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Revision Rhinoplasty By Dr. Keith Ladner Denver, Colorado Facial Plastic Surgeon

Unfortunately, many patients are often left with a noticeable defect after rhinoplasty that must be surgically corrected. The objective of a rhinoplasty should be to eliminate a distraction while maintaining or improving the ability to breathe through the nose. The resulting defect from a primary rhinoplasty may be subtle or colossal. Communication between the patient and surgeon is essential to determine mutual and realistic goals of the surgery. With the increasing trend of unqualified physicians performing facial cosmetic surgery, it is important for the patient to scrutinize their surgeon’s credentials. It is imperative that the patient verifies that their surgeon has completed a fellowship in facial plastic surgery and that he/she is board certified by the American Board of Facial Plastic and Reconstructive Surgery (ABFPRS). Dr. Ladner has performed hundreds of revision rhinoplasties. As a leader in the field, he recently authored the chapter on revision rhinoplasty for other facial plastic surgeons (Ladner K, Farrior EH. Revision rhinoplasty: evaluating the patient and the problem. Advanced Aesthetic Rhinoplasty. 2013; Chapter 69.)

When evaluating the nose, the surgeon must take into account the overall size and shape of the face, lips, and chin. Dr. Ladner also assesses the internal structures of the nose that affect breathing. In addition to correcting the shape of the nose, he will correct any internal abnormalities to optimize breathing. In revision rhinoplasty, it is often necessary to provide additional structure and shape to the nose. This can usually be achieved using the patient’s own cartilage from the nose. In severe cases, it may be necessary to use cartilage from the ear or ribs or use a synthetic biocompatible implant.

Dr. Ladner believes in tailoring the particular surgical technique for the individual patient's needs. Therefore, both the open and closed rhinoplasty approaches are commonly used. As a rhinoplasty surgeon, it is imperative to be comfortable with both approaches. In general, the open approach is used for revision rhinoplasties and complex rhinoplasties. The open approach offers better exposure of the underlying cartilaginous framework and is therefore the preferred method when multiple structural changes need to be made. The closed approach is a quicker and more direct approach that is extremely useful for noses that do not need drastic change. Depending on your goals, the decision to perform a closed or open rhinoplasty will be made together. The bone and cartilage of the nose is then reshaped to optimize the length, profile, and symmetry. Dr. Ladner may recommend additional procedures, such as a chin augmentation, to complement the revision rhinoplasty and provide the optimal facial harmony. It is best to bring to your consultation all of your before and after photos and operative notes from your prior procedure(s).

Revision Rhinoplasty Denver

before and 1 month after revision rhinoplasty

Revision Rhinoplasty Denver, CO

Before and 3 Months After Revision Rhinoplasty

Revision Rhinoplasty Denver, CO

Before and 9 months after Chin Augmentation and Revision Rhinoplasty

Revision Rhinoplasty Denver, CO

Before and 3 Months After Revision Rhinoplasty

 

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