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The ideal nose today is a natural looking nose that fits the face
 
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Rhinoplasty, popularly known as "the nose job," remains the most common form of plastic surgery. The introduction of advanced rhinoplasty techniques has made it possible to achieve more aesthetically-pleasing outcomes than ever
 

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What is Revision Rhinoplasty?
 

Revision rhinoplasty involves re-operating a nose to improve a previous poor result and can be one of the most difficult surgeries to perform in plastic surgery. Revision rhinoplasty can take two forms. The first is the small “touch up” revision of an acceptable previous result. The patient may be happy with the overall appearance of the nose, but may wish a small and slight improvement. For example, a small tiny bump was left on the bridge or a small visible edge on the tip. Revision rhinoplasty in this case is usually a less involved operation. The patient is typically content with having the surgery performed by the original surgeon since trust was not lost. Patients are typically not emotionally upset.

The second form is when the revision rhinoplasty is performed to reconstruct a previous poor result. A failed rhinoplasty can be one of the most devastating experiences a patient undergoing plastic surgery can have. Patients that undergo rhinoplasty have usually thought about the surgery for several years. When the result is a nose that is worse in appearance than the original nose, the patient can become extremely disappointed. Self esteem and confidence may decrease and affect the person’s social activities. I have a deep and personal understanding of the emotional distress that patients undergoing through this feel and I am committed to helping them.

Rhinoplasty, also known as “nosejob”, is a surgical procedure that is performed to permanently change the shape and size of the nose. The surgery is done by reshaping nasal skeleton, which is made of bone and cartilage. The skin of the nose is not altered, but when the underlying structures are changed, the skin conforms to the new shape of the nose.

 
 

 

 
  Revision Rhinoplasty: The Surgery  
 

Revision rhinoplasty is performed with either an open or closed approach, much like a primary rhinoplasty. When using the closed approach, minimal additional scarring will occur since the incision is place inside the nose. When correcting results of prior surgeries it may be necessary to use an open approach with the incision placed across the skin between the nostrils. This open technique allows for better visibility for the surgeon to see and access the problems. The specific techniques that will be used are dependent on the aim of your surgery. For example, bone and cartilage are removed when treating a hump that has formed. If a depression is in need of raising, cartilage grafts will be needed to build it up.

 
  Revision Rhinoplasty Secondary Rhinoplasty  
 

Revision rhinoplasty is a very specialized area in the field of Plastic Surgery. It corrects the inferior results of what is often considered the most difficult procedure in cosmetic surgery: rhinoplasty. When performing revision rhinoplasty, thinks it is important to address not only the aesthetic issues or the way the nose looks, but also the functional issue of breathing problems, all the while being sensitive to the emotional concerns of patient who has been "traumatized" by one or more previously undesirable results.

 
 

 

 
  Repair a bad nose job with revision Rhinoplasty surgery  
 

revision rhinoplasty noseBad nose jobs can be repaired with a revision Rhinoplasty surgery, The incisions for revision rhinoplasty can be made on the inside of the nose (closed rhinoplasty), or on the underside of the nose between the nostrils (open rhinoplasty). Closed rhinoplasty has the advantages of being less traumatic and invasive to the tissues because the surgeon only uncovers the areas that need correction, whereas the open approach involves a wider dissection and more disconnection and reconnection of supporting structures. The closed approach may be safer if you have scarring from earlier nose surgeries, but some surgeons prefer the open approach for the exposure that it provides, or to better understand and visualize complicated cases. If you are unhappy with your previous nose job, setup a consultation with Dr. Kassir to see if he can repair your poor rhinoplasty with his 

 
 

 

 
  The Benefits of a Revision Rhinoplasty  
 

Increased Confidence

The nose is a central feature of the face and can have a profound effect on a person’s overall appearance. The majority of patients experience an enhanced self-image and significantly increased confidence after improving this influential facial characteristic.

rhinoplasty keywords

A Trusted Expert

Revision rhinoplasty expert and has studied this procedure in depth. It is he who other nose specialists often ask for advice. Dr. Pearlman uses his expertise to achieve significant improvement for his patients, and he has lectured around the world to educate other surgeons on ideal surgical techniques.

 
 

 

 
  Revision Rhinoplasty?  
 

Your nose may have one or more of the following:

Pinched tip

Pulled up nostrils (notched)

Deep creases above the nostrils

Tip "knuckles" (bossae)

Upturned nasal tip (pig nose)

"Scooped out" profile

Collapsed bridge

Narrow bridge

Crooked nose

Nasal length discrepancies

Difficulty breathing

Other abnormalities
 
 

 

 
  Revision Rhinoplasty?  
 

Recovering from revision rhinoplasty is similar to recovering from the initial procedure. You will need to take one to two weeks off from work or your usual activities. During the week after your procedure, you should keep your head elevated, even while sleeping.

