Rhinoplasty is a common plastic surgery project and is widely popular for its remarkable effect in improving facial contours. However, various problems may occur during or after the operation, resulting in failure of the rhinoplasty and the need for repair surgery. The manifestations of rhinoplasty failure are diverse and may include asymmetric nose bridge, exposed prosthesis, infection, collapsed nose tip or unnatural shape. The repair surgery methods are different for different types of rhinoplasty failure. This article will systematically introduce the common surgical methods for repairing rhinoplasty failure and their indications, key points of operation and precautions, aiming to provide a reference for clinical practice.
1. Common manifestations of failed rhinoplasty and repair needs
Symptoms of failed rhinoplasty include:
①. The prosthesis is displaced or tilted, resulting in an irregular shape of the nose bridge.
② The prosthesis is exposed or punctures the skin, causing a foreign body sensation and aesthetic defects.
③. Infection or rejection reaction, resulting in symptoms such as redness, swelling, pain, and pus secretion.
④. The tip of the nose or the bridge of the nose collapses, and the nose shape is deformed.
⑤. Postoperative scar contracture or tissue sclerosis affects appearance and function.
It is crucial to choose the appropriate repair plan according to the specific problem to avoid the risks of repeated surgeries and the psychological burden on patients.
2. Classification of surgical methods for repairing failed rhinoplasty
The repair surgeries for failed rhinoplasty mainly include prosthesis removal and replacement, autologous cartilage transplantation, soft tissue repair and comprehensive reconstruction.
1. Prosthesis removal and replacement
Prosthesis is a commonly used material in rhinoplasty surgery and is widely used because of its simple operation and significant effect. However, prosthesis displacement, infection and foreign body reaction are its main complications. For prosthesis-related failures, prosthesis removal is often the primary measure to completely remove the source of infection or foreign matter.
Timing and technical points of prosthesis removal
The removal of the prosthesis should be performed after the inflammation is under control to avoid aggravating tissue damage during acute surgery. During the operation, secondary damage to the nasal cartilage and soft tissue should be avoided, and the capsule and infected tissue should be thoroughly cleaned.
Replacement options
For patients who need to continue rhinoplasty, the prosthesis can be replaced when conditions permit and there is no risk of infection. Commonly used materials include medical silicone, expanded polytetrafluoroethylene, etc. Attention should be paid to the morphological design and fixation method of the new prosthesis to avoid displacement.
2. Autologous cartilage transplantation
Autologous cartilage transplantation is widely used in rhinoplasty repair due to its good biocompatibility and low rejection reaction, especially in cases where the prosthetic material is not suitable for continued use or there is severe infection.
Cartilage Source
Commonly used cartilage sources include nasal septum cartilage, ear cartilage and rib cartilage. Nasal septum cartilage is suitable for mild or moderate repair, ear cartilage is suitable for detailed shaping, and rib cartilage is suitable for large-scale reconstruction.
Transplantation method
Depending on the repair needs, cartilage can be used as a support column (such as nose bridge support) or to modify the shape of the nose tip. During transplantation, the shape and size of the cartilage should be suitable for the anatomical structure of the recipient area and fixed firmly to prevent displacement.
Advantages and limitations
Autologous cartilage transplantation can effectively reduce the risk of infection and foreign body reaction, and integrate well with tissues, but the sampling site may cause significant trauma and scars. In addition, the absorption and deformation rate of costal cartilage is low, but the operation is complicated.
3. Soft tissue repair and filling
Soft tissue repair technology provides a minimally invasive repair approach for morphological abnormalities caused by nasal soft tissue collapse or scar contracture.
Fat Grafting
Autologous fat transplantation can improve the fullness of the nose bridge and nose tip tissue. It is suitable for patients with mild depression and thin skin. Fat transplantation is easy to operate, but there are individual differences in transplant survival rate and maintenance time.
Tissue expander use
For cases with severe scar contraction, tissue expanders can gradually increase the amount of soft tissue coverage to provide sufficient skin and soft tissue foundation for subsequent repair.
Skin relaxation and scar correction
Surgery can improve skin texture and appearance by loosening scar tissue and reducing contracture forces, combined with laser or injection therapy.
4. Comprehensive reconstructive surgery
In cases of multiple failures or severe nasal structural defects, comprehensive reconstructive surgery is required.
Multi-layer structure reconstruction
Systematic repair including bone scaffold, cartilage support and skin soft tissue coverage, often combined with autologous rib cartilage skeleton construction and local flap or free flap coverage.
Personalized design
We use three-dimensional imaging and computer-aided design to develop personalized repair plans to improve the naturalness and stability of surgical results.
Function and beauty
Repair should not only focus on morphology, but also pay attention to the recovery of respiratory function to prevent problems such as nasal congestion after surgery.
3. Preoperative evaluation and postoperative management of rhinoplasty revision surgery
Successful revision rhinoplasty surgery depends on detailed preoperative evaluation and scientific postoperative management.
Preoperative evaluation
It includes comprehensive nasal structure analysis, infection index detection and psychological status assessment to clarify the cause of failure and tissue status, providing a basis for the formulation of surgical plans.
Postoperative Management
Emphasis is placed on infection prevention, swelling control and prosthesis protection. When necessary, antibiotic treatment and regular follow-up are used to avoid secondary complications.
4. Risks and Challenges of Revision Rhinoplasty
Rhinoplasty revision surgery is difficult and carries risks:
① Intraoperative tissue fibrosis and scar hyperplasia affect surgical procedures.
②. The selection and fixation of repair materials are difficult.
③. The trauma and psychological burden of secondary surgery increase.
④. A high balance between functionality and aesthetic goals is required.
Therefore, repair surgery should be performed by experienced plastic surgeons, who should develop a reasonable plan based on the individual characteristics of the patient.
Beauty Encyclopedia Tips: Repair surgery for failed rhinoplasty is a complex and meticulous medical procedure. It is necessary to select the appropriate repair method based on the patient's specific situation and detailed preoperative evaluation. The repair process should fully consider the dual needs of function and aesthetics to avoid tissue damage caused by frequent surgery. Patients should maintain a good attitude and actively cooperate with the doctor to complete the surgery and postoperative recovery.