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 Englewood, 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. 

You could be a good candidate for secondary or revision rhinoplasty if you want to change or repair the complications from your initial surgery. Rhinoplasty revision is usually performed to restore or change the shape and function of your nose. You should be prepared for a lifetime solution and have pragmatic expectations before going into a revision rhinoplasty surgery. In addition, you should know that this surgery can be more difficult than the initial rhinoplasty.

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 had been contemplating a revision rhinoplasty after not being fully happy with my first rhinoplasty. I went to several doctors and all told me to put fillers into my nose. I wasn’t comfortable with that as I wanted a permanent fix. I had a few issues with my nose and overall I felt the nose just didn’t fit my face. After talking with Dr Shah I finally felt like I was being heard! I am now 6 or so weeks post revision and I can say all the “problem areas” I was concerned about were corrected. The results are far beyond my expectations! I am also a little bit of a worrier and I’m concerned about persistent swelling occurring again. Even though my follow up is several weeks away, he fit me in sooner to hear my concerns. Having a Dr willing to see you when you feel concerned or worried is worth everything! So not am I only over the moon with my results, I feel as though I can come to him with concerns along the way and he will listen. I would highly recommend Dr Shah to anyone considering rhinoplasty or revision rhinoplasty. He is truly and artist and did a wonderful job creating a nose that fits my long, angled face! I am So thankful and so happy!!! Thank you Shah team!!!

M.N. Google

I came to Dr. Shah the fall of 2019 seeking a revision rhinoplasty. Let me provide a backstory to my experience. Approximately 13 years ago, I received my initial rhinoplasty from a well-known and supposedly "top tier" plastic surgeon in Denver. After the initial surgery and several follow-up "corrections," this surgeon left my nose not only completely disfigured and disproportionate for my face, but also did not correctly support the tip, and so I was left with what was essentially lopsided scar tissue on top of a droopy columella. Sadly, after handing over nearly $10k, I could tell something was amiss even before the cast was removed. As a revision specialist, Dr. Shah determined right off the bat exactly what was wrong with my nose and how to fix it. While the COVID pandemic interfered with my original surgery date, Dr. Shah and his team worked efficiently to get me rescheduled once it was safe to proceed with surgery. There are very few individuals with both the knowledge and skill to become a plastic surgeon, let alone having the artistic ability and finesse to bring these components together -- AND correct someone else's mistake. I look forward to our long and substantiated relationship. Thank you to both Dr. Shah and his fabulous team.

D.D. Google

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

I had been contemplating a revision rhinoplasty after not being fully happy with my first rhinoplasty. I went to several doctors and all told me to put fillers into my nose. I wasn’t comfortable with that as I wanted a permanent fix. I had a few issues with my nose and overall I felt the nose just didn’t fit my face. After talking with Dr Shah I finally felt like I was being heard! I am now 6 or so weeks post revision and I can say all the “problem areas” I was concerned about were corrected. The results are far beyond my expectations! I am also a little bit of a worrier and I’m concerned about persistent swelling occurring again. Even though my follow up is several weeks away, he fit me in sooner to hear my concerns. Having a Dr willing to see you when you feel concerned or worried is worth everything! So not am I only over the moon with my results, I feel as though I can come to him with concerns along the way and he will listen. I would highly recommend Dr Shah to anyone considering rhinoplasty or revision rhinoplasty. He is truly and artist and did a wonderful job creating a nose that fits my long, angled face! I am So thankful and so happy!!! Thank you Shah team!!!

M.N. Google

Very happy with my results - I wanted to repair some damage from a previous broken nose and possibly tweak the shape a little. I consulted with another popular doctor first and was scared off the procedure and decided not to do it. But I had already paid the consultation fee for Dr. Shah so I went to see what he had to say. After my meeting with Dr. Shah, I was put at ease and ready to do it. He addressed all my concerns...

M. RealSelf

19

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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 Englewood, 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.