Revision rhinoplasty: physician–patient aesthetic and functional evaluation

Abstract

The drooping tip followed by residual hump were the main complaints reported by the patients and confirmed by the objective examination by the physicians. The presence of nasal obstructive complaints in 37.2% of the patients shows that greater attention needs to be paid to functional deformities during the first surgical procedure. The differences observed between patients' complaints and surgeons' evaluations confirm the need for detailed assessment and clarification to the patients regarding their expectations and actual surgical possibilities.

Prevalence of considering revision rhinoplasty in Saudi patients and its associated factors

“…Concerns in primary rhinoplasty patients are often different from those in secondary rhinoplasty patients [17]. The most common complaints among patients seeking revision rhinoplasty include nasal airway obstruction, saddle nose deformity, open roof, crooked nose, dorsum asymmetry, excessive dorsal resection, residual dorsal hump, bulbous tip, tip asymmetry, drooping tip, hanging columella, alar collapse, nostril asymmetry, and wide nostrils [8, 14, 17, 20–22]. Moreover, it has been widely reported that issues with breathing functionality are common among revision patients [16, 17, 20, 23, 24].…”

“…The most common complaints among patients seeking revision rhinoplasty include nasal airway obstruction, saddle nose deformity, open roof, crooked nose, dorsum asymmetry, excessive dorsal resection, residual dorsal hump, bulbous tip, tip asymmetry, drooping tip, hanging columella, alar collapse, nostril asymmetry, and wide nostrils [8, 14, 17, 20–22]. Moreover, it has been widely reported that issues with breathing functionality are common among revision patients [16, 17, 20, 23, 24]. There is controversy however, over which type of complaint is more common among patients seeking revision rhinoplasty: esthetic or functional [20, 22, 23, 25].…”

Rhinoplasty in Context of Head and Neck Malignancy

“…According to Vian et al, a correlation between subjective obstructive symptoms and the intranasal assessment performed by surgeons was present in 87.5% of cases with one or more nasal obstructive symptoms. Among the patients with respiratory symptoms, the main deformity found was residual septal deviation (56.25%), followed by turbinate hypertrophy and synechiae, both observed in 28.5% of the patients, and the collapse of the internal nasal valve in 19.75% of patients with obstructive nasal complaints [36].…”

“…The patients have high expectations and anxieties due to dissatisfaction with previous surgery and difficulty in understanding the limitation of the resurgery cases. In most cases, the need for revision rhinoplasty is the result of a poorly performed prior evaluation, inappropriate patient selection, failure to adequately explain about the limitations related to surgery to the patient, and limitations in performing the surgical maneuvers during the procedure [36].…”

“…To optimize patient satisfaction after a revision surgery, the surgeon must be aware of the esthetic and functional complaints reported by the patient, as well as perform a very detailed and objective nasal evaluation, to ensure that no alteration in nasal anatomy goes unnoticed and is amenable to be addressed by surgery. The surgeon must validate the patient's esthetic and functional complaints through a detailed external and internal evaluation of the nose [36].…”