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At
Makeover Travel we are specialists in the repair to cases of
Cosmetic Surgery that have been performed in other centres and have
resulted in being deficient or unsatisfactory.
This
is one of the exclusive products you will only find at Makeover
Travel, thanks to the high professional level of our Plastic
Surgeons.
Medicine and Surgery are not exact sciences, and therefore contain a
degree of variability and unpredictability. In part, this is due to
the human factor, thanks to which Cosmetic Surgery at Makeover
Travel is offered at the highest degree of professionalism.
However,
this same human factor, if it lacks the correct level of excellence,
can be the cause of inadequate or complicated results.
Separately, there are the individual and genetic factors
corresponding to each patient, that may condition the work performed
by the professionals.
Currently,
Cosmetic Surgery is a massive phenomenon
that has
been popularised and has penetrated all social levels.
Whether due to the factors inherent in each patient or, what is more
customary, through errors in the indication or execution of
treatment, from the vast number of operations performed certain
patients may be frustrated in their desire for improvement.
The situation for patients suffering from poor results in their
treatments is, at times, desperate, because they cannot find
Specialists who are sufficiently honest or who have enough
experience in this type of re-operations.
It
is not about applying customary and normal techniques of Cosmetic
Surgery.
Cases of secondary surgery require a meticulous and personalised
study by professionals especially dedicated to these types of
repair. The techniques applied have to be designed to measure for
the condition of the tissue.
Our
medical team provide a great wealth of experience in secondary
surgery
or for the
revision of those cases that have already been operated on and in
which the patient wishes to improve the result. These situations are
very demanding professionally and only certain Specialists can meet
them with due guarantees. We assess you in a totally independent and
professional manner, we shall inform you of the real possibilities
of improving your result, and we shall try to achieve the success so
desired from the previous treatments.
At Makeover Travel we shall know how to listen to you and to
understand what you are looking for.
Thanks to our Plastic Surgeons many patients have recovered their
belief in Plastic Surgery and the joy of living.
Revision
Rhinoplasty
With any
cosmetic surgery, a touch-up or revision procedure is sometimes
necessary. Even in the hands of the best surgeon, the need for
revision sometimes occurs. And because rhinoplasty is a complex
operation, it has a higher revision rate than other cosmetic
procedures.
Revision rhinoplasty is a
surgical procedure designed to repair both form and function of a
nose that has previously been operated on. Many people have
difficult breathing from their nose or are dissatisfied with the
cosmetic appearance of their nose as a result of prior nasal
surgery. In fact, many patients have had several unsuccessful nasal
surgeries, even as many as six or seven prior procedures. Because
rhinoplasty is one of the most difficult of all plastic surgery
procedures, there is a large need for secondary surgeries. Further,
revision rhinoplasty tends to be an even more complicated procedure
than primary rhinoplasty, making it essential that patients find a
sufficiently qualified and experienced surgeon. Good candidates for
revision rhinoplasty include physically healthy men and women who
are realistic in their expectations and are unhappy with the results
of a prior rhinoplasty procedure.
In
our plastic surgeons' practice, about 40% of the rhinoplasties they
perform are revision rhinoplasty cases from patients who had
operations elsewhere by another surgeon.
The most common thing these patients say is they did not realize at
the time of their first operation that not all plastic surgeons
specialize in rhinoplasty or facial surgery.
If your first surgeon specializes in whole body plastic surgery,
chances are his/her practice does not specialize in nose surgery.
Rhinoplasty may not be the most common procedure performed in their
practice. Unfortunately, most people seeking revision surgery
realize this after a bad outcome.
Why Revision Rhinoplasty?
Like any other cosmetic surgery, rhinoplasty is not an exact science
and some irregularities may appear after rhinoplasty surgery.
Rhinoplasty surgery, as opposed to all other cosmetic surgeries, is
by far the most challenging surgery.
No two noses are alike, each surgeon's sense of aesthetics is
different and the surgery is performed differently by each surgeon.
