Revision rhinoplasty is a term to describe a nose surgery procedure to correct problems or deformities that are the result of a previous rhinoplasty. There are many reasons a rhinoplasty may fail to produce the desired results, but in any case it can be an exceptionally traumatic event to face. Dr. Manish H. Shah is a specialist in revision rhinoplasty in Denver, CO. His fellowship at the Manhattan Eye, Ear, and Throat Hospital in New York City, allowed him to work with his mentor, Dr. Tabbal, one of the best revision rhinoplasty surgeons in the world. during this fellowhips, Dr. Manish Shah was able to learn many advanced techniques to help patients with postoperative nasal deformities. Revision rhinoplasty makes up at least 30% of the rhinoplasty operations he performs each year. Revision rhinoplasty is generally considered the hardest procedure amongst all cosmetic surgeries. This is due to the fact that once a nose has been operated on, there are multiple soft tissue types that are now scarred. Skin, mucosal lining, cartilage, fat, and bone are all damaged in the process of performing the initial rhinoplasty, plus blood supply to the nose is altered and is usually diminished.
Revision Rhinoplasty Reviews
"Best Experience So Far - Denver, CO - I went to Dr Shah after much web searching, and I am so happy and lucky to have found him! I have had two rhinoplasties done in New York, by two different doctors, both with bad results. My nose has never been straight, but nobody explained to me exactly what was going on, how asymmetrical my face was, how the left side of my face is smaller and tighter and it's pulling the nose with it, and how the cartilage has a memory of going back to how it was. So I was very unhappy with my nose, especially after going thru 2 surgeries.Dr Shah has reviewed my records and my history prior to meeting with him, and we talked at length about the anatomy of my nose/face, what the plan for surgery is, what my expectations should be after. He took all the time I needed to understand the entire process, and not only he is very professional, bright, but friendly too, very pleasant and personable. He never pushed anything on me, like some other doctors do. He answered all my questions, he made me feel very comfortable, and post op he checked regularly on me, even texted me from his cell phone!!!! My experience with him was amazing. His staff is also incredible, and I'm talking here about Brenda, so nice and caring and accomodating each time. I am very happy with the results, I have more confidence than before, and I can take pictures from either side of my profile :-) . I still see Dr Shah, now for Botox injections, and he is a master at that too! I would recommend him to anyone."- S. / RealSelf / Sep 01, 2016
"Excellent Nose Surgeon Dr. Shah operated on my nose recently. He literally built my nose, or half of it depending on how you see it, due to the underdeveloped mid-section of my face. I had consulted three surgeons, including Dr. Shah, for my procedure. Unlike other HCPs that provided brief, standard, and diplomatic answers (mostly by the assistants), Dr. Shah had his individualized approach by offering specific information on my situation. When it came to the final outcome, ONLY Dr. Shah had the assurance of high success rate with Autograft. And he DID it beautifully with great precision. His charge is VERY competitive. From my own experience, Dr. Shah makes good effort in understanding and accommodating his client?s needs. He is genuine and has a great sense of humor."- Anonymous / RateMDs / Aug 17, 2011
"Excellent Nose Surgeon - Dr. Shah operated on my nose recently. He literally built my nose, or half of it depending on how you see it, due to the underdeveloped mid-section of my face. I had consulted three surgeons, including Dr. Shah, for my procedure. Unlike other HCPs that provided brief, standard, and diplomatic answers (mostly by the assistants), Dr. Shah had his individualized approach by offering specific information on my situation. When it came to the final outcome, ONLY Dr. Shah had the assurance of high success rate with Autograft. And he DID it beautifully with great precision.His charge is VERY competitive.From my own experience, Dr. Shah makes good effort in understanding and accommodating his clients needs. He is genuine and has a great sense of humor._______________________,,"- Anonymous / Vitals / Aug 18, 2011
"Thank you Dr Shah and staff for being true professionals. I am fortunate l selected Dr Shah to do corrective and cosmetic surgery on my nose. He is extremely competent and caring....nice combination for a doctor! His staff are most pleasant and professional. I'm impressed with photos taken pre and post surgery and throughout check ups to see the success of the procedure. Thank you. 5 stars for Dr Manish H Shah!"- Anonymous / RateMDs / Jul 07, 2015
"For as long as I can remember, I was teased about my large nose. It didn’t fit with the rest of my face and protruded quite far. I wanted a rhinoplasty ever since I was in middle school. My nose was not feminine at all and seemed to be the butt of most jokes amongst my peers. I just wanted to look pretty, feel pretty, and have the teasing and comments stopped for good. I had a rhinoplasty in August of 2008 by another plastic surgeon in Denver. I was so excited and emotionally ready to finally have the procedure done, I had been dreaming of this day for almost 15 years. After my surgery my nose was straight but very swollen. I was thrilled at how straight it was since I had the classic “italian bump” in my nose. I was growing concerned over the swelling and how it was taking so long to go away, I was reassured by my surgeon that it was normal and would go away eventually. Over the next few months, the tip of my nose become very bulbous looking and it was starting to droop. I noticed it in a picture of myself that was taken on a night out and I was devastated. This wasn’t what I wanted or hoped for. My family and close friends were even commenting on the way it was starting to look.I was still told by my surgeon that it was normal and to be patient before he told me I may need another surgery to correct it. This was not the news I wanted to hear, but it also wasn’t the result I had wanted either. 