Plastic surgery has become a trend in recent decades, and the most famous is rhinoplasty, which is in great demand around the world. For this reason, some inexperienced surgeons claim that they can perform this delicate surgery, and many patients are dissatisfied with their results and have to undergo another surgery to correct the bad results of the previous surgery. . This is called rhinoplasty or rhinoplasty. Many people undergo rhinoplasty in Iran due to the high reputation of Iranian surgeons in plastic surgery in general and in rhinoplasty in particular.

Why do patients reconsider rhinoplasty?

Patients seeking reconstructive or secondary rhinoplasty challenge the skill and experience of plastic surgeons. Corrective rhinoplasty is applied to any patient who has had rhinoplasty one or more times and wants to improve the appearance and often the function of the nose. These are just some of the goal setting shareware that you can use for cosmetic surgery.
For example, patients are often dissatisfied with their previous surgery and may not realize that further rhinoplasty may not be completely successful in completely correcting cosmetic abnormalities that occurred in the last unreformed surgery or as a result of surgery. Scar tissue from previous rhinoplasty is often a problem in revisions and can limit the end result, as it may recur even after rhinoplasty. Also, corrective rhinoplasty often requires the use of cartilage to replace damaged and / or incomplete cartilage removed in previous surgery.
The nasal septum may have a deviation that needs to be corrected to improve the appearance and function of the nose. Nasal obstruction may also be caused by the collapse of the tip cartilage, resulting in the collapse of the external valve. Deviation of the nasal septum with deficiency in the upper lateral cartilage is a common occurrence in revision cases, leading to the collapse of the internal valve, which requires the use of cartilage grafts called "diffuser grafts" to open this narrow area.

Rhinoplasty in Iran: Everything you need to know

A common question always arises in the minds of some people: What is revision rhinoplasty? The short answer is that rhinoplasty is a surgery that many patients consider to have a better nose shape or to treat respiratory problems or improve outcomes after one or more previous rhinoplasties with adverse consequences.

SUCCESS RATE OF REVISION RHINOPLASTY IN IRAN:

M ost patients achieve amazing results, and it all depends on the patients’ expectations in the first place. However, the fact remains that revision nose job is a complex procedure that requires master knowledge of the anatomical structure of the nose as well as high practical skills.

Revision Rhinoplasty Risks and Complications

Although higher than in primary rhinoplasty, revision rhinoplasty overall has a low rate of complications. Individual surgeon’s results may vary widely, however. That’s why it is important to find an experienced surgeon with superior surgical judgment and meticulous technique, honed over years of specialized practice.
These are perhaps the most important risks your surgeon will discuss with you:

1. Bleeding may be the most common risk of rhinoplasty or revisional rhinoplasty, since blood vessels may be damaged during each surgery. Most patients lose a small amount of blood during surgery and a very few may experience significant post-surgery blood loss. In the absence of a bleeding disorder, blood loss almost never rises to the level needing hospitalization or blood transfusion. Usually, nasal packing for 12-36 hours is all that’s needed. Blood-thinning medications, even mild ones like baby aspirin, can cause excessive bleeding, so you will be instructed to avoid certain prescription and non-prescription drugs and herbal supplements. Be gentle with your nose during the healing process, since forceful blowing of your nose or bumping the nose can also cause bleeding.
2. Adverse anesthesia reactions are avoided when a highly qualified anesthesiologist administers general anesthesia (typically needed for revision rhinoplasty). Top surgeons work with only the best anesthesiologists to ensure patients are well cared for and properly monitored throughout the rhinoplasty procedure. General anesthesia involves both intravenous medications and an airway-protecting breathing tube. A physical exam prior to surgery to make sure your health is good and the investigation of any prior anesthesia reactions that you or your family members may have experienced helps forestall any problems.
3. Nasal blockage or the sensation thereof can occasionally occur. As your nasal contours are reshaped, changes may need to be made to the septum and, in some cases, the overall size of your nose may need to be reduced. There will be initial swelling and numbness that may contribute to temporary breathing difficulties, which typically resolve as swelling decreases and you become accustomed to your new nose. In some cases, the nasal septum may be perforated or a weakened nose may collapse. Impeccable surgical technique and proper patient selection usually prevent these major problems. Scar tissue from initial and/or secondary rhinoplasties may narrow the airway. Rarely, a graft may slip out of place and partially block the nasal passage. A careful pre-surgery exam and detailed, well-executed surgical plan can prevent these complications in most cases. Make sure to describe any breathing problems you may have to your surgeon to ensure the complete repair of internal abnormalities.
4. Infection is a rare risk since the nasal blood supply is fundamentally robust. Compromised nasal lining, prior drug use, scarred soft tissue coverage and the need for grafting can complicate matters. To help prevent problems due to infection, patients are instructed to watch for symptoms, such as a fever, excessive swelling, odorous nasal discharge or pain—and contact their surgeon right away.
5. Dissatisfaction with the outcome is a risk that can be minimized with clear surgeon-patient communication and a meticulous well thought out plan prior to surgery. Unrealistic expectations are managed by a straightforward surgeon who honestly explains the improvements that can be achieved with corrective surgery. The corrections depend upon your desires/expectations, the quantity and quality of remaining tissue and structural support, scar tissue from prior surgery, the thickness and elasticity of skin and many other variables. Make sure the result your surgeon describes matches closely enough with your goals—and that your goals are realistic—before going forward with surgery.