Even if the surgeon does everything within his/her power to do the
operation as well as he can, he cannot control how the body heals
postoperatively.
It may seem that nobody would want to have rhinoplasty surgery to
start with. In reality, if you have real expectations about plastic
surgery, the majority of outcomes are positive and most people will
not require additional plastic surgery.
But let’s focus on the small percentage of patients who did not get
the outcome they wanted. How and why does this happen?

Patient expectations are very important. No one’s nose, or face for
that matter, is perfectly symmetric. Therefore, it is important to
understand that minor asymmetries are present prior rhinoplasty
surgery, so asymmetries will be present afterward as well. Some
patients may not be able to accept minor imperfections after surgery
because of the idea that results after surgery should be “perfect.”
Remember, there is no perfection when it comes to surgery; it is
merely an improvement. Your nose was not perfect before rhinoplasty
surgery and will not be after either.
There
are other common reasons why one might seek revision rhinoplasty.
Callous or bump: A small callous or bump may appear on the dorsum
up to one year following your procedure. The cause of this is
unknown, but if it occurs, it can usually be removed in a minor
procedure.
Polly beak: Sometimes called a "parrot beak," this can occur
when a hump on the bridge of the nose isn't sufficiently reduced in
the area just behind the tip or when there's a build-up of scar
tissue. Correction requires revision rhinoplasty.
Pinched tip: When the tip of the nose appears pinched, it's
often because too much tip cartilage was removed or the cartilage
didn't heal well and collapsed. To correct this, cartilage is
usually added to the nasal tip in a revision rhinoplasty procedure.
Inverted V: When a hump is reduced, sometimes the middle
vault of the nose collapses inward, causing an "inverted V"
appearance. This may be corrected with the placement of grafts in a
revision rhinoplasty procedure.
Post-operative changes: In general, following primary
rhinoplasty, the nose changes every year. These changes can be
unpredictable, and you may not like the way these changes look.
Disappointment with results: Despite your surgeon's best
efforts, it's possible that you may be disappointed with your
results. Disappointment may be due to unrealistic expectations on
your part, unclear communication of your goals, surgical aesthetic
misjudgment, or complications during the healing process.
Even if you're completely satisfied with the way your nose looks
following surgery, it is possible to experience a nasal obstruction
that make it more difficult to breathe through your nose. Most nasal
obstructions can be corrected with revision rhinoplasty. If your
breathing is hindered in any way, you may want to consult with your
surgeon about a follow-up procedure to alleviate the problem.
Be
Realistic Concerning Revision Rhinoplasty
No plastic surgeon will get a perfect result. If your surgeon tells
you that he never performs revision rhinoplasty on his own patients
because they all turn out great, say thank you for the consultation
and leave the office. All rhinoplasty surgeons at one time or
another must perform Revision Rhinoplasty surgery on their patients
because rhinoplasty surgery and the postoperative healing are not
completely 100 % predictable processes.
The real question then becomes:
What percentage of Revision Rhinoplasty surgery does each surgeon
perform in his own patients? And, what are the problems needing
Revision Rhinoplasty surgery?
The acceptable rate, in our opinion, for patients requiring Revision
Rhinoplasty should be about 5%.
The type of problems requiring Revision Rhinoplasty surgery
performed by each plastic surgeon is also important.
Not all
revisions are the same.
Revision Rhinoplasty surgeries in one doctor's practice may imply
coping with minor problems after healing. While in someone else's
practice, it may mean returning to correct plainly unacceptable
results after the first surgery.
It is true that we cannot control all aspects of the surgery, but
the way the surgery is performed, the level of expertise of your
plastic surgeon in the field of Revision Rhinoplasty, the type of
training and the number of nose surgeries he does will have a
significant influence in the outcome of the procedure. Stated
simply: You cannot control all aspects of the surgery and the
healing accompanied with it, but you can control who you choose to
do your surgery. From all controllable aspects in rhinoplasty,
choosing the right plastic surgeon is probably the most important
factor in achieving a desirable outcome.
