main menu

Close
딤처리

Readjustment with the Complex Structure in Mind

#Nose Revision surgery

Reconstructed nose, diminished side-effects

의사선생님이미지

01 What’s important in a nose revision surgery is the surgeon’s experience and skills

의사선생님이미지

Our nose, despite its small size, has a complex structure of bones, cartilages and soft-tissues. Moreover, changes made through a nose surgery further complicate the existing structures and tissues.
Because there are many reasons for a revision surgery (e.g. aesthetic dissatisfaction, issues with nose functions, surgical complications, etc.), conducting a revision surgery on a nose with everything in mind is a difficult task.

Therefore, it is important to receive a nose revision surgery from a skilled and thorough specialist.
What is required is the know-hows and the skills from experience, which allow the surgeon to calmly tackle many surgical variables in the operating room. BANOBAGI has maintained a dedicated nose surgery team since our opening in 2000, and ensures that nose revision surgeries are conducted by highly-experienced nose surgery specialists.

의사선생님이미지

There is a right time for a nose revision surgery

Those who have decided on a revision surgery wish to receive one as soon as possible.
When it comes to noses, the stress from dissatisfaction is great due to its central position in the facial silhouette, and the patients tend to wish for readjustments sooner than later.

However, a nose revision surgery cannot be rushed, because there is a right time to operate.
Although it depends on how the previous surgery has been done,
the usual timeline for a revision surgery is around three to six months from the original surgery.
The reason is that only after such time has passed that the overall tissues stabilize and allow for a detailed surgery.
Also, in case of inflammation, it is advisable to remove the source of it and confirm that the inflammation has subsided before receiving a revision surgery.

Therefore, when it comes to nose revision surgery, it is important to select the clinics that can provide the procedure by identifying the source of dissatisfaction and determining the present status through sufficient consulting. Do not consider those clinics that recommend immediate surgery.

The Ideal Time for a Nose Revision surgery

  • Three to six months
    following the previous surgery
  • In case of inflammation:
    after the source has been removed
  • After inflammation
    has subsided
  • 코끝성형 1번유형 코끝성형 1번유형

    If the nose tip sinks over time

    If the nose-tip cartilage is weak and the columella is short, giving insufficient resistance when the nose tip is pressed down, the cartilage in the area will sink over time.
    Therefore, the shape and the hardness of the nose tip must be precisely determined in the consultation/diagnosis stage, and the nose tip can be re-sharpened by elongating the septum itself or reinforcing it.

    • Determining the structural support for the nose tip through detailed diagnosis

      Supporting the nose tip through septum elongation or columella surgery

  • 코끝성형 2번유형 코끝성형 2번유형

    If contracture has elevated and shortened the nose tip

    This is a rare complication caused by not treating the post-surgery inflammation.
    To correct this, the nose tip must be readjusted while the problematic tissues within the inner nose are removed and the remaining tissues are released. Afterwards, the lowered tip is finely readjusted through artificial or autologous implants. At this point, it is very important to sufficiently elongate the exfoliated soft-tissues so that the fixed nose top is not elevated again. After the surgery, proactive care (e.g. limited smoking and drinking, massages, etc.) is required to prevent reoccurrence.

    • Sufficient removal of the cause of contracture and the problematic tissues

      Sufficient elongation of the exfoliated soft-tissues

    • Selecting appropriate implants to affix to the nose tip

      Proactive aftercare (e.g. limited smoking and drinking, massages, etc.)

  • 코끝성형 1번유형 코끝성형 1번유형

    If the nose tip looks blunt

    Blunt-looking nose tip after a surgery is dissatisfactory for many patients. This may be caused when the cartilage has insufficiently narrowed down, subcutaneous fat has been insufficiently treated, or the cartilage grafted into the nose tip was of improper shape: all at the time of the previous surgery. Once the source of dissatisfaction has been identified, readjustments can be made by exfoliating the scar tissues and then re-narrowing the cartilage or re-grafting the nose tip cartilage after reshaping it into a more proper size.

    • Readjusting the nose tip cartilage width

      Re-grafting the cartilage after reshaping it into a more proper size

  • 콧대성형 1번유형 콧대성형 1번유형

    If the nose bridge feels too high or too low

    The proportions among the facial features (e.g. forehead, jaw line, etc.) is important in a nose surgery, and how the nose fits the patient’s image must also be kept in mind. Without doing so, any given nose bridge may seem excessively high or low. Many of those patients who desire revision surgeries fall into this category. In this case, it is important to readjust the bridge height by reshaping the bone or resizing the implants with the overall facial harmony in mind.

