The rhinoplasty is one of the most performed aesthetic surgeries in the world. Generally, approximately 20% of those who have the rhinoplasty surgery need a second surgery, either small or large, that is, secondary rhinoplasty.
Second, third or more surgeries performed to correct the complications after the first rhinoplasty is called secondary rhinoplasty. The secondary rhinoplasty is also known as the revision rhinoplasty, correction rhinoplasty, second rhinoplasty among the people.
The secondary rhinoplasty is a much more complex operation than the primary rhinoplasty (primary rhinoplasty). Because;
The patients who applied to us for the secondary rhinoplasty usually had their first surgery in another center, so we cannot have information about the first surgery. There are cases that we detect only by the inspection.
There can be serious scars in the area to be operated. This makes the interventions on scars difficult.
The arrangement of the tissues can be distorted, they can be intertwined.
The structure of the cartilages, which is one of the main components of the roof of the nose, can be impaired and decreased in quantity.
In addition, some cartilages from the nose can be used in the primary rhinoplasty, but these cartilages required for the secondary rhinoplasty can be consumed.
Even if no excess tissue was removed from the skin in the first surgery, the nasal skin can also be shortened to adapt to the cartilage and bone deficiencies.
The patient can come to the secondary rhinoplasty examination disappointed and with higher expectations. In this case, they usually do not want to experience what they have experienced before. The doctors who will perform this surgery have to act much more carefully than the first surgery; they have no chance of making a mistake or missing it. This is a challenge for the doctors.
In the secondary rhinoplasty, in addition to correcting a few parameters, it is also necessary to eliminate the deficiencies.
First of all, if the scars are visible, they need to be corrected.
Due to the excessive removal of the nasal bone, there can be serious collapses on the nasal ridge and the nasal ridge can take an inverted V shape.
There can be cartilage deficiencies in the tip of the nose, on the sides of the nose, on the back of the nose or in the inner roof that we call the septum that keeps the nose standing. There can also be asymmetries in the nostrils. The missing cartilages in these areas must be corrected with the new cartilages in accordance with the anatomical structure and shape of the nose.
To replace the missing cartilages; if it is left, it is necessary to complete it by taking cartilage from the cartilage roof, which we call the septum in the inner part of the nose or from the more practical ear cartilage, if there are too many deficiencies, from the rib cartilage. If the cartilages to be used are carefully removed, it does not create a deficiency in that area.
When Should the Second Nose Surgery (Secondary Rhinoplasty) Be Performed?
The edema, swelling and bruising can occur on the face in the first 10 days after the primary rhinoplasty. During this time, it is not expected to fully understand the shape of the nose. However, it takes up to 6 months for the nose to take its full shape, depending on the skin structure of the person. The second nose surgeries performed before this period will decrease the success rate of the surgery since the exact shape of the nose cannot be understood. The secondary surgeries should be performed at least 6 months to 1 year after primary surgeries.
How is the Secondary Rhinoplasty Surgery Performed?
The open or closed technique can be used as the surgical technique in the secondary rhinoplasty. There is no such approach that the open or closed technique is better. What is decisive in this regard is what kind of the interventions are needed to the nose and with which approach these interventions can be made completely. For this reason, the open technique is more preferred in order to fully see the irregular cartilage and bone tissue, especially in the secondary rhinoplasty. Here, there is a half-centimeter scar on the lower part of the nose and this scar almost disappears within 1 year.
The revision surgeries are more complex and difficult than the primary surgeries. It is required to be performed under the sterile operating room conditions by an experienced physician. Before the procedure, a very detailed physical examination should be done, problems should be determined and plans should be made for this. The nasal dorsum can be sunken, the wings of the nose can be asymmetrical, and the tip of the nose can be low or excessively raised. Since there will be cartilage deficiencies in the people who will undergo the secondary surgery, the cartilage grafts can need to be taken from a different part of the body. These are usually cartilage taken from the ear or ribs.
Depending on the procedure to be performed, the type of the anesthesia and the time can vary. While the minor interventions can be performed under the local anesthesia between 30 minutes and 1 hour, the major interventions can require 3-4 hours under the general anesthesia.

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Every surgery has different risks and complications. It is necessary to explain these risks and complications in detail to the patients before the surgery. The probability of needing the revision after the primary rhinoplasty is 5%. However, although the surgery was successful and there were no complications, approximately 20% of the patients who were not satisfied with the result undergo the revision surgery.
All of the cartilages in the inner part of the nose can have been used in the previous nose surgery or surgeries. If the extra cartilage is needed and it is not in the nose, it can be necessary to use the ear or rib cartilage in surgeries.
Since there is more intervention to the nose in the secondary rhinoplasty operations, it can take longer for the nose to take its final shape than the primary rhinoplasty. In general, a period of 8 months to 1 year is needed.