Is a Rhinoplasty Revision Painful?

Rhinoplasty revisions are conducted under general anesthesia so patients do not feel any pain during the procedure. The night following your surgery, you may experience some pain and discomfort that can be controlled with your prescribed pain medication. Temporary bruising, swelling, and numbness are common the first night after surgery. Keep your head elevated and leave the nasal splint and dressings in place overnight.

How Many Appointments Will I Need?

To ensure a smooth recovery period, you may need several appointments, from the initial surgery to the follow-up appointments required by Dr. Motykie. During your consultation, Dr. Motykie will be able to advise you on the number of post-operative appointments necessary.

How Long Until I See Results?

The recovery after revision rhinoplasty is often less extensive than after a primary procedure. Though the face may look and feel puffy right after surgery, there is generally less bruising and swelling encountered. The bruising should subside within about seven to ten days, while the swelling may take several months to disappear completely. Most of Dr. Motykie’s rhinoplasty revision patients return to their regular workout routine within 4-6 weeks after their surgery. All patients vary in their ability and speed to recover after surgery, but most commonly, the final result is evident six to twelve months after surgery. Your nose should be close to its final shape and size by this point.

Can I Combine a Rhinoplasty Revision With Other Procedures?

For certain patients, Dr. Motykie recommends pairing a rhinoplasty revision with a chin implant in order to balance the facial profile or facial fat grafting to balance the remaining facial features, improve overall facial contour, and rejuvenate a tired or aging appearance. Please inform Dr. Motykie about any and all of your preferred procedures during your consultation so he may devise the safest and most comprehensive surgical treatment plan to address all your facial aesthetic goals.

What Are the Risks Associated With a Rhinoplasty Revision?

A rhinoplasty revision is an inherently risky surgery that results in higher than typical reoperation rates. Patients are informed that some risks of a rhinoplasty revision procedure include but are not limited to: Shortness of breath or general difficulty breathing Changes or loss in tissue sensitivity Tissue death Bleeding Altered sense of smell and taste Infection Nasal septal perforation Asymmetrical appearance in the nostrils or overall shape of the nose

Beverly Hills, CA

Rhinoplasty Revision

Introduction to Rhinoplasty Revision

A successful rhinoplasty surgery should aim to achieve the best possible nasal shape while maximizing breathing and minimizing possible complications. Unfortunately, sometimes rhinoplasty surgeries can go awry due to surgical inexperience, poor surgical technique, or scarring after surgery.

Rhinoplasty surgeries have the highest reoperation rates of all plastic surgery procedures, so selecting a highly experienced plastic surgeon for a revision rhinoplasty is important to correct the results of a previous rhinoplasty. Dr. Gary Motykie is based in the Beverly Hills & West Hollywood, CA, area and welcomes patients everywhere to schedule a consultation to learn more about how a revision rhinoplasty can correct their nasal problems. With Dr. Motykie, the aim is to make your next revision of rhinoplasty your last!

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What is a Rhinoplasty Revision?

Rhinoplasty revision is a surgical procedure that corrects nasal problems of an aesthetic or functional nature resulting from previous rhinoplasty surgery. Rhinoplasty revision may correct or improve a number of issues, such as nasal obstructions and other functional problems that may inhibit breathing or cause depressions, bumps, collapsed or pinched tips, and/or excessive scarring. Cartilage grafts or implants may sometimes be necessary to replace missing structures.

Rhinoplasty revision is more difficult to perform than primary rhinoplasty because the normal anatomy of the nose has been distorted, and there are sometimes missing pieces of cartilage or scar tissue formation inside of the nose. This makes rhinoplasty revisions one of the most challenging surgeries to perform, as they require a highly skilled plastic surgeon with a strong aesthetic sense and a deep breadth of experience to reconstruct the cartilages and bony framework of the nose while performing successfully on a consistent basis.

For best rhinoplasty results, Dr. Motykie recommends avoiding the three “P’s” of rhinoplasties: the “Piggy,” “Puggy,” and “Pinchy” nose. In other words, Dr. Motykie recommends all of his patients to vehemently avoid noses after rhinoplasty that look turned up like a pig, smashed in like a pug dog, or pinched in like a witch. These appearances can appear unnatural after surgery and are difficult to correct surgically.

What Are the Benefits of a Rhinoplasty Revision?

Dr. Motykie’s patients in Beverly Hills, CA, often request a rhinoplasty revision for the following improvements to their aesthetic and functional nasal issues:

Improved breathing and functionality
Reduction or replacement of damaged tissue
Restructuring the size and shape of the nose
Correcting unnatural-looking results from a previous rhinoplasty

Some doctors who do not possess the required or adequate training to perform an actual rhinoplasty will tout the possible advantages of injectables to reshape a nose non-surgically. This approach to nasal reshaping may temporarily improve the shape of a nose, but it is ineffective in reducing the size of a large nose or having any permanent improvement in nasal contour. Since the injectable fillers need to be repeated, the expense of such a “non-surgical” approach can become considerable and disappointing with time.

