Los Angeles Facial Plastic Surgery Institute

Revision Rhinoplasty

Many patients that see Dr. Swartout have had prior nose surgery by other physicians. Initially the results may have been favorable, but over time certain changes have occurred. Frequently the breathing has worsened as well.

Functional = Breathing

Most patients presenting for correction following a prior rhinoplasty have some sort of functional deficit and this means a decreased ability to move air through the nostrils. Often, the purpose of the original surgery was to improve breathing, but since the surgery breathing has gotten worse.

There is much discussion of nasal septal deviation, and this may be a factor, but it may by only one of the factors. Another common reason why a nose may be blocked is if there is insufficient support in the nasal valve area. The nasal valves are the narrowest areas in the nose and can be prone to collapse. Although the nostrils may be of sufficient size at rest, with a moderate inspiration of air, the nostril or deeper areas in the nose may collapse. This indicates that there is not enough support in the nose. This is best diagnosed with a physical exam where an instrument is used to support the different distinct areas within the nose and checking improvement in air flow.

Another possible reason why the nose may be blocked is if there is swelling in the soft tissue of the nose and may relate to allergies or environmental sensitivity. This kind of blockage may not be consistent throughout the day, and may in fact switch from side to side. This is best diagnosed with a physical exam by a physician looking inside the nose and may be improved with medical therapy.

FAQ

Question :

I had a nose job when I was a teenager, and now, 15 years later, my nose looks pinched and I cannot breath. Can you help me?

Answer :

Some rhinoplasty techniques used in the past were excellent at creating narrowing of the nose during the initial post operative period, but, unfortunately, as the nose healed and the swelling subsided, the nose became too narrow and the inside became pinched and obstructed. Typically, this pinching and nasal obstruction gets worse over time. The goals of any revision rhinoplasty would be to strengthen the supportive structure of your nose and try to restore normal function. Of course, this would depend on the exact nature of your obstruction and would require a complete physical exam.