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Revision Rhinoplasty

Since establishing his Rochester, NY practice, Dr. Vito C. Quatela's expertise in revising rhinoplasty procedures performed by other surgeons has led many men and women to the Quatela Center for Plastic Surgery. The goals of revision rhinoplasty are the same as a primary rhinoplasty procedure: reshaping the cartilage of the nose to achieve an aesthetically pleasing nose that also allows the patient to breathe well.

It is an extremely challenging operation that should be performed only by a surgeon who has extensive experience dealing with the unique issues presented during revision rhinoplasty, such as the presence of scar tissues and lack of structural support.

Patients from Buffalo to Syracuse and throughout New York seeking a facial plastic surgeon qualified to perform revision rhinoplasty can request a consultation with Dr. Quatela using our online form. Or call our office at (585) 244-1000 to schedule an appointment.

Vito C. Quatela, M.D., FACS

Specializes in Facial Procedures

Compassionate and dedicated to personalized patient care, Dr. Quatela is a board-certified facial plastic surgeon recognized worldwide for his expertise in facial rejuvenation. He established the Quatela Center for Plastic Surgery in Rochester, New York to provide excellence in aesthetic surgery.

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What Is Revision Rhinoplasty?

Revision rhinoplasty is more complicated than primary rhinoplasty because it involves reconstruction after a surgeon has already made changes to the structure of your nose. In the initial procedure, the distorted cartilage is removed for straightening the nose. In a revision rhinoplasty, there is little or no cartilage left, so cartilage is taken from behind the ear to restore the nasal form. The ear incision is well hidden, and there is no change in the shape or function of the ear.

Analyzing the Nose

An ideal nose should complement the other features of the face. The ideal shape of a nose, whether male or female, is rooted in an aesthetic perception of beauty. This transcends lines and numbers, in that the ideal has an indescribable artistic quality. That said, in the study of beauty and faces, plastic surgeons and artists alike recognized that certain proportions and guidelines make up the aesthetically ideal nose. There are a few angles Dr. Quatela considers in assessing the right projection of the nose.

• Nasofacial angle
  Measured from the base of the nose to the bridge
  The nasofacial angle is one way to assess whether the nose is properly projected from the face. If the nasofacial angle looks big, this means that the nose is projected far from the face. If the nasofacial angle is little or short, the opposite can be true. In most cases, assessing the projection is as simple as looking at the nose in profile. This does require measurements, which are an added science to the skill of facial analysis.
• Nasomental angle
  Measured from the tip of the nose to the tip of the chin
  In some cases, a small chin makes the nose appear larger. In such cases, surgeons consider the nasomental angle along with other measurements to analyze the adjustments needed in achieving facial harmony. Also, the surgeon determines whether the lips are properly aligned or linked to other facial parts.
• Nasolabial angle
  Measured from the tip of the nose to the tip of the upper lip
  A droopy nose can have an overly acute nasolabial angle, while a nose that is uplifted or too short may have an overly obtuse nasolabial angle.
• Columellar show
  Measured at the tissue between the nostrils
  The columellar show is a consideration during rhinoplasty surgery. Ideally, no more than 4 millimeters of columella (the tissue at the bridge between your nostrils) will be visible at profile view.

Heather Lee, M.D.

Specializes in Facial Procedures

Fellowship trained in facial plastic and reconstructive surgery, Dr. Lee is dedicated to improving the lives of adults and children by using her surgical talents. She specializes in procedure of the face and head including facelift, functional and cosmetic nose surgery, blepharoplasty, and injectable treatments.

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Other Factors to Consider

Dr. Quatela will ask early in the process what about your nose is bothering you and take note of his own first impression. For instance, he may find a patient's nose to be too big, twisted, with a large hump, or "over-operated." First impressions are important as these are most likely the same issues that you dislike. From the front view, Dr. Quatela determines whether your nose is straight or twisted, narrow, normal, or wide. He considers your nasal tip — if it is asymmetric, bulbous, or abnormal — and also takes note of the skin's quality, which may be thick, medium, or thin.

From the side view, Dr. Quatela determines whether your nose is too short or too long, has a hump or a ski slope, or has a pleasant profile that suits your face. He also determines whether your nose is over-projected, under-projected or properly projected, and examines whether too much nostril is shown. Considering all angles of the nose, from top to bottom, is critical to the success of any rhinoplasty procedure.

Form and Function

Both form and function are important factors considered by rhinoplasty surgeons. Your nose needs to both look great after the procedure and function well. Dr. Quatela needs to check your nose both inside and out. Whether you have a breathing problem or just want a smaller nose, your surgeon takes every step to ensure that your nose will work properly.

Your Procedure and Recovery Time

Although revision rhinoplasty has special considerations, it is a very rewarding procedure. Dr. Quatela gives you some pre-operative and post-operative instructions. Revision rhinoplasty typically takes more time than a primary nose job. Because the surgery includes general anesthetic, the initial recovery time from anesthesia is also a consideration. In all, the process takes about five hours.

The mucus membranes revert to their normal size in one to two weeks after the surgery, but the results are visible only after about a year. The key is being patient while the nose heals.

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