought-after surgeons are accustomed to patients traveling into NJ for the best care. At Cohen/Winters we can arrange for patients to stay overnight in one of our recovery suites at our Vanguard Surgery Center. Or you can opt for an overnight stay in a local hotel with a private nurse, which our office can help arrange for you.
If necessary, we have admitting privileges at Hackensack University Medical Center.
After the Surgery and the Splint – the Smile!
There’s really nothing like seeing the smile on a patient’s face when their splint comes off soon after the second rhinoplasty, correcting problems with the first. Many patients have lost hope and may even feel betrayed by their first plastic surgeon.
Others are skeptical, feeling that their nose can never be repaired or ever be attractive. Even though patients are still swollen when the splint is removed (it’s just a few days after surgery), the results of the second rhinoplasty are evident – and the smiles are amazing.
Choose an Experienced NJ Revision Rhinoplasty Specialist
Select a surgeon with at least 10-15 years experience complete with revision rhinoplasty interests. Surgeons who specialize in revision rhinoplasty in the populous NJ area see more than their share of complicated rhinoplasty surgeries.
Surgeons in NYC get lots of practice as well, but NJ is less crowded and less stressful for most patients. According to statistics from the American Society of Plastic Surgeons, the northeastern US, (including NJ) is the top market for rhinoplasty, with 30 percent of all nose jobs being performed here. Even if the majority of them are done acceptably, simple math dictates that there are a multitude of complications and disappointments.
The opportunity for experience with a variety of patients helps dedicated NJ-area surgeons to hone their surgical skills and judgment over many years. Rhinoplasty is one of the most challenging plastic surgery procedures and revision rhinoplasty is even more difficult. Meticulous and exact surgical technique is absolutely necessary for successful corrective rhinoplasty.
At Cohen/Winters in Bergen County, we devote a significant portion of our practice to the most complicated revision rhinoplasty cases.
Cohen/Winters: Experience + Dedication Second to None
You need experience combined with true dedication from your corrective rhinoplasty specialist to ensure revision rhinoplasty success. At Cohen/Winters, we consider it our true calling to help patients achieve their goals and improve their lives through plastic and reconstructive surgery. For us, this is more than a business, a job or a profession. We really gain satisfaction from knowing our patients and providing them with exactly the help they need.
We don’t want to give you “our idea” of a great nose or the same nose as a particular famous athlete or actor. We want to find out what you want and examine you to find out what is best for you physically. Then we want to communicate honestly how we will achieve your goals. If we think your goals are unrealistic or inadvisable in our expert (experienced) opinion, we will be honest and tell you. As top revision and reconstructive rhinoplasty surgeons, we will not go forward until we understand what you want and we (both surgeon and patient) agree on the expected outcome. This is the formula for revision rhinoplasty success—and it’s what we practice at Cohen/Winters every day.
Partner with an Elite Revision Rhinoplasty Specialist in NJ
Work with a surgeon who shows these qualities:
Choose a Rhinoplasty Surgeon Who is a People Person
Some plastic surgeons concentrate mainly on the technical side of their surgical work. Of course, you need a surgeon with precise technique and top-level surgical skill, but planning is crucial as well—especially in revision rhinoplasty. You don’t want a surgeon to only fix your nose, you want him or her to fix it the correct way. You want an outcome that appeals to you personally. So you need a surgeon who cares deeply about providing a result you will love. You will be able to tell if your NJ revision rhinoplasty specialist has this quality when you meet. Basically, I advise you to seek a surgeon who is passionate about improving the lives of his or her patients.
Choose an NJ Plastic Surgeon Who is Upfront
At the same time, you need honesty. You need a surgeon who will let you know if your goal for revision rhinoplasty is not anatomically feasible or desirable. Your surgeon’s vast experience can help you understand what you can expect from your surgery and which solutions will work best. Honesty and clarity from your surgeon is a signal that you can trust him or her. You really need that trusted relationship for a successful revision rhinoplasty.
Choose a Revision Rhinoplasty Specialist in NJ with an Artistic Vision
Select a surgeon who has a knack for aesthetics; the artistic side of rhinoplasty, in addition to their other qualifications like years of experience and surgical skill. You’ll get a good sense of this as you discuss rhinoplasty goals you’re your NJ plastic surgeon. Of course, looking carefully at the surgeon’s portfolio of prior work will also help build your confidence if the surgeon is right for you.
Get Expert Revision Rhinoplasty Advice from Cohen/Winters
At Cohen/Winters Aesthetic & Reconstructive Surgery in Bergen County, NJ, we want to help you bring out your natural beauty and repair your nose to improve your quality of life. If you’re curious about the possibilities for revision rhinoplasty, schedule a no-charge consultation with noted revision rhinoplasty specialist Dr. Richard Winters.
You should always get professional advice and insight into the revision rhinoplasty procedure and get answers to your questions. Provided you’re a good candidate for revision rhinoplasty, and you decide to go forward, Dr. Winters will partner with you – to achieve your new look and improve any breathing problems. Your consultation is free of charge.