However, injectable fillers are useful in temporarily filling contour deformities of the nose if revision rhinoplasty surgery is to be performed sometime in the future and the patient wishes to camouflage the deformity in the meantime.

Who Are the Best Candidates For a Rhinoplasty Revision?

Rhinoplasty revision surgeries should aim to be the final surgery to correct any aesthetic or functional issues persisting after a previous rhinoplasty. Dr. Motykie recommends his patients should pursue a rhinoplasty revision if they are experiencing any of the following as a result of their previous rhinoplasty:

Difficulty breathing normally
Polly beak deformity (excess tissue in the nasal bridge)
Nasal tip contour deformities
Pinched, dropped, or upturned nose tip
Residual dorsal hump
Crooked nose
Hanging or retracted columella
Flared or uneven nostrils
Wide nose
Runny nose

Your Revision Rhinoplasty Journey with Dr. GARY MOTYKIE

What’s the First Step?

Please schedule a consultation with Dr. Motykie in West Hollywood, CA, to evaluate whether a revision rhinoplasty would be the next recommended step to address your current nasal issues. Please be prepared to discuss your medical history and use of any current medications, vitamins, herbal supplements, alcohol, tobacco, and/or recreational drugs, as these can impact your safety if proceeding with a revision rhinoplasty. Please also arrive with any and all questions so you can be prepared to learn as much as possible during your visit with Dr. Motykie.

Dr. Motykie will provide you with a book containing reference photographs of different results from rhinoplasty surgery. You are also encouraged to bring in photographs you may have obtained on your own that show the desired “look” you would like to achieve from surgery. This will help Dr. Motykie understand which type of nose you find attractive and which rhinoplasty technique may best help you achieve your desired outcome from surgery.

Because a revision rhinoplasty procedure depends heavily on the surgeon’s artistic eye, Dr. Motykie offers computer imaging to all of his patients so that they can see what their noses might look like after surgery, even before undergoing any surgical procedure. This will allow Dr. Motykie to clearly define your nose problems and show you a realistic view of what can be accomplished surgically to create your new nose.

You should leave your consultation with a preliminary game plan for your surgery. As discussed in your consultation, Dr. Motykie will develop a personalized surgical treatment plan tailored to address your needs. When you are ready to proceed, a patient care team member will help you schedule your surgery.

What to Expect on the Day of Rhinoplasty Revision Surgery

Two major techniques are used to perform a rhinoplasty revision: a “closed rhinoplasty” or an “open rhinoplasty.” Dr. Motykie is able to perform your rhinoplasty using either technique, and he can, therefore, customize your revision rhinoplasty surgery by choosing the best technique to perform in your own unique individual case.

Closed Rhinoplasty Revision

Dr. Motykie prefers to perform his rhinoplasty revision surgeries utilizing the more advanced “closed” technique, which delivers superior results, no visible scarring on the nose, and quicker overall healing. In the closed approach to rhinoplasty revision, all of the incisions used to perform the surgery are confined to the inside of the nose. This is often referred to as an “invisible” rhinoplasty because it results in no visible scarring. During this technique, the skin of the nose is separated from its supporting framework of bone and cartilage in order to be sculpted into its final desired shape. At the end of the surgery, the skin is gently laid over the new nasal framework since it was never entirely lifted in the first place. This is important because an experienced plastic surgeon realizes that it is better not to destroy and/or distort as much of the natural architecture of the nose as possible so that there is less room for swelling, scarring, and complications after surgery.

Open Rhinoplasty

In the open approach to rhinoplasty revision, an incision is made on the outside of your nose along the base of the columella, which is the hanging lower, middle portion of your nose that separates the nostrils. The skin of the nose is then separated from the underlying supportive framework of bone and cartilage. This framework is then reshaped to achieve the desired contour of the nose. Once the nose has been sculpted and remodeled to its final shape, the skin is re-draped over the new framework. When the surgery is complete, a splint will be applied to help the nose maintain its new shape during the healing process. This approach to surgery is typically used in more complicated revision surgery cases. However, an open approach to revision rhinoplasty surgery may often be ill-advised because the tissues of the nose have already been traumatized by prior surgery, and further disruption of any remaining normal anatomy and healing pathways in the nose can lead to more long-term warping and scarring of the nose. For these reasons, Dr. Motykie only performs an open rhinoplasty procedure in the most complex revision rhinoplasty cases where the benefit outweighs the risks.

Grafting

One of the main differences between primary and revision rhinoplasty procedures is that cartilage grafting is less readily available in revision procedures. This can make revision rhinoplasty more difficult because the plastic surgeon is left with missing parts of the nose and/or poor remaining natural cartilage. Somehow, the surgeon must use their experience, skills, and aesthetic sense to modify the existing nasal cartilage to create a more attractive, natural shape of the nose. If it is absolutely necessary to borrow cartilage from somewhere on the body, ear cartilage is the most readily available, and it is naturally contoured and curved to match the shape of the nasal tip when harvested and carved properly for use in grafting. After all cartilage and bone have been re-sculpted, grafted, and/or removed, the incisions inside of the nose will be closed with dissolvable sutures, and a nasal splint will be placed on the outside of your nose along with a dressing that is to be left in place overnight.