HOW LONG DOES IT TAKE TO RECOVER AFTER A REVISION RHINOPLASTY?

The average rhinoplasty recovery time is one year. That may sound like a long time, but it becomes much more manageable when it’s broken down into a timeline. The following recovery milestones may vary from patient to patient, but generally, it goes something like this:
1 Week: The splint can be removed from your nose and you can go out in public without showing noticeable signs of surgery unless there is bruising around the eyes. This may take 2 weeks to resolve. It is safe to resume activities of daily living.
2 Weeks: The majority of the facial swelling has subsided and most of the bruising should have resolved.
3-4 Weeks: You can safely return to cardiovascular activities such as jogging, swimming and cycling.
6 Weeks: The bones are stable, you can resume resistance workouts (weight lifting), wearing glasses and blowing your nose.
3-6 months: The numbness and abnormal sensations in your nose and nasal skin should be resolved.
1 Year: The healing process is complete – swelling should have subsided entirely and the nose’s new shape is fully refined.Is there any way to speed up this timeline? There are actually quite a few things you can do to make your plastic surgery recovery go by more smoothly.  

HOW LONG DOES IT TAKE FOR SWELLING TO GO DOWN AFTER REVISION RHINOPLASTY?

Swelling and bruising are common after rhinoplasty, and most of the swelling goes away in about two weeks, and the remaining swelling goes away in a few months .

What is a grafting and what materials are USING for grafting in revision rhinoplasty?

A Grafting is a surgical procedure that involves moving tissue from one place to another in the same body or from another person.
One of the main goals of revision surgery is to restore the structural support of the nose and replace lost tissue. To achieve this goal, the surgeon must rely primarily on the ligaments. Many transplant materials are available in modified rhinoplasty and each type has its own unique physical, chemical and biological properties. Surgeons believe that the graft material should be impact resistant, easy to shave, resistant to infection and extrusion, and durable.
The most common types of grafts are known as autogenous grafts, which are removed from the patient's body during surgery and placed in the nose after proper displacement. These grafts are highly desirable due to their long-term clinical results and low risk of rejection or infection. Autogenous grafts are known as non-artificial grafts and include cartilage, bone, and subcutaneous tissue.

Why rib grafts are preferable?

Rib grafts have recently found great popularity in complex nasal revisions because the rib provides a considerable volume of cartilage with good dimensions. This large bulk of cartilage allows all known forms of augmentation reconstruction to be performed without uncertainty regarding the amount of available cartilage.

Tips to Speed up Rhinoplasty Recovery Time after surgery in iran

1) Listen to Your Doctor
Following the procedure, your surgeon will provide you with a detailed plan and post-op instructions on what medications to take and activities to avoid. It’s important that patients carefully follow the advice.
2) Keep Your Head Elevated
In that first 1-3 weeks, keeping your head elevated when sleeping can limit additional bruising and swelling. Sleep with your head propped up for six weeks after the procedure to speed up your recovery.
3) Use Cold Compress
In the days following the procedure, apply a cold compress on the swelling. Apply the compress to the cheeks and not on the nose itself – this can inadvertently shift bones and cartilage.
4) Get Plenty of Rest
As always, rest is an essential part of recovery. Get enough sleep at night and ask for help with daily tasks and chores. This ensures all of your body’s energy is being used to heal itself.
5) Healthy Diet
A healthy, balanced diet is always a plus for our health, and a diet filled with protein and vitamins is vital to give your body the nutrients it needs to heal.
6) Avoid Exercises
The nose is extremely fragile following surgery, so rigorous exercise is only recommended after six weeks. Wait until you get the green light to resume and then ease back into your workout routine.
7) Don’t Blow Your Nose
After rhinoplasty surgery, patients will experience nasal congestion for a few weeks (caused by swollen tissue). Patients should resist nose blowing to ensure they don’t disrupt the healing and, as for sneezing, patients are advised to sneeze through the mouth to protect the fragile nasal passages.
8) Avoid Sun Light
Prolonged sun exposure is always ill-advised, but, after a nose job, it’s especially important. Too much sun can cause scarring to darken and swelling to increase.
9) Don’t Wear Glasses
Anything that puts pressure on your nose can cause additional bruising and swelling, including your glasses. Switch to contact lenses if possible and, if not, use your lightest frames only when necessary.
10) No Smoking After the Surgery
Smoking should be stopped two weeks leading up to the rhinoplasty procedure and two weeks after. The nicotine limits blood flow, interfering with your body’s recovery and increasing the risk of complications.

Why is revision rhinoplasty so difficult?

A revision rhinoplasty is more difficult than primary rhinoplasty surgery for many reasons. The most important reason is that the anatomy inside the nose has already been altered during the first nose surgery (primary rhinoplasty). Prior to any nose surgery, there are layers of tissue planes that have natural separations between the types of nasal tissues. As a surgeon operates on your nose for the first time, the surgeon can easily separate these layers to access different structures. This is not the case, however, with revision surgery. These anatomical plane no longer exist. That makes revision surgery harder. It's almost as if someone has put glue in the nose because skin is stuck to cartilage and bone .