18 months after my original surgery, I consulted with Dr. Shah about a secondary rhinoplasty. Dr. Shah came highly recommended to me as someone who specializes in “secondary rhinoplasty procedures”. I knew if I was going to have to go through this again, I was going to go to a surgeon who has a great reputation for doing not only rhinoplasty’s but secondary procedures as well. I had even considered seeing a surgeon in Los Angeles before seeing Dr. Shah. Dr. Shah took one look at me and knew exactly what had gone wrong in the first surgery and how to correct with a simple second surgery. I knew right then, I had to have Dr. Shah correct my nose once and for all. I became excited again and I knew that I was in the right hands. Dr. Shah showed me my pictures on a computer program and together, we talked about my goals and his plan for my final results. He made sure he knew what I was requesting for him to do. I was put at ease because he knew exactly what I wanted, and he was going to be able to do it. I am not very good at being patient so I scheduled my surgery to be done in two weeks. My surgery was a breeze. Everyone at the surgical center was so sweet and made it a very comfortable experience. The hardest part of the recovery is waiting for the splint to come off. Once it did, I was stunned. So stunned that I didn’t say anything, I was speechless. Dr. Shah did it! He did exactly what I wanted. I finally look the way I pictured myself looking and I finally like the way I look! I had my surgery 8 months ago and the swelling continues to go down, just like Dr. Shah told me it would. I saw a picture taken of myself from a friends birthday party and for the first time in my life, I didn’t immediately look to see how my awful my nose looked. I absolutely loved what I saw and I know that other people see me the way I always wanted them to. Words can not express how grateful I am to Dr. Shah. I do not even want to think about how much worse I would have looked and felt, had Dr. Shah not corrected my first surgery. My self esteem is the best that its ever been thanks to him. Dr. Shah gave me a nose that compliments the rest of my facial features with out looking like I had anything “done”. A thousand “Thank you’s” don’t seem to be enough for what he did for me; a surgery that he performs almost everyday changed my life. by LP, 29 yo female"- LP / Office Visit / Apr 19, 2014
Full Rhinoplasty Revision@headingTag>
When the initial rhinoplasty results in unsightly features, it can be difficult for the plastic surgeon to revise the initial surgery. Open rhinoplasty is the ideal technique because it allows the doctor access to the nose’s supporting framework, and corrects the internal structure of the nose as originally intended. It may involve re-cutting and reattaching the cartilage or bone. It may even need skin, tissue or fat grafting to make sure the aesthetic intent is achieved. The peeled skin will be draped back, and a nose splint or packets may be provided to aid with healing.
Similarly, secondary rhinoplasty may be necessary to adjust minor issues from the initial surgery. It may be a case of slight unevenness or misshapen contours. In these cases, the first surgeon is often the one who will perform the touch up as the procedure is less complex and typically involves minor techniques, such as slight shaving of the bone, augmentation or reduction for volume issues. The results from minor revision rhinoplasty are mostly satisfying.
Oftentimes, damaged cartilage will need to be virtually rebuilt from scratch to create the new nasal skeleton. Sometimes, too much cartilage was removed at the first surgery and now needs to be put back to fix the nose and improve its support. To build a new nasal skeleton, graft material, or cartilage, may be harvested from one of three areas of the body: the nasal septum (septal) cartilage, ear (conchal) cartilage, or the rib (costal) cartilage. In extreme cases, Dr. Manish Shah has taken split calvarial (skull) bone to rebuild noses. These particular cases require the use of titanium hardware to fix the bone in place. There are pros and cons to the use of each of these materials, which should be discussed between the patient and Dr. Manish Shah. In some cases the damage may be too severe so synthetic tissue may be used instead. Various synthetic tissues include silicone, e-PTFE, and Gore-tex. Another possibility is that all of the above materials may be used, both the natural and synthetic. If at all possible, Dr. Manish Shah prefers the use of natural materials over synthetic ones. They are less likely to cause long term complications like infection, rejection, skin erosion, palpability, capsular contraction, and malposition. The soft tissues of the nose are prone to inflammation after having plastic surgery. The inflammatory changes result in scarring that increases the stiffness of the tissues. When patients have had several revision rhinoplasty surgeries, it can make the plastic surgeon feel like they are operating on cement. It can take much longer just to remove all the scar to see what the “normal” anatomy looks like. When scar that is obstructing function has to be removed, new tissue in the form of skin grafts or mucosal grafts may need to be used. Due to all these various reasons, revision rhinoplasty takes much longer to perform in the operating room. Postoperatively there is a longer recovery time also. Recovery time might be anywhere from 6 months to 2 years depending on the severity of the damage and the health of the skin.
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Revision Rhinoplasty FAQs@headingTag>
Better or Worse?@headingTag>
Revision procedures can be really complex since there is always the possibility of a worse outcome. It is extremely important to find a revision specialist who has years of experience with this particular treatment. It is critical for the surgeon to understand what went wrong with the initial surgery to be able to shape it into the intended surgical plan. This involves manipulating the internal structures of the nose and resetting the wrongly placed elements.
In cases when there is loss of cartilage or bone, it will be harvested from other parts of the body – the ribs for example. The grafted bone or cartilage will make up for the reconstruction of the internal framework of the nose. However, this is only likely in severe botched cases, which accounts for a small rate of rhinoplasty procedures.
The most important thing for revision rhinoplasty patients to understand is that each time their nose gets operated on, the outcome of a “perfect” nose becomes harder to achieve. Dr. Shah advises to be patient and have realistic goals. The lesson is that it is best to get it right the first time. But that is not always possible. If you need revision rhinoplasty in Denver, Colorado, make sure you see a rhinoplasty specialist like Dr. Manish H. Shah.