Op. Dr. Bekir Can Gümüşlü
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Rhinoplasty is one of the most complex procedures in aesthetic surgery, and worldwide, a second corrective surgery (revision) may be required in 5-10% of cases. Patients who are unhappy after their first surgery—whose noses still have curvature, a drooping tip, or breathing difficulties—rightfully wish to resolve this situation as soon as possible.
However, when it comes to Revision Rhinoplasty, the most important rule is “PATIENCE.” Op. Dr. Bekir Can Gümüşlü explains to his patients the medical reasons why they must wait at least 1 year.
Our patients generally think, “My nose is already bad, let’s fix it immediately.” However, early intervention can make the situation even worse. Here are the 3 main reasons for waiting:
After the first surgery, the lymphatic channels of the nose are severed, and edema (swelling) occurs. It takes up to 1 year for these swellings to subside 100% and for the true shape of the nose to emerge. Operating on a swollen nose is like fishing in murky water; the surgeon cannot see the defects clearly.
“Scars,” which are healing tissues, form under the skin. These tissues are hard during the first few months (immature scar). If intervened early, the skin will not lift properly, bleeding will be excessive, and a risk of circulatory disorders in the skin (necrosis) arises. After 1 year, the tissues soften (maturation) and become suitable for surgery.
The process of the cartilages bending and taking their final shape must be completed.
Revision surgery is not like building a structure from scratch; it is like restoring a damaged building. Generally, the spare material inside the nose (septum cartilage) is exhausted during the first surgery. Strong cartilage is needed to rebuild the bridge of the nose and lift the tip.
Op. Dr. Bekir Can Gümüşlü prefers to use the patient’s own rib cartilage (costal cartilage) in the vast majority of revision cases.
Rib cartilage is abundant, strong, and straight. It is harvested through a small 2-3 cm incision made under the chest. Ear cartilage, on the other hand, is usually used for shaping or camouflage; it may remain too weak to serve as a primary support.
The success rate of revision surgeries performed by experienced hands at the right time is quite high. The goal is not only to correct the shape but also to restore the breathing function that was impaired during the first surgery.
If the problem is only a small protrusion (hump) on the spine and can be resolved with local anaesthesia, a ‘Minor Revision’ can be performed after 6 months with your doctor’s approval. However, a 1-year waiting period is required for major revisions.
You may experience a slight stabbing sensation in the rib area for 2-3 days when breathing or laughing. However, this process can be comfortably managed with strong painkillers. In the long term, there will be no deficiency or deformity in the rib cage.
Yes. Revision surgery is technically much more difficult, the operation time is longer, and it requires additional procedures such as cartilage removal. Therefore, the cost is higher than that of the primary (first) surgery.
Depending on the difficulty of the procedure and whether the ribs will be removed, it can take between 3 and 5 hours.
This fear is very common, but surgeons specialising in revision surgery, such as Op. Dr. Bekir Can Gümüşlü, approach the operation by minimising risks and carrying out detailed planning. The aim is always to achieve a better outcome than the current situation.