    • Height determined by the proportion relative to the facial features

      Grafting appropriately sized implants

  • 콧대성형 2번유형 콧대성형 2번유형

    If the nose bridge feels too wide or too narrow

    Preferences on nose bridge vary by individual, but what is fundamentally important is the silhouette of the line that starts at the brow ridge and follows either side of the nose bridge. It is also important to understand the preferences of both men and women. The key to a nose bridge readjustment is sculpting the implant to an appropriate size and symmetrically grafting it, based on the aforementioned elements. The area of the existing implant must also be sufficiently exfoliated before grafting: to minimize the chance of implant warping from insufficient space.

    • Determining the nose width from the eyebrow shape and the individual proportions

      Symmetrically grafting the implant

      Preventing implant warping by sufficiently exfoliating the area

  • 콧대성형 3번유형 콧대성형 3번유형

    If the nose bridge appears curved

    The nose is centrally located within a face, and therefore is more sensitive to asymmetry or curving. In this case, it is not only the curving that should be addressed, but also the overall facial symmetry, angles of the nose bone, curvature of the central-face line and whether any previous implants have been warped must be determined. If the cause of the curve is not precisely located during diagnosis, it may lead to reoccurrences. If the face is asymmetrical or the central-face line itself is curved, facial contouring is an option, but no one’s face is perfectly symmetrical and there is no way to completely fix the asymmetry. However, if the asymmetry lies in the angled plane of the nose bone, a symmetry can be created with an exterior osteotomy that cuts away the outer area of the nose bone. Also, if the problem lies within the implant, there is a relatively easier fix through replacing the implant after sufficiently exfoliating the area.

    • Determining the cause of asymmetry from the overall face

      In case of facial asymmetry, two jaw surgery or facial contouring is needed.

      In case of asymmetry in the nose bone, the curve is addressed with exterior osteotomy.

      In case of warping of the existing implant, implant replacement after sufficient exfoliation prevents reoccurrences.

  • 보형물 성형 1번유형 보형물 성형 1번유형

    If the implant can be seen through

    In case of pale and thin skin, or if the implants have been too ambitiously placed, the implant may be seen through. In these cases, improvements can be made with AlloDerm or temporal fascia that can complement the skin thickness. Also, reoccurrences can be prevented by moving the implant further away from the epithelium.

    • Protecting thin skin with AlloDerm or temporal fascia

      Moving the implant further away from the epithelium

  • 보형물 성형 2번유형 보형물 성형 2번유형

    If the implant seems to be moving

    Rarely, patients may experience sensations as if their nose bridge implants are moving around. However, this is usually caused by the slippery sensation given by the fibrous epithelium formed around the implant, and actual moving of implant within the tissue is very rare. Of course, if the sensation alone causes discomfort and stress, improvements can be made by inserting the implant underneath the periosteum according to the shape and the curves of the nose bridge or using Gore-Tex implants.

    • Requires detailed examination of whether the implant actually moves

      Fixing the implant according to the shape and the curves of the nose bridge

      Switching to Gore-Tex implants

  • 보형물 성형 3번유형 보형물 성형 3번유형

    If the cartilage grafted into the nose tip can be seen through the skin or seems out of place

    If the skin on the nose tip is thin, patients may experience the grafted cartilage being seen through the skin or becoming out of place over time. In these cases, improvements can be made by grafting autologous dermis or AlloDerm that can supplement the skin thickness between the thinned skin and the cartilage, or by removing the existing cartilage and then newly grafting a different cartilage and dermis at a correct location.

    • Grafting autologous dermis or AlloDerm that can supplement the skin thickness between the thinned skin and the cartilage

      Replacing the existing cartilage with a different cartilage into a correct position

These are examples of common nose revision surgeries, and the actual reasons and methods for a revision surgery may differ, depending on the individual conditions. BANOBAGI aims for a more satisfying nose revision surgery through systematic consultations and comprehensive surgeries.

Click here to see the before and after photos

BEFORE & AFTER

Before
3MonthsAfter
Before
4MonthsAfter
Before
3MonthsAfter
Before
3MonthsAfter
Before
3MonthsAfter
Before
3MonthsAfter

※ This image may look different from the real look depending on the shooting conditions, and was posted under the agreement of patient himself/herself