Second Chances for Your Nose
The recent Elle Magazine had a feature article written by an experienced medical writer in which she discussed the issue of a second nose job – the so called “secondary rhinoplasty.” The operation is always challenging and there are as many ways to do these operations as there are surgeons to perform them.
A few weeks ago, I participated in a seminar where several lecturers and panel discussions dealt with the issue of the “nose job re-do’s.” Everyone agrees that it is difficult, less predictable and this often translates to a lower level of patient satisfaction. There are procedures employed, including transplanting portions of rib, cartilage and even skull bone in order to reconstruct a nose that has not fared well with the first operation. This is why the procedure becomes unpredictable; the fate of these tissues when implanted into the nose is often unpredictable.
I was a bit disappointed that hardly any attention was given to the alternatives to grafting and transplanting tissues, that is the use of injectable “fillers.” The mission is the same, to replace tissue that has been over sculpted, over-removed leaving dips, depressions, pinches and scooped out bridges. There is a place for these filling injections, some of which are permanent. I think patients owe it to themselves to check out all of the alternatives, surgical and nonsurgical before committing to a second major nasal reconstructive surgery.
-Robert Kotler, MD, FACS
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