Revision rhinoplasty is one of the most complex operations that a facial plastic and reconstructive surgeon performs. It generally refers to operations on noses that have undergone one or more rhinoplasties. When a rhinoplasty is performed the underlying framework of the nose (bone and cartilage) is modified by removing, altering or adding to it. If the patient is not satisfied with the cosmetic and/or functional result he or she may decide to undergo a revision operation.

When the operation is being performed by a different surgeon, it is very hard for the surgeon to know what was removed or altered during the previous operation. The surgeon must be able to draw from a vast experience of different techniques in order to perform a successful operation.

One of the most common problems encountered in revisional surgery is the lack of healthy tissue that can be used. In order to modify and rebuild a nose that does not look good and does not work well it is necessary to recreate to the normal anatomy of the nose as best as possible. This requires grafting tissue to the nose to create support in most cases and to achieve proper contour and shape in others. The most useful tissue that is used for grafting is cartilage. Cartilage is incredibly versatile, it can be shaped, bent, cut and fixed to the nasal tissues. The cartilage from the nasal septum is most commonly used, but is not always available or sufficient in these cases. A common alternative is to use conchal (ear) cartilage. This tissue is great for contouring and adding some bulk where needed, but it does not offer any structural support because it is not rigid enough.  A great alternative is the use of rib cartilage. This tissue is plentiful, offers great structural support and can be easily shaped and cut to replace almost any missing tissue in the nose. This type of cartilage does not resorb and will remain as living tissue within the nose for years to come.

I have published the largest series of rib cartilage nasal reconstruction in Canada and have done over one hundred of these cases during the past ten years. The results are extraordinary and offer the possibility for normal nasal function and excellent cosmesis.

This entry was posted on Monday, July 28th, 2008 at 9:21 pm and is filed under Rhinoplasty. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.