So,
should you have another surgery?
Who should do your surgery? And when is it appropriate to have it?
As discussed earlier, no plastic surgeon gets perfect results all
the time. The first issue you must address is whether the problem
needing repair is minor or an unpredictable result after the surgery
was performed properly by your surgeon. If this is the case, the
first surgeon likely will be able to take care of it.
On the other hand, if the result of the first surgery is plainly
unacceptable and you just realized that your plastic surgeon's
practice doesn’t really specialize in rhinoplasty surgery, it is not
in your best interest to have the same surgeon correct the first
surgery. Chances are your doctor is not equipped to perform the
revision surgery required. Just as he did not get it correct the
first time, he/she will not get it right the second time. In fact a
bigger problem may be waiting for you.
Emotionally this is very difficult. You just invested energy, time
and money on a procedure that had an unacceptable outcome (assuming
your expectations were realistic before and after surgery).
The
last thing you feel like doing is paying for another surgery. Having
a second surgery by the same surgeon to repair the problem at no
charge now sounds very appealing. What you do not realize is that
you have a very high probability of having a second bad outcome. A
second bad outcome will result in even more emotional distress to
you and more damage to your nose, which will be even more difficult
and expensive to repair.
It is hard to make the decision to pay someone else for a second
surgery. But, before you commit to revision surgery by the first
surgeon, get a second opinion by someone who specializes in
rhinoplasty to weigh all options.
Timing of surgery is also very important. Several months after
surgery swelling may still bother you, and no treatment may be
needed. Conversely, problems that are not evident several months
after surgery may only be visible a year later when swelling fully
subsides. I know it is very difficult emotionally to wait for
resolution of your concerns, but be patient.
Why is Revision Rhinoplasty So Difficult?
During revision surgery, the surgeon usually encounters scar tissue
inside the nose. It is very difficult and time consuming to operate
with scar tissue. Also during this surgery, the surgeon typically
must “undo” what the previous surgeon did and then “redo” an entire
operation. This is a reason revision rhinoplasty will take up to
four times as long as a primary nose surgery.
Here’s another thing to consider. In most revision surgery cases the
nose’s skeletal support has been overly weakened from excessive
removal of cartilage and bone. Thus, the support and breathing
function must be rebuilt at the same time as the cosmetic aspect is
addressed.
Manage Your Expectations
If your first surgery was less than satisfactory, chances are that
in the right hands you will achieve a very good result with revision
rhinoplasty. Just like with primary rhinoplasty, you must have
realistic expectations about what the surgeon can and cannot do.
Expect improvements, not perfection. Remember, during the second
surgery your nose may have large amounts of scar tissue that makes
it more difficult to manage during surgery and creates even less
predictable results than the first time. Consequently, it is
important to have the surgery done by someone who specializes in
revision surgery; someone who is accustomed to dealing with scar
tissue and who can maximize your chances of a good outcome.
Are You Emotionally Prepared For Revision Rhinoplasty?
If
you had a less-than-ideal outcome from your first procedure and you
will require further surgery, do not rush into it. You must be ready
emotionally t deal with another operation and another recovery
period. As mentioned before, revision rhinoplasty involves operating
on scar tissue. Scar tissue will take even longer to heal as
compared to normal tissue. It may take your nose twice as long to
recover from swelling as compared to your first surgery.
The resolution of swelling associated with surgery is a continuous
and slow process. Your nose should look better after surgery, but it
will not have its definition or desired shape for many months. You
must prepare yourself to accept small incremental improvements on
the appearance of your nose as the months go by, rather than expect
to be fully healed after several weeks.
Revision rhinoplasty is a highly skilled surgery and is very time
consuming. It may take two or three times the length of time
required for a first-time surgery.
Revision rhinoplasty can be done successfully if done properly. Make
sure you choose the right doctor, have realistic expectations and
are emotionally ready to have another surgery.
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Revision Rhinoplasty
BEFORE
AFTER

BEFORE
AFTER

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