The decision to undergo a revision rhinoplasty is a very difficult decision for a patient. The patient has already likely had a negative experience from their previous rhinoplasty. Emotionally the desire to seek and undergo a revision rhinoplasty can be very taxing for a patient.
Dr. Bared has vast experience with revision rhinoplasty and has seen many different reasons for a patient to want to undergo a procedure. Dr. Bared understands the difficulty a patient may experience when choosing a surgeon for their revision rhinoplasty. Given the patient’s likely dissatisfaction with their previous experience, they have reservations about undergoing a revision procedure. It is of utmost importance for the patient and the surgeon to develop a sense of mutual trust prior to undergoing a surgery. The patient needs to feel confident that the surgeon will be able to help them achieve their desired goals and the surgeon needs to have sense that the patient has the proper motivation and realistic expectations. Revision rhinoplasty is a highly complex surgery as the normal anatomy of the nose is no longer existent. The revision surgeon needs to have the appropriate set of skills to be able to attend to what is discovered during the individual case. It is Dr. Bared’s practice to not utilize artificial or foreign implants in rhinoplasty. This becomes particularly important in revision rhinoplasty as the nose is more susceptible to infection during revision procedures. To accomplish a sound structural framework, Dr. Bared uses your body’s own cartilage. Dr. Bared uses your own cartilage to provide for a natural foundation. Depending on certain findings in the nose, Dr. Bared either uses ear cartilage grafts or rib cartilage grafts during revision procedures.
The immediate recovery period after a revision rhinoplasty is one week. The cast and sutures are all removed one week after surgery. At this point a small amount of tape may be placed over the nose for an additional few days. If any bruising is present around the eyes, this usually tends to resolve in about 7-10 days after surgery. Dr. Bared attempts to limit the possibility of bruising and swelling related to the surgery with his surgical technique however this it, at times, inevitable. The first week after surgery should be a week of rest. You should be walking around while not over-exerting yourself. You do not want to be laying around for too long nor bending over and increasing the blood pressure to your face. Walking around the house or in air conditioned spaces will help limit the discomfort and help expedite your recovery. The only diet restriction Dr. Bared recommends is the amount of salt you ingest. If you consume too much salt in the days and months following your surgery, the swelling of your nose will be aggravated. Salt ingestion aids in the retention of water. This retention of fluid will manifest itself as swelling of your nose. You will also notice that the swelling of the nose will be worse in the morning and will improve throughout the day. The fluctuation in swelling of the nose is normal after surgery and will slowly subside with time. It is important to sleep with your head elevated with about 3 pillows or in a recliner for the first week after surgery. After the first week, you may recline your head to the use of two pillows for an additional week. The swelling that you see on the outside of your nose will also manifest itself as congestion on the inside of your nose. It is normal to feel congested for several weeks after surgery. This is secondary to the swelling of the inside of your nose as a result of the procedure.
Dr. Bared recommends that you refrain from exercising for four weeks following surgery and to avoid the use of eyeglasses or sunglasses for six weeks after surgery. Starting at around 4 weeks time, Dr. Bared may commence small steroid injections to the nose. These injections are commonly used to help with the swelling to certain areas of the nose. Dr. Bared uses a very diluted amount of steroid which has no systemic effect and is limited to targeting focal areas of swelling of the nose. It is not uncommon for Dr. Bared to recommend the start of nasal pressure exercises. These are often utilized to address focal areas of swelling and especially after surgeries on deviated noses. Given that there exists an elevated risk of infection after revision rhinopasty, Dr. Bared may have you start on antibiotic soaks to your nose. These are placed within the nostrils and directly over the incisions.
The patient’s knowledge and adherence to the post-operative instructions is imperative to the recovery following a revision surgery. Regular follow up appointments with Dr. Bared are very important to the ultimate results following surgery. Lack of regular follow up could negatively affect your ultimate outcome.