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Revision Rhinoplasty Washington DC

The reasons why a patient seeks a revision rhinoplasty can be due to a combination of factors. It can be due to an aesthetic or cosmetic concern or the inability to breathe through the nose. Regardless of the reason, Dr. Somenek knows that this can be an emotional time filled with anxiety and hesitation. For that reason. Dr. Somenek believes that the consultation is of utmost importance to discuss your concerns and help you get the desired results that you want for your nose. Dr. Somenek’s expertise in rhinoplasty has led to many seeking him out to treat some of the most challenging cases.

Your consultation with Dr. Somenek

During the initial consultation, Dr. Somenek uses this time to understand your motivation and expectations for a revision rhinoplasty. It is an opportunity to develop a mutual level of trust and understanding. A detailed physical examination is performed to determine the areas that will require correction in the nose to provide the best result. Dr. Somenek will go over a thorough list of expectations and risks that are involved in surgery. 

Photos will be taken and with the help of sophisticated imaging software, computer imaging will be performed to create a realistic outcome that is in line with the patient’s needs and desires. Dr. Somenek will explain the various structures in the nose, including bone and cartilage, and how sculpting these can alter the appearance of the nose. Dr. Somenek believes that the use of computer imaging provides the patient with a realistic potential outcome for the patients individual anatomy and expectations. It is always beneficial for the patient to compile a list of questions to ask during the consultation as this can clarify any concerns about the procedure and help better delineate if your expectations are in line with Dr. Somenek’s aesthetic goals for your nose.

Reasons for a revision rhinoplasty

In cases of revision rhinoplasty, Dr. Somenek frequently sees that many of the elements that provide structure to the nose have been over-resected. This frequently leads to breathing problems for the patient as much of the support has been altered. He believes in re-creating the structure of the nose to restore the integrity and function for improved breathing. Dr. Somenek uses cartilage grafts to rebuild the structure of the nose to give a new, aesthetic shape that withstands the inevitable contraction of the nasal skin that can occur over the course of many years. There is typically a paucity of nasal septal cartilage to use in cases of revision rhinoplasty. Because of this, Dr. Somenek has to obtain cartilage from either the ear or costal rib cartilage. The type of cartilage used will depend on the deformity that needs to be corrected. These options will be discussed with you at the time of the consultation. Dr. Somenek does not use artificial implants in the nose for revision rhinoplasty due to an increased risk of infection and extrusion of the artificial material. An open rhinoplasty approach is used in cases that Dr. Somenek feels is indicated. This involves making a small incision on the columella of the nose which allows greater access to the nasal structures. This approach allows Dr. Somenek to better identify the concerns that the patient has with their nose by directly visualizing the problem. By directly looking at the structures, Dr. Somenek can create symmetric changes to the nose which maximizes the likelihood of a good cosmetic outcome. As with any incision, if closed correctly, will heal with very little evidence of a scar.

Surgery and Recovery

The surgery is typically performed on an outpatient basis under general anesthesia. Dr. Somenek will see you the following day to clean the area around the nostrils and ensure that you are doing well. At your one week postop visit, Dr. Somenek will remove the nasal cast and fine sutures that he uses to close the incision. It is important to realize that your nose will be swollen when the cast is removed. Dr. Somenek will place tape on the nose when necessary to decrease the overall amount of swelling. The majority of swelling will resolve within 2 weeks. It is not uncommon in cases of revision rhinoplasty for the swelling to continue for a longer period of time due to the underlying changes that have occurred from previous surgery. For months following your surgery, you will continue to see changes and a more refined appearance to the nose.

Following up with Dr. Somenek

It is imperative throughout the postoperative process that you follow the directions given by Dr. Somenek. Follow-up care is vital for this procedure to monitor healing and it essential to provide an optimal result. Even though much of the swelling will decrease about two weeks postoperatively, the healing process will continue to occur for many months after surgery. Persistent swelling of the nasal tip can occur in some patients depending on their individual anatomy and thickness of their skin. Throughout the followup period, Dr. Somenek may recommend steroid injections to the nose or nasal taping to aid in resolution of the swelling and produce the best outcome for his patients. Occasionally a minor revision to the nose is required and will be discussed with the patient if needed.

Insurance does not generally cover surgery that is purely for cosmetic reasons. Surgery to correct or improve nasal function or surgery for major deformity or injury may be reimbursable in whole or in part. The office will work with the patient to provide the best care possible. Dr. Somenek looks forward to meeting you and working to provide the best aesthetic result to meet your needs.

Contact Our Office Today!

If you have further questions regarding Revision Rhinoplasty, please call or contact our office today to schedule your initial consultation.

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