For the first few days after surgery, your nose might feel stuffed up, and you may have to breathe through your mouth. You may also notice that your nose is sore, swollen or bruised, and the bruising may continue into the eye area, contributing the look of “black eyes.” However, many patients are pleasantly surprised with the lack of bruising and swelling, thanks to surgical techniques. Note: It takes about one year for any residual swelling to subside completely.

If you experienced an extensive degree of scar tissue after your first surgery, it may take longer to realize your final results than it did with your initial procedure.

 
 

 

 
Procedure
Nasal Cosmetic Surgery
- Special

Nasal Surgery
Special (this Month)
Special (this Month)
 
  In the Advanced Surgical Institute we accept the following payment:
   
  • Cash
  • Credit Cards
 
  ( For more info click here )
   
 

Are patients outside of the Los Angeles area able to have a consultation and surgery on the next day? We can help you with Travel Arrangement . (For more info click here)

Many of out of town patients have their initial physical exam and consultation immediately prior to scheduled surgery. During this consultation, the doctors will discuss the surgery in full detail.

 
 
  WHEN SUCH A PROCEDURE IS DEEMED NECESSARY:  
  Sometimes this may be the only option remaining when all other treatments like allergy shots etc. have failed to alleviate the symptoms. Even a slight physical deformity in the nasal area can result in problems that can severely impede a person's quality of life. The "septum" which is the two openings to the nostrils that are separated by just a thin wall of cartilage is especially prone and susceptible to injury. In some cases, a patient may just have a septum that does not develop properly. In these cases, the septum may become 'bent' or 'deviated', which can in turn cause difficulties in the sinuses or turbinates, which are other susceptible nasal areas. If the bone and cartilage in the nose becomes misaligned, this can cause increased air flow on one side and partial reduction in air flow on the other side, causing a definite imbalance. This imbalance in the flow or air will irritate the mucous membranes that line the insides of the nose and the 'turbinates', which are curved bones in the nasal passage that help to keep the nose lubricated and clean. This irritation can cause swelling and blockage on both sides of the nose. This swelling in turn can block access to the sinus cavities and prevent proper drainage.

Some of the problems that can arise due to improper drainage of the sinuses and require Nose Surgery may include:
Difficulty breathing
Discharge from the nose, which may include bleeding
Post nasal drip
Dryness of mouth
Shortness of breath
Snoring
Headaches

 

1. The doctor may recommend one of the following procedures, or a combination of them, to help correct the problem, but this recommendation will vary based upon the individual symptoms being experienced by each patient: Septoplasty - This involves the surgical realignment of the septum in order to straighten it.

2. Osteotomy - This involves the fracturing and resetting of the nasal bones.

3. Partial Turbinectomy - This involves the reduction of the swollen turbinates.

4. Rhinoplasty - This involves the reshaping and restructuring of the nose for cosmetic and/or functional reasons.

These procedures are typically performed as outpatient procedures but may require a brief stay in the hospital. Anesthesia will range from just heavy sedation to general anesthetic. In either case, the patient will need someone to collect them from the hospital and take them home safely. Very little swelling and bruising should be evident if only the septum was straightened. However, in the case of refracturing, the swelling and bruising may take several weeks to subside.
The healing process may take several weeks and during this time, the utmost caution must be taken to avoid any blow or trauma from occurring to the nose. Some of the symptoms that were present before surgery may continue for variable amounts of time after the procedure, so it is wise not to expect instant results. Some relief can be obtained by using a saline spray several times a day, or through administering other medications. The symptoms may in fact remain, until the healing is complete, which may be a period of several months.
Nasal surgery cannot be expected to cure all symptoms, especially if the patient is also susceptible to allergies, but it can definitely help correct some major breathing and sinus problems.

The most common symptoms that sinus-sufferers describe are headaches,
facial pain, the loss of the sense of smell, post nasal drip, nasal congestion and the
inability to breathe through the nose.

The causes for these symptoms are quite simply explained. The sinuses are chambers containing air and are located on the face, directly under, between and above the eyes. These chambers are lined with mucous membrane whose function it is to produce up to two pints of mucous a day. Each sinus has it's own opening into the nose and there are a sum total of four pairs of sinuses starting from the pair above the eyes, and proceeding downwards: Frontal, Ethmoid, Maxillary and Sphenoid Sinuses.
The mucous is then swept into the ostium or the opening and enters the nose and cleared through the throat. Allergens, viruses, bacteria and other air contaminants cause an inflammation, followed by the swelling of the linings of the sinuses. The swelling causes the opening to become blocked and prevents the drainage of the mucous, causing infection and thickening. This infection causes more swelling and more obstruction. So when these openings become obstructed, the patient may experience difficulty breathing, facial pain around the sinuses, behind and below the eyes and other chronic sinus infections. Although allergies, colds and septal deviations are all potential causes of sinus obstruction, the results are the same, with retained secretions of mucous becoming infected and thus resulting in 'sinusitis'.
 
