Rhinplasty and nose revision
Nose revision solve the changes of nose shape, given by congenital defects or by postaccident deformations.
The nose as a centrum of face is very sensitively perceived by every man and his surroundings especially because his shape gives the expression to the face and influence by this the look of his personality. Every change of nose shape is also the change of face look and it's often very obvious at the first glance.
Revision rhinoplasty as is noticeable even from brief overview of plastic surgery history, were always in the centre of focus of surgeon and until present time it belongs to the most demanding aesthetical surgeries and require not only a technical mastering of the operation itself, but also the big experience and good appraisal of the surgeon.
Preoperation examination and consultation is the first very important step. The lower age limit is given by the end of growth, above all the grow of the face skeleton and tooth span. This is by girls from 16 - 17 years, by boys about 18 year. The upper age limit is not exactly set, but good result is conditioned by enough skin elasticity, that have to accomodate to the new shape of nose, that is very important especially with the strong nose revision.
Sufficient elasticity has the skin of nose approximately up to 30 - 35 years, but it's pretty individual and it doesn't mean, that you can't operate the nose later. Another very important factor is the self type of nose skin, that has effect on healing and scar appearing at hypodermis, that could sometimes quite unfavourably influence the end shape of nose. Oily, strong and porous skin especially at the nose head has always bigger risk of massive hypodermic cicatricial tissue and lower adaptability to the new nose shape.
By the most of revision surgeries is needed to make complete rhinoplasty, it means fully loosen as the gristly so also the osseous skelet of the nose and give the nose new shape with keeping certain dimensional proportions.
For example if we would operate only the gristly part of the nose (so called tender nose), often originates a disproportion between slenderized head of nose and massive non-operated osseous part of the nose. Or if only the nose bump is bring down and is not conducted the necking of side nose bonelets, comes up wide and flat dorsum nasi and similar.
The self nose revision is conducted in full anesthesia. The whole operation is conducted through nares, thus without external strias. The nose revision is ended by nose fixation with plaster splint and anterior nasal packing.