Revision Rhinoplasty in Denver, CO

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Overview

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. 

Surgical Technique

Full Rhinoplasty Revision

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.

Touch-Up Rhinoplasty

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.

I am only giving one star because there’s no other option, but if I could, I would give him a 0. I had a revision rhinoplasty done by Shah Manish in April 2019. All I wanted was to breathe better and have a better projection because my nose tip was significantly dropped. I regret so much having had surgery with this doctor as he did a horrible job. Not only did he make my nose worse than it was, but he destroyed my nose. My nose looked ugly. He could not fix my tip; my breathing problem worsens. One year later July 2020, I went back to his office and said he would fix it by doing another office procedure, I trusted him again, and he just made it worse. He left a bump on my nose that was not there.I absolutely hated my nose, had no confidence, had depression for a while, and could no longer pursue my modeling career because of the results. I kept going back to his office to express how I felt about it, and he never listened to me or let me talk. All he said was that my nose was very swollen and that it would get better eventually, which never did. I spent two years dealing with this awful doctor, and nothing changed. He just wasted my time and money. I spent 8k on the first procedure and $300 on the second one. PLEASE AVOID THIS DOCTOR AT ALL COSTS. HE ONLY CARES ABOUT MONEY AND DOESNT HAVE THE KNOWLEDGE OF WORKING WITH A VARIETY OF NOSES. I HONESTLY DONT KNOW HOW HE HAS HIS BUSINESS RUNNING AND HAS A DEGREE OF IT. HIS WORK IS HORRENDOUS. I WISH HE COULD HAVE BEEN HONEST WITH ME INSTEAD OF DESTROYING MY NOSE AND CONFIDENCE. I recently got back from Mexico, where I had to find another doctor (a professional one). She recorded the surgery and showed me all the issues he did with my nose, which I was utterly shocked. However, she fixed my nose and breathing problems. Currently, my nose looks completely different and beautiful. I am so in love with my results. She exceeded my expectations even though it has only been a few weeks.

Y.M. Yelp

I am only giving one star because there's no other option, but if I could, I would give him a 0. I had a revision rhinoplasty done by Shah Manish in April 2019. All I wanted was to breathe better and have a better projection because my nose tip was significantly dropped. I regret so much having had surgery with this doctor as he did a horrible job. Not only did he make my nose worse than it was, but he destroyed my nose. My nose looked ugly. He could not fix my tip; my breathing problem worsens. One year later July 2020, I went back to his office and said he would fix it by doing another office procedure, I trusted him again, and he just made it worse. He left a bump on my nose that was not there.I absolutely hated my nose, had no confidence, had depression for a while, and could no longer pursue my modeling career because of the results. I kept going back to his office to express how I felt about it, and he never listened to me or let me talk. All he said was that my nose was very swollen and that it would get better eventually, which never did. I spent two years dealing with this awful doctor, and nothing changed. He just wasted my time and money. I spent 8k on the first procedure and $300 on the second one. PLEASE AVOID THIS DOCTOR AT ALL COSTS. HE ONLY CARES ABOUT MONEY AND DOESNT HAVE THE KNOWLEDGE OF WORKING WITH A VARIETY OF NOSES. I HONESTLY DONT KNOW HOW HE HAS HIS BUSINESS RUNNING AND HAS A DEGREE OF IT. HIS WORK IS HORRENDOUS. I WISH HE COULD HAVE BEEN HONEST WITH ME INSTEAD OF DESTROYING MY NOSE AND CONFIDENCE. I recently got back from Mexico, where I had to find another doctor (a professional one). She recorded the surgery and showed me all the issues he did with my nose, which I was utterly shocked. However, she fixed my nose and breathing problems. Currently, my nose looks completely different and beautiful. I am so in love with my results. She exceeded my expectations even though it has only been a few weeks.

