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Revision rhinoplasty
Rhinoplasty is one of the most complex surgical procedures. The final aesthetic results relies on an interplay between surgical planning, surgical technique, the patient's own anatomy, and the body's natural healing processes.
As a result, some procedures may not achieve the change that a patient wanted, or may result in other irregularities that they would like to address.
As an experienced and specialised rhinoplasty surgeon, Mr Jacques is frequently consulted by patients wishing to undergo revision surgery.
The decision to have surgery to change the appearance of your nose is a highly personal one. It is essential to work with your potential surgeon to discuss your aims and wishes in detail, and to have a full understanding of the procedure and its limitations. You should take all the time you need to arrive at a decision, and feel confident that your surgeon understands your aims, and is able to meet your expectations.
About revision rhinoplasty
Revision rhinoplasty can range from a small touch-up to a highly complex procedure that addresses all elements of nasal structure and function. Individualised assessment and planning is exceptionally important, as is providing patients with realistic and relevant information about what can be achieved in their case.
Mr Thomas Jacques is highly specialised in nasal surgery and has performed over 1,000 rhinoplasty and septorhinoplasty procedures. He is dedicated to the highest standards in patient care, and is known for his natural and individualised approach to cosmetic nasal surgery.
Consultations for revision rhinoplasty take place in Chelsea, Belgravia and Marylebone. Surgical procedures are performed at Cadogan Clinic and HCA Lister Hospital, both in Chelsea.
AT A GLANCE
Anaesthetic
Duration
Hospital stay
Dressing removed
Back to work
Exercise
Final result
General
2-3 hours
Day case
1 week
2 weeks
4 weeks
12 months +
Surgical technique
Mr Jacques performs all revision rhinoplasty procedures utilising the open approach. This approach allows for the greatest visualisation, flexibility and accuracy in surgical technique, and is increasingly the gold standard in complex procedures. It allows for meticulous control over soft tissue and any bleeding, limiting postoperative bruising.
The only external incision is across the thin strip of skin between the nostrils (the columella): this incision heals extremely neatly, and is very difficult to see in the vast majority of cases. If a patient's original procedure was performed via an open approach, the original incision is usually followed.
Surgery is performed under general anaesthesia and takes between two and three hours in most cases. In some cases, additional cartilage may be needed to help with the careful reconstruction and support of the nose, if the patient's own cartilage has been depleted or disrupted by previous surgery. This can be acquired from different sources, but in most cases we utilise donor rib (costal) cartilage, which is a safe and reliable source of additional support for the nasal structure.
Patients are able to go home the same day, a few hours after surgery ends. They are discharged with all the medication required for their recovery, following a review with Mr Jacques and the nursing team.
Patient journey
The revision rhinoplasty journey starts with an outpatient consultation in one of our clinics in Central London. We welcome detailed enquiries from patients wishing to see Mr Jacques about revision rhinoplasty, and may ask for photos for review before your appointment.
We allow plenty of time for an unhurried and detailed consultation about your ongoing nasal concerns, a thorough examination and photography, followed by a discussion about what can be achieved in your case. Information about the procedure, its risks and limitations in your case are all covered in this consultation.
A second consultation is always arranged before surgery takes place (no fee is charged). This consultation is intended for the patient to raise any questions about the procedure that they may not have asked previously, and for a discussion of their photos and surgical aims. Simulated profile imaging (a "morph") is used in most cases to aid communication about what we want to achieve together. Following this, surgery can be arranged whenever you are ready to proceed. Some patients opt for a further consultation later, or close to the date of surgery, which can be arranged free of charge.
Dressing removal and clinic follow-up appointments will be arranged by Mr Jacques's team prior to your surgery. We are available for any questions around the time of surgery and throughout your journey.
Recovery and aftercare
Mr Jacques is dedicated to providing a reassuring and smooth journey through surgery, with the minimum discomfort possible. He does not utilise nasal packing or internal nasal splints. A moulded plastic dressing protects the nose after surgery and is removed after one week.
Patients are provided with pain relief medication, antibiotics, decongestant nasal medication and antibiotic ointment, for regular use during the first two weeks after surgery. Small stitches placed in the columellar incision dissolve on their own over approximately a week, and so do not need to be removed. Our patients typically report limited discomfort, and favourable levels of swelling or bruising compared to average or expected amounts.
Patients are able to self-care throughout the recovery period, and should feel ready for work after two weeks. There is some swelling present at this time, which will recede significantly over the first six weeks. It is unusual for other people to notice the presence of nasal swelling. Some milder swelling remains for up to a year as the nose gradually heals and achieves its final shape.
Limitations and risks of surgery
In all cosmetic procedures there can be some variation in the final outcome, and it is essential that patients are informed about the limitations of the surgery they are undergoing. This is especially true in revision cases due to variations in prior surgical technique. Revision rhinoplasty is a safe procedure, but has some risks, which will covered in consultation and in writing.
Realistic expectations
Revision rhinoplasty aims to provide improvement in the nasal appearance, but cannot produce perfect results, or a nose that is entirely free of imperfection, asymmetry or irregularities. It is important that patients undergoing revision surgery are aware that minor imperfections they may see in their nose after their initial or revision procedures are not necessarily due to improper surgical technique. The achievable end result can vary according to the patient's original nasal shape, their facial proportions, facial asymmetry, their skin type and the body's natural healing processes.
Mr Jacques aims to provide all patients with an individualised assessment of the limitations of surgery specific to their case. As in all cosmetic procedures, there is a chance that further surgery is necessary in order to progress the appearance of the nose closer to the original goal.