Secondary rhinoplasty differs from the primary procedure in that it may require cartilage or bone grafting. If too much tissue or bone was removed in the first surgery, the doctor will need to replace this in order to achieve the desired look. Often, cartilage is taken from the ear or other areas of the nose. In rare cases, it is harvested from a rib, in what is known as a costal cartilage graft.
Your nose is one of your most prominent features. If you are dissatisfied with the shape of your nose, and wish to refine it with cosmetic surgery, you should be prepared to define your goals, determine the surest way to achieve those goals, and make no compromises in your pursuit of the results you desire. Meet with several reputable and credentialed surgeons, ask questions, and make your choice based on the surgeon's ability to listen and educate, as well as his or her track record of providing beautiful results.
Naturally, patients should choose a doctor who has a good reputation for success. Individuals should ask friends, family, and general practitioners for recommendations. Additionally, all state medical boards are required to make a doctor's information public. Patients may access these records to look for any past lawsuits or infractions. In many areas, these records are available online, but in some states, they can only be accessed through the mail.
Dr. S. Valentine Fernandes, the Conjoint Senior Clinical Lecturer, at the Department of Otorhinolaryngology, Newcastle University, conducted a comprehensive study about the risks of rhinoplasty. According to Fernandes, the complication rate of nose surgery falls between 4 and 18.8 percent. While this may seem an alarming number, Fernandes reports that there is a much lower 1.7 to 5 percent risk of life threatening complications. He also notes that the complication rate falls in proportion to the doctor's surgical experience.
“I generally recommend that my patients take between three and seven days off after liposuction, depending on how many areas were worked on and your pain tolerance,” Dr. Samuel Sohn, a Henderson, Nevada, plastic surgeon says in a liposuction recovery Q&A. Your doctor will prescribe pain medication, though you may find you only need an over-the-counter pain reliever.
Choosing a liposuction surgeon based on the lowest price might ultimately be the most expensive choice, If the initial cosmetic results are so bad that another surgeon must be paid to repair the work of the first liposuction surgeon. Among the most common undesirable outcomes of liposuction are 1) incomplete liposuction with very little evidence that liposuction was actually done, 2) excessive liposuction producing an unnatural or disfigured appearance, 3) irregular and uneven results with unsightly depressions in the skin, and 4) large scars that reveal that the patient has had liposuction. Caveat emptor (Buyer beware).
Liposuction is often called "liposculpture" because when it is performed by an experienced surgeon such as Dr. Weinberg, the technique is used to sculpt the contoured appearance patients want. Liposuction is often performed along with other cosmetic surgery procedures to fine-tune the results. Dr. Weinberg commonly combines liposuction with the following procedures:
“Insurance will typically cover procedures to help improve nasal function (i.e. septoplasty, nasal valve repair, turbinate reduction),” says Dr. Sam Naficy, a Seattle facial plastic surgeon, in a RealSelf Q&A. “The extent of coverage varies based on the details of the insurance plan. Insurance will not cover procedures that improve the appearance of the nose but are not necessary to improve nasal function.”
Both open and closed rhinoplasty can be extremely effective. The doctor will determine the right technique for each patient, based on the natural shape of the nose and the goals for surgery. If the patient desires dramatic changes, or if the doctor is performing post-traumatic rhinoplasty, an open technique may work best. This method gives the doctor access to a larger part of the nose. In many cases, it also helps him or her to make small adjustments to the nasal tip. If a patient wants to address the bridge of the nose, closed rhinoplasty may work well. However, because each patient is different, there are no hard and fast rules regarding the "right" procedure to use.
“Patients who undergo open rhinoplasty typically have more edema (swelling) that persists longer compared to patients in whom closed rhinoplasty techniques were used,” says Dr. C. Spencer Cochran, a Dallas, Texas facial plastic surgeon, in a rhinoplasty recovery Q&A. “If the nose was surgically broken by performing osteotomies, then there is usually more swelling and bruising."
“The biggest difference between the open and closed rhinoplasty is a small incision on the columella (bottom) of the nose,” says Dr. Kent V. Hasen, a Naples, Florida plastic surgeon, in a rhinoplasty Q&A. “This 6 mm incision allows the surgeon to peel the skin of the lower nose back to fully visualize the tip and dorsum of the nose. In the closed procedure, there is not as much visualization since the skin is not peeled back.”
Rhinoplasty can be performed in one of three places: private surgical suites, ambulatory surgical centers, or hospitals. You should speak with your surgeon and make certain that their chosen venue has been accredited by an organization such as the American Association for Accreditation of Ambulatory Surgical Facilities (AAAA), the Accreditation Association for Ambulatory Health Care (AAAHC), or the Joint Commission for Accreditation of Healthcare Organizations (JCAHO).