How To Fix a Botched Nose Job | Dr Moustafa Mourad | Mourad NYC скачать в хорошем качестве

How To Fix a Botched Nose Job | Dr Moustafa Mourad | Mourad NYC

What is a revision rhinoplasty? Dr. Moustafa Mourad of Mourad NYC is here to tell you. Visit his websites: https://www.nycfacedoc.com/ Follow him on social channels: Instagram:   / nycfacedoc   Facebook:   / moustafamouradnyc   #revisionrhinoplasty #rhinoplasty #manhattandoctor #drmoustafamourad #mouradnyc #plasticsurgeon #cosmeticsurgeon #manhattanplasticsurgeon Revision rhinoplasty refers to any time you've had a prior surgery on the nose, and you need to change it again. Some of the most common causes to undergo a revision rhinoplasty include the inability to breathe out your nose, a secondary deformity from the original surgery. These deformities can vary from a recurrence in your dorsal hump to twisting of the nose to excess scarring or the tip falling down. These are some of the most common reasons that people come in for a revision rhinoplasty. What makes revision rhinoplasty a lot different than other surgeries, especially a primary rhinoplasty, is the presence of excess scar tissue in the nose, secondary to the trauma of the original surgery. From a surgical standpoint, it's more complicated because you have to kind of address the things that went wrong the first surgery. Whether the bones didn't heal well, whether the nose is collapsing, or the rotation isn't right, how you address that intraoperatively can be very challenging and difficult. Oftentimes after the first surgery, the nose is left with less structure. So what complicates the surgery is that you need to replace that structure. You need to leave the nose a lot stronger. But since septoplasty is most commonly done with rhinoplasty at the same time, what we usually use is the septum. That's gone, so we have to go to other grafting material. The three most common grafting materials are ear grafting, rib grafting, and synthetics. Most commonly with revision rhinoplasty, rib is often used in conjunction to help reconstruct the nose and leave the nose functioning better than when you originally found it. There's cadaver rib, and then there's your own rib. Cadaver rib is a rib that's been chemically treated and radiated from a donor body. Now, this is a great option. A lot of people use it and employ it in their practice. However, there's a small risk that you may have some warping or changes to the rib over time simply because there's no living tissue. The other option is using your own rib. Now, it's your own tissue. It heals really well. It's cellular, so there's actual living tissue in it. So people do typically pretty well with their own rib. In my practice, I use about a 1.2 to 1.7-centimeter incision, and I harvest a piece of rib through a very minimally invasive approach that allows me to access the rib that's needed. The scarring heals very well, and it does not add anything in terms of postoperative recovery. The vast majority of my patients describe it as a soreness that resolved after three days as if they had gone to the gym. So by being able to offer this to my patients, I can use rib grafting to really reconstruct the nose and give them a better nose. Revision rhinoplasty or reconstructive rhinoplasty oftentimes is covered by insurance. Especially if patients have been left with a non-functioning nose and they can't breathe through their nose, or they've been left with a significant external deformity. So we work very closely with insurance companies to really demonstrate the functional and reconstructive need for the surgery in order to have it covered. Revision rhinoplasty healing is very different from the original surgery. The swelling can last much, much longer. And a good rule of thumb is I tell my patients, if your swelling lasted for four weeks after the surgery, you multiply that by every subsequent surgery. So if this is your second surgery, the swelling will last twice as long. So it'll last for eight weeks. If this is your third, it'll last for 12 weeks. That's because the trauma introduced through surgery in the nose really leaves the nose less vascularized and with more scar tissue from the original surgery that the body then has to deal with. So the trauma of a subsequent surgery in the nose really complicates the healing process. And it's really important for patients to really understand what that healing process entails. Nobody wants to go through surgery a second time. So when you go through that process a second time, you really should be well versed in the risks, the benefits, and the alternatives. You really need to know what's at stake because with every subsequent surgery you have on your nose, you run the risk of things not going well. Revision rhinoplasty's a really important, big part of my practice. When considering a revision rhinoplasty, it's really important to sit down with a surgeon and really understand what exactly is needed for your subsequent surgery. You really need your surgeon to be on the same page as you.