Before & After Gallery – Revision Rhinoplasty
Revision rhinoplasty is performed when the initial rhinoplasty procedure does not meet patient's expectations. Although on occasion patient expectations may be unreasonable, typically, when patients are not happy with their rhinoplasty results, there is a definite reason for their dissatisfaction. The cause of dissatisfaction typically involves desire for more definition or contour asymmetries, and less seldom irregularities created from poor structural support. For example, for patients undergoing an open
rhinoplasty where tip manipulation is required, reinforcement of the tip is critical; when reinforcement is omitted, the nasal tip can drop in position and create a supratip fullness. For patients who have been over-resected in the nasal dorsum, a saddle nose deformity may occur, where there is a saddle like, indent at the mid nose level.
What makes Revision Rhinoplasty challenging is four fold and include:
1st: all of the nasal structures are scarred making surgical dissection and achieving hemostasis more technical
2nd: the structural supportive elements are no longer malleable and usable following the initial surgery
thus requiring introduction of new supportive cartilaginous material
3rd: more often than not, the donor supportive cartilaginous materials such as the septal cartilage have already been used up in the
4th: the overlying nasal skin tends to thin out following each surgery, making stable soft
tissue nasal coverage more challenging.
Recent advances in medicine have allowed us to overcome many of the above obstacles. For example, harvesting of rib cartilage is often required to complete a revision rhinoplasty since the septal cartilage has already been used. This harvest does add an hour to your surgery and prolongs your surgery; however, we can now use organ donated rib graft material thus avoiding need to harvest yours! Another advancement involves use of Nitro-paste to your nasal skin during surgery which promotes improved blood flow to the nasal skin minimizing risk of skin compromise during revision rhinoplasty. Revision rhinoplasty before and after results below will help you recognize what nasal contour improvements are possible for you.
Before & After Photos
30 year old female status post open rhinoplasty revision.
21 year old male status secondary open rhinoplasty to correct saddle nose deformity.
42 year old female 3 months following secondary rhinoplasty to correct malposition of nose implant.
47 year old male 1 month following rhinoplasty to correct left nasal dorsal irregularity and prominence of right internal nares following a functional rhinoplasty performed by another surgeon.
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The only way to really know and understand the cost of any cosmetic procedure is to book a consultation.
When Dr. Mowlavi can talk with you to learn about your needs and desires and can see you and determine what needs to be undertaken can he really determine the cost of your procedure.
Breast Augmentation FAQs
During your breast augmentation consultation we will discuss:
- The ideal implant size, shape, and form
- Breast sizing
- Discussion of various approaches for implant placement’
- Preoperative management and planning
- Postoperative care
There are many reasons why you might feel that one of your breasts is firmer than the other. This can be caused by early capsule formation or it may be that the implant was malpositioned. You will need to follow up with your plastic surgeon for this as this diagnosis is more accurate when made by feel during an examination.
Capsular contracture prophylaxis exercises can be initiated as early as one week following surgery but you have to make sure that you don’t push your breasts up; I recommend using a breast band over the first two weeks that minimizes the risk of malposition. When messaging your breasts, it is very important to keep one hand over the top of the implant while the other hand messages your breasts so that you don’t inadvertently push the implants up.
A radiated breast will always feel firmer and sit higher but this is not capsular contracture. This is caused by fibrosis of your skin, underlying fatty, and fibro septal network. The capsule, in fact, might be absolutely normal assuming that you placed your implant after the radiation. Fat grafting has been recommended as a treatment to soften your breasts.
The only way to ensure that your chosen implants are going to provide you your desired breast size augmentation is to complete breast sizing during your consultation. During this visit, you are provided the opportunity to try out amongst a variety of breast implant sizers in order to hone in on your desired breast size.
Also, when the implants are placed inside you, they will be actually 5% smaller in size. As a result, you must take this into account. A final reason why you may feel that your breasts are smaller at two months is that you have gotten used to your swollen breasts over the first six weeks that is now resolving.
You can side sleep immediately after breast augmentation. The idea is to not allow your implants to move from the dissected breast pocket until the pockets have scarred down (creation of a capsule).
This occurs by 4 weeks following surgery. Regardless, as long as you wear a breastband (my favorite is the Mermaid band), you should have no problems with any activities that don’t require heavy weight lifting with your arms. The only exception is sleeping on your tummy in the early postoperative period which can push the implants out of their pocket.
Universally patients are not allergic to silicone. In fact, silicone is found in your diet as it is present in a potato skin. It is also used in your acrylic nails! Finally, it can be found in our cartilaginous structures such as the knees and ears. There has not been a single case of a true allergic reaction to silicone to date.
Whether or not you will need a lift is dependent on your nipple position. If your nipple is below or at your inframammary crease, then you will need a simultaneous lift at the time of your breast augmentation.
The amount of lift is based on your chosen implant. The reason for this is to allow your nipple to be centered on your implant. This follows the fact that the implant must sit on your inframammary crease and such that the radius of your implant will be centered on your nipple. This is the most important consideration.
The breast lift can only raise your nipple approximately 5 cm so it can only be performed for minimal to moderate nipple sagging. A virtual consultation with a breast specialist is recommended to make sure you appreciate what needs to be done to get you an excellent outcome.