Y. RealSelf

Horrible experience with Manish Shah - I am only giving one star because there's no other option, but if I could, I would give him a 0. I had a revision rhinoplasty done by Shah Manish in April 2019. All I wanted was to breathe better and have a better projection because my nose tip was significantly dropped. I regret so much having had surgery with this doctor as he did a horrible job. Not only did he make my nose worse than it was, but he destroyed my nose. My nose looked ugly. He could not fix my tip; my breathing problem worsens. One year later July 2020, I went back to his office and said he would fix it by doing another office procedure, I trusted him again, and he just made it worse. He left a bump on my nose that was not there.I absolutely hated my nose, had no confidence, had depression for a while, and could no longer pursue my modeling career because of the results. I kept going back to his office to express how I felt about it, and he never listened to me or let me talk. All he said was that my nose was very swollen and that it would get better eventually, which never did. I spent two years dealing with this awful doctor, and nothing changed. He just wasted my time and money. I spent 8k on the first procedure and $300 on the second one. PLEASE AVOID THIS DOCTOR AT ALL COSTS. HE ONLY CARES ABOUT MONEY AND DOESNT HAVE THE KNOWLEDGE OF WORKING WITH A VARIETY OF NOSES. I HONESTLY DONT KNOW HOW HE HAS HIS BUSINESS RUNNING AND HAS A DEGREE OF IT. HIS WORK IS HORRENDOUS. I WISH HE COULD HAVE BEEN HONEST WITH ME INSTEAD OF DESTROYING MY NOSE AND CONFIDENCE. I recently got back from Mexico, where I had to find another doctor (a professional one). She recorded the surgery and showed me all the issues he did with my nose, which I was utterly shocked. However, she fixed my nose and breathing problems. Currently, my nose looks completely different and beautiful. I am so in love with my results. She exceeded my expectations even though it has only been a few weeks.

Y. RealSelf

Horrible experience with Manish Shah - I am only giving one star because there's no other option, but if I could, I would give him a 0. I had a revision rhinoplasty done by Shah Manish in April 2019. All I wanted was to breathe better and have a better projection because my nose tip was significantly dropped. I regret so much having had surgery with this doctor as he did a horrible job. Not only did he make my nose worse than it...

Y. RealSelf

Dr. Shah made me feel comfortable every time I saw him - I had a revision rhinoplasty by Dr. Shah and I couldn't be happier. I had a rhinoplasty in 2005 that I was never really happy with. As I reached my mid-40's my nose started to get lumpy and you could actually see and feel the bumps on the bridge of my nose. I wanted to get a revision but didn't have the time to focus on it, until COVID. I live in a mid-sized city (Colorado Springs, CO) and I believe I went to every plastic surgeon in CS and I could see doctors faces become uncomfortable when I would go in for a consult for a revision. Most of them just made me uncomfortable with how defensive they would become. I found Dr. Shah through research on the internet and went in for my consult. Within 30 seconds of looking at my nose he said "I know how to fix this" and boy did he ever. I didn't want a drastic change and he gave me that as well. Dr. Shah has a system for minimal bruising that works magic and I had very little bruising after my surgery. Dr. Shah is professional and made me feel comfortable every time I saw him. The staff (especially Brenda) is amazing too. I like them all so much I am going back in several months for a neck lift and and chin implant. I will get pictures posted eventually but if you are considering a rhinoplasty revision - Dr. Shah is AMAZING and you will not be disappointed.

R. RealSelf

22

Total Reviews

4.7

Average Rating

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About Us

During/After Surgery

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.

Blog

This blog gives you all the information you might want about the most difficult procedure in cosmetic surgery, written by Manish H. Shah, MD, FACS, a specialist in rhinoplasty, revision rhinoplasty, and ethnic rhinoplasty surgery located in Denver, Colorado.

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Better or Worse?

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.

Donor Sites?

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.

Revision Philosophy?

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.

*Individual results are not guaranteed and may vary from person to person. Images may contain models.