Revision rhinoplasty is known to be the most complex and challenging of all cosmetic surgeries
Often times patients seek a revision for one of several reasons: they are unsatisfied with their previous cosmetic outcome, they are having difficulty breathing through their nose after their previous surgery, or they have sustained a trauma to their nose after previous surgery. The revision rhinoplasty surgeon needs to be extremely well versed in the nasal anatomy and they need to have the skill set to be able to address the complexity of the issues. Rhinoplasty is a very challenging surgery—one that requires a surgeon to appreciate both the external and internal nasal anatomy. Dr. Bared, a revision rhinoplasty surgeon in Miami, received his training through a highly reputable and rigorous head and neck residency which exposed him to the most complicated nasal cases. He went onto to perform specialized training during his fellowship in Chicago where he was trained under the guidance of one of the world’s most respected rhinoplasty surgeons. His extensive background in the intricacies of the nasal anatomy make him unique amongst revision rhinoplasty surgeons. He has adopted techniques to handle the complexities of revision rhinoplasty surgery. Dr. Bared is a strong advocate of using a patient’s own anatomy to help reconstruct a previously operated nose such as in a revision rhinoplasty. He is very well versed in using either the patient’s own ear cartilage or, if indicated, the patient’s rib cartilage. He does not advocate using foreign material in the nose such as Gortex or other foreign materials. Particularly in the in the case of revision rhinoplasty surgery the blood supply to the tissues of the nose have been compromised to an extent because of the scar tissue present from previous surgeries. The scar tissue makes one slightly more susceptible to infection following a revision rhinoplasty. If foreign material is introduced into the nose, the chance of an infection may be increased because the material is not incorporated in to the body’s blood supply. When one’s own cartilage is used, the graft material can be more readily incorporated into the body thus making it less susceptible to infection. Dr. Bared’s attention to detail does not end with the actual surgical techniques. Dr. Bared also takes the utmost precautions during revision rhinoplasty surgery to prevent infection. Throughout the procedure itself, he irrigates the nose with copious amounts of antibiotic impregnated solution and he has all patients start on antibiotic nasal soaks after the surgery, in addition to antibiotics which are taken orally.