There is a risk of revision in every plastic surgery. The experience of the surgeon, the technique applied, nasal structures, previous surgeries or accidents may result in requiring revision.
Surgical intervention depends on the the degree of deformity.
In revision rhinoplasty, the condition of the septum (cartilage separating nostrils) is very important. Preoperative physical examination should be performed by endoscopic examination and CT (Computed Tomography) if necessary.
Cartilage tissue to be used for repairing the deformities from the previous interventions is received from septum, but if cartilage is not enough, it can be taken from conchal cartilage around the outer ear. This does not deform the ear when done carefully. However, this is not used for support purposes due to the structure of cartilage, is used for camouflage or filling purposes only.
In severe cases requiring support, costal cartilage (rib cartilage) being more robust cartilage, is used. In females, this cartilage is received from inframammary fold and in males, it is received from the level corresponding 7 or 8th costal cartilage through 2-3 cm incisions.
The surgery is not very different from the primary rhinoplasty operation.
I prefer to do it under general anesthesia. After 2 to 3 hours of surgery, silicone breathable or perforated tampons are used if necessary. There will be plastic thermal splints and bands placed over the nose. Bleeding is normal within 24 hours following the operation and a gauze placed at the tip of the nose will be enough treatment. Food is allowed 3-4 hours after the operation and if the patient does not have any problems they may be discharged or required to stay at the hospital for one night.