 

 

* The Information Presented On This Website Is Intended To Be Used For Informational Use Only; It Is Not Intended To Be A Substitute For Professional Advice. If You Are Planning On Having A Procedure Performed Or If There Is Anything You Don't Understand Or Have Questions About Your Procedure, Time, Price Variation Due Patient Comorbidity, Blood Work, Additional Cost for General Anesthesia, Post Surgery Recovery, Combination Of The Different Procedures. Please Consult Our Physician Who Will Be Happy During Your Free Consultation To Go Over In Details With All Your Questions.
 
 
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REVISION RHINOPLASTY
Following are some common questions asked by those considering REVISION RHINOPLASTY
 
Question: I think my first surgeon took too much from my nose. Can you fix this?
Answer: This is a common reason for revision rhinoplasty. No matter where in your nose too much has been removed, Doctor's experience is that improvement is often possible.
 
Question: I want my nose to look natural again. Can you do this?
Answer: This is the most common request our patients have, and is perhaps the most important objective in revision rhinoplasty. Doctor is experienced at repairing the "over-operated" nose. While each case is different, in Doctor's experience it is usually possible to make significant improvement.
 
Question: My nose is too small. Can you make it bigger?
Answer: Yes, if a patient's nose has been over-operated and now looks too small, Doctor can generally improve it. He also can generally fix noses that are too short, too long, too narrow, too wide, twisted, and so forth.
 
Question: Is there a lot of pain or nausea?
Answer: Not typically. Time after time, Doctor's patients are surprised at how little pain and how little nausea there is. After-surgery pain is usually well-controlled with a mild narcotic. We are especially proud of our anesthesia team, who provide expert anesthesia that keeps after-surgery nausea to a minimum.
 
Question: What is the recovery period?
Answer:
  Patients may experience some degree of bruising and swelling to progressively resolve over two to four weeks
  A splint will be placed on the outside of the nose and possibly on the inside as well. Both types of splints are used to protect the, now delicate, nasal structures.
  Bed rest the day of surgery is recommended.
  Limit activity for the next two days following surgery.
  Avoid strenuous activities for about four to six weeks.
  Return to work in about one to two weeks.
 
Question: Will insurance cover my surgery?
Answer: If your requests are of a functional nature (for example, you cannot breathe through your nose), many insurance companies will cover the part of the surgery that is required to correct these problems.

However, any requests that relate simply to change of appearance are generally not covered by insurance companies, and do require a cosmetic surgery fee.
 
Question: I live far away, how do I arrange to see you and to have surgery?
Answer: You can contact Doctor's office and arrange an appointment. Many patients come for an initial visit and schedule surgery at the end of this initial visit. They then return for their surgery. Occasionally a patient may wish to come into town for consultation followed by surgery the next day. This is possible but obviously must be arranged in advance.
 
Question: The tip of my nose looks pointy, twisted and abnormal. Can you fix my nasal tip?
Answer: Yes, it has been Doctor's experience that significant improvements are possible in this relatively common problem.
 
Question: Do you do Computer Imaging?
Answer: Yes. Computer imaging is a very helpful way to communicate surgical goals. It is important for the surgeon to know what the patient wants to accomplish, and the patient must know what the surgeon envisions as a goal for the surgical result. Computer imaging is extremely useful to communicate this information, and we therefore perform computer imaging on virtually all patients prior to surgery.
 
Question: I'm not sure what I need to have done, I just know I don't like it!
Answer: We understand! Some patients know how they want their nose to look, but other revision rhinoplasty patients are frustrated, angry, and even a little scared. They know they don't like their nose, but they are upset and confused and just want someone to help them! We understand this and will take the time to work with you to help you have a happy outcome.
 
Question: I am scared!
Answer: We understand! You have had a bad experience, so it is okay to feel that way. It is important for you to be confident in the surgeon you choose to perform your revision rhinoplasty. Doctor is proud of his surgical results, but he also wants his patients to feel at ease. Doctor's staff plays an important role in helping his revision rhinoplasty patients feel more at ease before and after surgery.
 
Question: How do I know if I am a candidate for revision rhinoplasty?
Answer: If you have had a rhinoplasty and do not like the way your nose looks, and if you are in good health, then you are eligible for a revision rhinoplasty consultation. The next step is to meet with a skilled surgeon to see if surgery can meet your expectations. In Doctor's practice, Doctor talks to you in detail and examines you. Then, he explains his realistic expectations for your surgery and will let you know if he thinks you are a good candidate.
 
Question: Is this outpatient surgery?
Answer: YES
 
Question: Ever since my rhinoplasty, I can't breathe well through my nose. Can you fix this?
Answer: Yes. Unfortunately, this is a common complaint. Fortunately we are usually able to substantially improve nasal breathing. A number of the patients in the Photo Album had this problem. Many times, patients request improvement in breathing and appearance