Revision rhinoplasty (aka tertiary rhinoplasty) is a specialized procedure that improves or corrects the outcome of prior rhinoplasty surgery. Some individuals may experience functional issues such as nasal blockage or trouble breathing due to a poorly done initial rhinoplasty. Others may wish to have cosmetic issues corrected. 

Reconstructive surgery like revision rhinoplasty is significantly more complex for several reasons. The unique anatomy of every patient’s nose is distorted through scar tissue and surgical manipulation from the prior procedure. Blood supply to the nose is compromised each time a patient undergoes surgery with an increased risk of infection or graft resorption. Additional support grafts are required to stabilize the nose during revision surgery. Ideal grafts come from within the nose (nasal septum), which is typically not available for revision surgeries anymore. In this case, cartilage is harvested from a secondary donor site such as the ear (auricular conchal grafts) or rib (costal grafts). 

Dr. Walker is an acclaimed expert in these highly complicated revision rhinoplasty surgeries and is one of the very few rhinoplasty specialists in Atlanta, Georgia, and the Southeastern United States who successfully and regularly performs rib cartilage grafting for major revision rhinoplasty surgeries. Beautiful results are typically still achievable during a revision procedure when performed by Dr. Walker. During your consultation with him, he will let you know what can and cannot be achieved to assist you to make an informed decision about the best course of action. Dr. Walker is very sensitive to the fact of how traumatic the experience may have been for you and the level of dissatisfaction with your previous surgery or rhinoplasty surgeon.  

Recovery from revision rhinoplasty is very similar to that of primary rhinoplasty except for the donor site where cartilage may have been taken from (ear or rib). However, this does not add to your recovery time. The rate-limiting step in healing is always the nose itself. Bruising and swelling may occur but will subside over the course of a few weeks. Cold compresses, head elevation, and avoidance of salt/sodium can help lessen the swelling. A small cast will be placed on the outside of your nose and left in place for one week. The majority of clients describe minimal pain during recovery. A follow-up appointment will be scheduled for one-week post-op so Dr. Walker can ensure that you are healing properly. 

The recovery from rhinoplasty occurs in various stages. There is an initial 1- to 2-week period during which the bruising (if present) subsides and the nasal external and internal swelling improves for improved airflow. The nasal cast and sutures will be removed 1 week after your procedure, at which point in time you can let the water run over your nose again when washing your hair. Most patients experience some discomfort for the first couple of days that most patients can control with Tylenol although a small amount of prescription pain medication is prescribed to you in case you do experience some discomfort.

You are encouraged to rest during the first week and to adhere to Dr. Walker’s thorough post-operative instructions including a low-sodium diet, avoidance of strenuous activities, no nose-blowing, no straining with bowel movements, and avoidance of coughing if possible. After 4-6 weeks, most of your nasal swelling should have subsided and you may resume strenuous activities at such point. You will have near-final results after 3 months with final results being apparent one year after your surgery. Dr. Walker will closely monitor your healing throughout the recovery process with regular follow-up visits.