REvision Rhinoplasty Study NYC

Revision Rhinoplasty: Why the need?

NEW YORK CITY, NY - The medical literature is replete with studies that identify and evaluate objective “deformities” from the perspective of the surgeon, and subsequently discuss revision rhinoplasty techniques specific to the recognized deformity. These articles delineate the most common aesthetic abnormalities in multiply revised noses. Although these analyses are important, they are all retrospective, subjective in nature, and report from the surgeon’s point of view. Thus these studies may not reflect the patient’s primary reasons for pursuing revision rhinoplasty. Our study starts by asking 100 consecutive patients what they are unhappy with their original rhinoplasty. We seek to address patients concerns directly in this article instead of what surgeons feel might be the surgical priorities.

So, what makes a nose look over-operated?

• Pinched tip
• Pulled up nostrils (notched)
• Deep creases above the nostrils
• Tip “knuckles” called bossae
• Narrow middle third, with a chevron shaped dent called an “inverted” V deformity
• Scooped out profile

In the study above, patients seeking revision rhinoplasty were given a questionnaire of over 40 potential problems; it was found that the most common deformity they requested to be fixed is tip asymmetry. Second is nasal obstruction and third a crooked nose.

At the end of our survey we asked patients why they didn’t go back to their original surgeon. The most common answer was because the first or most recent surgery was not successful. The second most common reason was the original surgeon was not receptive to their concerns. Revision rhinoplasty surgeons and their staffs need to be more sensitive to patients who are unhappy with both their results and other surgeons’ results. Often patients wait many years before even considering revision rhinoplasty surgery. There is a common cliché that one of the definitions of insanity is repeating the same thing over and over again and expecting to get a different result. Patients need to be reassured that although more complex, revision rhinoplasty surgery can be rewarding and improved nasal form and function can be restored.

Dr Steven Pearlman, MD, FACS
New York City Revision Rhinoplasty Specialist