Skin Thickening and Other Perils of Revision Rhinoplasty
Rhinoplasty is one of the most popular plastic surgeries in the United States for both men and women. However, it is also one of the most challenging procedures to teach, learn, and perform.

BEVERLY HILLS, CA, February 02, 2012 /24-7PressRelease/ -- Rhinoplasty is one of the most popular plastic surgeries in the United States for both men and women. However, it is also one of the most challenging procedures to teach, learn, and perform. As a result, many people do not get the result they desire from a rhinoplasty, so there is a high demand for revision rhinoplasty. Even the best plastic surgeons may have a revision rate of 5% or more, while for less skilled plastic surgeons, the revision rate may be much higher.

Partly in response to the difficulty of the procedure and its revision rates, the culture of rhinoplasty is changing. More and more plastic surgeons are utilizing the "open" rhinoplasty technique. In this variation, an incision is made in the columella, the skin between the nostrils, allowing the skin to be peeled back from the nose, revealing most of the nose's internal structures. Being able to visualize the nose reduces the difficulty of the surgery and therefore the revision rate, but there is still a chance that the results may not be what you desire, leading to a need for revision.

Challenges of Revision

The irony is that revision rhinoplasty is much harder than primary rhinoplasty. The natural nose is very predictable. In general, a surgeon can look at the nose and know what structures to expect on the inside. Even if there are variations, they tend to be predictable. However, in a revision rhinoplasty, it is impossible to predict what lies below the surface. Surgeons use many different techniques in rhinoplasty, some of them very idiosyncratic, making it a very complicated guessing game. Even once the skin is pulled back, the changes made may be inscrutable.

The materials are also different in revision rhinoplasty. Where the native tissue has predictable characteristics, once altered the scars may make the tissue harder to deal with and limit the possible manipulations. Scar tissue can be very difficult to work with and a previously broken bone may not be free to break the way your new surgeon desires.

Skin Thickening as a Result of Revision Rhinoplasty

One complaint that people mention after revision rhinoplasty is the apparent thickening of the skin that can make the nose look larger and damage the cosmetic results. In actuality, this is not normally skin.

Instead the apparent thickening of the skin is the result of the buildup of scar tissue. Every time surgery is performed on the nose, scar tissue builds up under the surface. This scar tissue can be hard to remove and is another one of the challenges in revision rhinoplasty.

It is important to note that sometimes the apparent thickened skin of the nose is not skin or scarring but swelling. Although you do not need to take much time off from the surgery or even from vigorous activity with rhinoplasty, the surgery can take a very long time to fully heal. Swelling from rhinoplasty can persist for up to a year after surgery. Do not begin to worry about your rhinoplasty results until at least six months after surgery and do not see revision until a full year has passed.

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