When a nose has already undergone an operation, there are two major changes to the anatomy compared to a nose that has not had surgery. First, although the same components of skin, cartilage, bone, and mucosa (pink tissue inside the nose) are present, their shapes have been altered by the previous surgery. A revision surgeon therefore cannot rely on the normal shapes, or “landmarks”, when doing a revision surgery. He or she needs to proceed more slowly and carefully when identifying all structures. Second, there is always scar tissue that builds up under the skin and around the nasal structures. This scar tissue is firm and difficult to open. It hides the structures of the nose, so again, the revision surgeon must proceed slowly and carefully.

When a surgeon performs a revision rhinoplasty, it is very helpful to have a good understanding of what was done during the primary surgery. If you have had a rhinoplasty in the past,as much as possible, try to obtain an operative report from the first surgeon, and present it to Dr. Lansangan for a thorough review.