Rhinoplasty Revision Recovery

After surgery, you will be brought to the recovery area, where you will be allowed to rest and completely recover from anesthesia. Nurses will be on staff by your bedside to ensure you recover properly. They will also be able to provide you with pain medications and small amounts of water and/or ice chips while you are becoming more awake and alert.

After you have fully recovered from anesthesia, you may be released to home with a responsible adult, or you may choose to stay overnight in an outpatient recovery retreat where there are nurses on staff 24/7 to assist you with post-operative care and medications.

During your recovery period, arrange for someone to drive you home after surgery and take care of you for at least the first day or two afterward.

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How Much Does a Rhinoplasty Revision Cost in Beverly Hills, CA?

The cost of revision rhinoplasty in Beverly Hills and the greater Los Angeles area will vary based on the following: the surgeon’s fee, surgical facility costs, anesthesia fees, prescription medications, post-surgery garments, and medical screening tests. During your consultation, you will have the opportunity to understand all your possible financing options to make the best and most informed decision for yourself.

Why Choose Dr. Motykie?

Dr. Gary Motykie is a Board-Certified Plastic Surgeon who is highly skilled in breast surgery, body contouring, rhinoplasty, facial rejuvenation, and numerous other cosmetic surgical procedures. With about 50% of his practice consisting of revising surgeries from elsewhere, Dr. Motykie believes in performing safe, effective plastic surgery that focuses on “doing it right the first time.”

Dr. Motykie studied Medicine at Northwestern University and Plastic Surgery at the University of Texas, where he performed surgery at one of the world’s top cancer and burn reconstruction facilities. He subsequently completed an Advanced Cosmetic Surgery Fellowship in Beverly Hills, California, in 2004. Since then, he has spent the past ten years dedicated to designing an integrative approach to health, wellness, nutrition, and surgery to evolve his practice beyond the current standards.

Dr. Motykie has been featured in articles in the New York Times, LA Times, and Wall Street Journal and has appeared as a regular surgeon on the E! Channel’s Dr. 90201, Celebrity Plastic Surgery, The Doctors, Marie Show, Dr. Phil, MTV, VH1, EXTRA, ACCESS Hollywood, Inside Edition, and the Discovery Channel’s Plastic Surgery: Before & After. Dr. Motykie continues to present his work around the world, appearing on numerous televised programs to discuss a wide variety of plastic surgical topics.

Dr. Motykie strongly believes that the best plastic surgery results are beautiful, natural, and undetectable. He cares about educating and empowering his patients to make truly informed decisions about having safe, smart, and effective plastic surgery.

Dr. Motykie is certified and licensed by the American Board of Plastic Surgery (ABPS), the American Society of Plastic Surgeons (FASPS), the American College of Surgeons (FACS), the Los Angeles Society of Plastic Surgeons (LASPS), the International College of Surgeons, United States Section (FICS), the American Society of Maxillofacial Surgeons (ASMS), and the International Confederation for Plastic Reconstructive and Aesthetic Surgery (IPRAS).

Rhinoplasty Revision FAQ’S

Rhinoplasty revisions are conducted under general anesthesia so patients do not feel any pain during the procedure. The night following your surgery, you may experience some pain and discomfort that can be controlled with your prescribed pain medication.

Temporary bruising, swelling, and numbness are common the first night after surgery. Keep your head elevated and leave the nasal splint and dressings in place overnight.
The recovery after revision rhinoplasty is often less extensive than after a primary procedure. Though the face may look and feel puffy right after surgery, there is generally less bruising and swelling encountered. The bruising should subside within about seven to ten days, while the swelling may take several months to disappear completely. Most of Dr. Motykie’s rhinoplasty revision patients return to their regular workout routine within 4-6 weeks after their surgery.

All patients vary in their ability and speed to recover after surgery, but most commonly, the final result is evident six to twelve months after surgery. Your nose should be close to its final shape and size by this point.
For certain patients, Dr. Motykie recommends pairing a rhinoplasty revision with a chin implant in order to balance the facial profile or facial fat grafting to balance the remaining facial features, improve overall facial contour, and rejuvenate a tired or aging appearance. Please inform Dr. Motykie about any and all of your preferred procedures during your consultation so he may devise the safest and most comprehensive surgical treatment plan to address all your facial aesthetic goals.
A rhinoplasty revision is an inherently risky surgery that results in higher than typical reoperation rates. Patients are informed that some risks of a rhinoplasty revision procedure include but are not limited to:
- Shortness of breath or general difficulty breathing
- Changes or loss in tissue sensitivity
- Tissue death
- Bleeding
- Altered sense of smell and taste
- Infection
- Nasal septal perforation
- Asymmetrical appearance in the nostrils or overall shape of the nose

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