"Redoing" a prior nose job that left you unsatisfied is a daunting task.  To help prospective patients with this process, I have included three factors you should know prior to considering revision rhinoplasty.

1.) How long ago was your prior nose surgery? And what region of the nose you are concerned about?

Complete healing from a prior nose surgery can take up to a full year. This is especially true to at the tip of the nose. This region is the most cosmetically sensitive and the last to completely heal. Anxious patients looking to remedy some expected postoperative healing by having another surgery could potentially cause more problems.  For patients concerned about the shape or position of their tip, I typically recommend waiting a full year before considering revising the nose.

The bridge of the nose is less gravity dependent than the tip and tends to
“settle” faster.  This region can be assessed earlier than the tip for revisions.

2.) You may need additional grafts or implants to achieve the revision you are looking for.

When a patient whose surgery was previously done elsewhere comes in for a revision nasal surgery, one of the first things I consider is how preserved is his/her nasal anatomy.  In the past, prior nasal surgeries frequently altered the underlying nasal cartilage, weakening the nose and ultimately distorting the shape of the nose.  This has potentially impaired the true function of the nose (which is to breathe).  When this occurs, the nasal framework needs to be reconstructed.  To do so, I recommend using cartilage grafts in the region of the tip. 

Ideally the source for this graft would be from inside your nose (the nasal septum) but frequently, prior nasal surgeries have used all available cartilage inside your nose.  Alternative sources for cartilage grafting material for revision surgeries can be from your ear, your rib, or banked/donated rib.

3.) How long will the revision rhinoplasty take to heal?

In general, revision rhinoplasties take longer to heal.  Factors that contribute to how long it takes to heal are: amount of grafts used during the surgery and the amount of work done.  In general, the nose for redo rhinoplasties takes about one year.

Have more questions about revision rhinoplasty that I didn't answer here? Then I invite you to contact me today to find out more information about correcting a nose job that you're just not satisfied with. 

As the rates of travel for cosmetic surgery procedures increase, so do the misconceptions that Korean plastic surgery is best performed abroad. But that's not always the case.

Here are three things to consider about traveling for your plastic surgery:

1. Surgeons in Korea are more qualified to do Asian cosmetic procedures.

The medical education here in the United States is globally regarded as the best in medical training. Surgical advances along with research in plastic surgery are still regarded as the best in the world. While it is true, surgeons in Korea only operated on “Asian faces” quality over quantity should be the ultimate factor when choosing a plastic surgeon.

2. It will be cheaper to have the surgery done in Korea.

While fees for surgery maybe slightly lower in Korea, one must factor additional costs associated with traveling to a foreign country to have surgery. Airline tickets, hotels fees, and meals can easily push the cost of the surgery higher than prices here in the US. Additionally, stress of traveling to a foreign country and the risks of potential complications are also inherent costs associated with having surgery in Asia.

3. I can fly into Asia and come back home soon after without any worries.

A major role in achieving optimal results is having close postoperative care with your surgeon. Having the ability to reach your surgeon and freely communicate your concerns is one of the most important things I recommend for a prospective patient.

Choosing a cosmetic surgeon in Manhattan requires plenty of research. You have to know the right questions to ask in order to avoid choosing a surgeon who may not have your best interest in mind. To help with that I've come up with 3 vital questions to help you choose the right plastic surgeon for you.

1.) Are you board certified in facial cosmetic surgery?

More specifically I would recommend only going to surgeons board certified by the American Board of Facial Plastic and Reconstructive Surgery or the American Board of Plastic Surgery.  Although choosing a board certified surgeon will not guarantee a competent surgeon skilled in your surgery of interest, it will insure that the surgeon meets a minimum requirement.

2.) If I am getting a nose job should I go to a facial plastic surgeon or a general plastic surgeon? 

The gamut of cosmetic surgery is pretty large.  So a surgeon may have a practice that is largely focused on bodywork, (liposuction, breast augmentation, or tummy tucks) while only performing a few facial cosmetic surgeries a year.  If you are looking at a facial cosmetic procedure, it makes sense to seek a surgeon that focuses only on facial cosmetic surgery.

3.) How many of these surgeries do you do a year? 

Even though all cosmetic procedures are viewed individually, this question will give you an impression of your surgeons area of expertise.   

Revision rhinoplasty is one of the most technically challenging surgeries performed in the field of facial plastic surgery.  Altered anatomy and scar tissue are only a couple of issues a revision rhinoplasty specialist will have to address.

One of the more frequent concerns patients who are inquiring about revision rhinoplasty is for correction of a tip irregularities or tip bossa - (Bossa - is the term used to describe irregularities of the nasal tip region, such as knuckling of the cartilage or asymmetries of the cartilage structures.)  What causes these irregularities are a combination of two factors, thin skin in the nasal tip region or strong underlying cartilage structures that have been cut unfavorably resulting in sharp edges or bumps that show through.

To correct tip asymmetry, the underlying tip cartilages must be reoriented and sometimes reconstructed so as to create smoother contours in the nasal tip region.  

Augmentation rhinoplasty is a term used to described nasal surgery in which the shape of the nose is increased. Although many of the patients undergoing augmentation rhinoplasty are non-Caucasian this type of surgery is performed on patients of all ethnicities.

Whether the nose requires a larger bridge or a more pronounced tip region, grafts or implants are frequently necessary for the required changes. A graft is a term used to describe a material harvested from your own body, and transfered to another location. The most frequently used grafts are cartilage grafts from inside your nose (septal grafts). Septal cartilage grafts are typically the first-line option used nasal surgery.

Sometimes the amount of material needed is greater than the amount of grafting material available, in which implants may be an option. Implants are synthetic materials designed to use in the nose. There are several implants available for augmentation rhinoplasty. Common implants used include: polytetrafluoroethylene (Gore-Tex), Silicone, and porous polyethylene (MedPor). Although no ideal implant exists, these implants can be safely used in nasal surgery.

To learn more about augmentation rhinoplasty we welcome to a consultation with Dr. Kwak.