Revision rhinoplasty is on the rise: How can we reduce dissatisfaction and side effects?

[Medical Tribune] A survey published a few years ago revealed that 40% of people in their 20s had experience with plastic surgery or cosmetic procedures. Since then, the number of plastic surgeries has further increased, and it is now considered a way to help resolve physical complexes or improve specific bodily functions.

Among various facial features such as the eyes, nose, chin, and forehead, the nose is a feature where even a slight change can lead to significant improvements in appearance, ranking second only to the eyes in the number of surgical procedures performed.

Located in the center of the face, the nose determines the overall impression and atmosphere depending on its shape, angle, and height. This is because, even with the same face shape, the nose can create a slimmer, sharper, or softer image depending on its contours.

On the other hand, rhinoplasty is also known as a procedure with high rates of dissatisfaction and revision surgeries. Being in the center of the face, poor surgical outcomes lead to a much steeper drop in satisfaction compared to other areas. As a result, many patients undergo multiple revision surgeries, and experts emphasize the need for caution.

▲ Director Kim Seong-hoon (Photo provided by SH Plastic Surgery)

The main reason for revision rhinoplasty is dissatisfaction with the results—such as when the nose is too high or too low. The next leading cause is surgical side effects. Examples of side effects include inflammation caused by artificial implants failing to settle properly, as well as contracture (capsular contracture), where the tissue hardens due to irritation from surgery or scarring. Other issues include implant visibility, movement, or deformation.

Plastic surgery specialists emphasize that the top priority in revision rhinoplasty is identifying the cause of dissatisfaction or failure from the primary surgery. According to Kim Seong-hoon, Head Director of SH Plastic Surgery, revision rhinoplasty is more complex and difficult than the initial surgery, requiring greater consideration of both functional and aesthetic aspects of the nose.

This is why a thorough process is necessary, using 3D-CT (Computed Tomography) to analyze the shape, condition, and size of the nasal bones and surrounding soft tissues, closely examining the state of the nose, and checking for contracture and inflammation.

To increase satisfaction and reduce the occurrence of side effects after revision surgery, one must also be cautious in selecting materials. Because a variety of materials are used in rhinoplasty—such as cartilage (ear cartilage, septal cartilage, costal cartilage), dermofat, silicone, Gore-Tex, and Alloderm—it is essential to carefully determine their suitability for each patient.

Director Kim advises, "Since the nose is located in the center of the face, a natural design that fits facial proportions is crucial in rhinoplasty. For revision surgery as well, a systematic surgical plan must be established, especially to improve both aesthetic and functional aspects."

He also adds that if one is planning a revision surgery, it is advisable to proceed only after monitoring progress for about six months following the initial surgery.

Source: Medical Tribune