Rhinoplasty is one of the more common procedures in modern plastic surgery. Its purpose is to improve the nasal shape and enhance the three-dimensional sense of the face. However, due to individual differences, improper surgical operation, inadequate postoperative care and other factors, some patients may face surgical failure, such as prosthesis displacement, infection, skin necrosis, too high or unnatural nose bridge, etc. This not only affects the appearance, but may also have a negative impact on the patient's psychology. The repair of failed rhinoplasty surgery requires a systematic discussion from the aspects of evaluation, repair strategy, surgical method and postoperative management.
1. Common manifestations and causes of rhinoplasty failure
Failure of rhinoplasty surgery may manifest in the following situations:
Prosthesis displacement or protrusion : often caused by incorrect nasal dorsum dissection during surgery, loose fixation of the prosthesis, or external force impact after surgery.
Infection or rejection reaction : When using allogeneic materials such as silicone, expanded polytetrafluoroethylene, etc., if there is no strict aseptic operation or the body is intolerant to the material, it is easy to cause redness, swelling, exudation, and suppuration.
Excessive skin tension leads to tissue necrosis : If the height of the rhinoplasty is too high or the volume of the prosthesis is too large, the skin tension on the tip or dorsum of the nose will be too high, and the blood supply will be restricted, which may lead to tissue necrosis.
Unharmonious or unnatural nose shape : including too sharp a nose tip, a stiff nose bridge, and a high nose root, which are often caused by unreasonable design or improper carving during surgery.
Nasal dysfunction : such as nasal congestion, nasal dryness, etc., may be caused by damage to the nasal structure during surgery.
These reasons for failure suggest that repair surgery needs to be tailored to the individual condition. Clarifying the original surgical method, implant material type and cause of failure is a prerequisite for developing a repair plan.
2. Evaluation process of repair surgery
Before formulating a repair plan, a comprehensive assessment of the patient's nasal condition and physical condition is required:
Detailed medical history collection : including the time of the first operation, surgical procedure, materials used, time of occurrence of postoperative complications and treatment process.
Examination of nasal appearance and function : assessment of prosthesis position, skin thickness, scar degree, nasal ventilation function, etc.
Imaging-assisted examinations : CT or MRI can help determine whether the prosthesis has been perforated, whether the position is abnormal, or whether there is an infection focus.
Assessment of mental status : Some patients may experience anxiety and depression due to failed experiences and require psychological support and patient communication.
The comprehensiveness of the evaluation directly determines the safety and expected results of the repair surgery.
3. Selection of surgical methods for rhinoplasty repair
Rhinoplasty revision surgery is more complicated than the initial surgery and requires a personalized plan based on the type of failure. Common repair methods include:
1. Prosthesis removal and replacement
For patients with prosthesis displacement, strong foreign body sensation or rejection, removal of the prosthesis should be given priority . If soft tissue conditions permit, a second implant can be performed immediately. If necessary, the secondary repair can be delayed to wait for tissue recovery.
2. Autologous cartilage repair
Autologous ear cartilage, costal cartilage, and nasal septum cartilage are widely used in rhinoplasty repair. Their advantages are high biocompatibility and low risk of rejection . They are particularly suitable for nasal tip reconstruction and repair scenarios with high skin tension.
①. Ear cartilage is suitable for shaping the nose tip;
② Rib cartilage is suitable for reconstruction of nose bridge structure or extensive tissue defects;
③. Nasal septum cartilage is used for mild to moderate repair.
3. Tissue expansion and local flap transplantation
If the soft tissue condition of the nose is poor due to skin necrosis or scar contracture, consider using an expander to expand the adjacent tissue, or using a forehead flap, forearm flap, etc. for skin replacement to improve the repair environment.
4. Comprehensive surgical planning
Some repairs require a combination of multiple methods, such as removing the prosthesis first, reconstructing the structure three months later, and then performing aesthetic reshaping. Multi-stage surgical design helps control risks and optimize postoperative results .
IV. Postoperative Management and Prevention of Complications
The success of surgery depends not only on intraoperative operation, but also on postoperative management:
Anti-infection management : routine use of antibiotics after surgery to prevent secondary infection;
Reasonable braking and protection : avoid external impact and prevent early displacement of the prosthesis;
Regular review and follow-up : observe tissue healing, detect and handle abnormalities in a timely manner;
Psychological intervention and aesthetic guidance : assist patients in establishing reasonable expectations and alleviating postoperative anxiety.
In addition, patients should be instructed to avoid smoking, excessive drinking, and control chronic diseases to facilitate tissue healing.
5. Timing of repair surgery
The timing of repair should be determined according to the condition of the nasal soft tissue . If there is obvious infection or tissue necrosis, surgery should be performed after the infection is controlled and the soft tissue has stabilized. It is usually recommended to do it more than 6 months after the initial surgery. If the prosthesis is simply misaligned or the shape is unsatisfactory and there is no sign of infection, repair can be performed 3-6 months after surgery.
6. Preoperative Communication and Expectation Management
Rhinoplasty repair has a higher degree of uncertainty, and sufficient communication with the patient is required before the operation to explain the possible surgical risks, repair limits and expected effects, and to sign a detailed informed consent form. At the same time, the patient should be guided to establish reasonable aesthetic expectations to avoid repeated surgeries due to the pursuit of a "perfect nose shape."
Beauty Encyclopedia Tips:
Failure of rhinoplasty is not terrible. The key lies in early detection of problems, scientific evaluation and standardized repair. The repair surgery should choose experienced professional doctors and be designed with multidisciplinary support and individualized plans. Rational decision-making before surgery, precise operation during surgery and meticulous care after surgery are the three core elements to ensure the success of the repair. When considering rhinoplasty, patients should fully understand the possible risks and recovery period, avoid blindly pursuing changes in appearance, and thus improve the safety and satisfaction of plastic surgery.