Dr. Papel has developed a referral practice which emphasizes not only primary rhinoplasty, but revision cases as well. Many surgeons are not willing or prepared to take on complex reconstructive or cosmetic revision surgery. Dr. Papel welcomes these challenges.
It is not unusual to encounter patients who have had multiple rhinoplasty operations. In years past it was common for surgeons to remove much of the nasal cartilage in attempts to narrow the nose, or make it smaller. Unfortunately this often lead to later deformities and impaired nasal function. Modern techniques now emphasize preservation of essential structures, retaining important support in critical areas of the nose. This leads to more predictable results with improved cosmetics and function.
Revision rhinoplasty operations often employ cartilage grafts to restore lost structures. This cartilage may come from the nasal septum, if available, or from the bowl of the external ear, called the concha. In more severe cases, rib cartilage may be harvested to replace extensive loss of cartilage and/or bone. These grafts are harvested with techniques which leave minimal or no visible deformity.
The approach to the revision rhinoplasty operation may also utilize an open technique. This procedure utilizes a very small incision across the columella, combined with internal incisions to better expose the nasal skeleton and make repairs easier. This is a particular advantage in situations where extensive scar tissue is present from prior surgery, making it difficult to appreciate the underlying
anatomy and condition of the nasal cartilages. The columellar incision heals very well, and is not significant after a short healing period.
Many patients seeking revision rhinoplasty feel victimized by poor results from their prior surgery, and are quite anxious about having further operations. This is quite understandable, and a normal concern. For this reason we encourage an open conversation about these anxieties, and try to answer all questions thoroughly. Rhinoplasty is not a simple operation, and the complications from previous surgery may be complex with regard to both physical and emotional issues.
Dr. Papel and the staff of the Facial Plastic Surgicenter understand this multifaceted situation, and have developed a practice to address these personal concerns in a friendly and supportive manner.
