Key points to check in early revision rhinoplasty at 14 days post-op

Hello.

I am Dr. Peter C. Kang, medical director of the Rhinoplasty Research Center.

Today, I will talk about early revision surgery. In this case, the patient had undergone surgery and even an attempted revision, but the nasal deviation remained uncorrected, leading the patient to come to NOSELAB urgently for revision surgery just 14 days later.

Early revision surgery can be performed within 2 weeks; once 2 weeks have passed, surgery is generally possible only after at least 3 months. Fortunately, the patient visited shortly after the prior surgery, allowing us to perform early revision rhinoplasty at the 14-day mark.

The plan was to remove all silicone implants and tip cartilages placed at the previous clinic, and to correct the crooked nose while elevating the nasal tip stably using autologous rib cartilage. I anticipated that the deviation had likely been caused by asymmetrical suturing of the tip cartilage during the previous surgery, and planned accordingly. Considering that swelling had not yet subsided from the bridge and tip and that scar tissue begins to form rapidly around the tip cartilage at this stage, I planned a surgical approach aimed at minimizing tissue damage.

Let us compare the preoperative photos with the photos immediately after surgery (Day 0).Immediate postoperative photos show swelling and may differ from the final result.

On the profile view, the radix was lowered, and the blunt, uneven contour of the nasal dorsum was refined.

On the oblique view, a noticeable difference in the dorsal angle can be seen relative to the repositioned radix.

On the front view, the upturned appearance was resolved, and the C-shaped deviation showed marked improvement.

The bulbous appearance of the nasal tip was substantially refined. There was a significant amount of scar tissue at the tip, which was excised carefully with consideration for the possibility of recurrence.

Early revision rhinoplasty is not a routine procedure. In other words, it is reserved strictly for cases where it is truly necessary. It should be considered only when a poor outcome is clear, or when it is evident that a surgical error occurred. It is not an operation to pursue simply out of dissatisfaction with the early post-operative appearance. In this case, the previous surgeon acknowledged the issue and mentioned that future correction might be difficult, so the patient decided to proceed after a consultation with us.

I advise patients to receive an accurate diagnosis to determine whether early revision is genuinely required within the first 14 days before deciding on surgery.

Today, we reviewed early revision rhinoplasty performed within 14 days after surgery. I hope this provides helpful insight for those considering early revision after surgery.

This was Dr. Peter C. Kang. Thank you.