Piazza Center for Plastic Surgery and Advanced Skin Care
7900 Farm to Market Road 1826, Bldg 2, Suite 206
Austin, TX 78737
Phone: (512) 288-8200
Monday–Thursday: 9 a.m.–3 p.m.
Friday: 9 a.m.–2 p.m.
The emotional impact of a failed rhinoplasty can sometimes be devastating. After looking forward to changes based on your aesthetic goals, you can be left disappointed in the appearance and function of your nose. This can negatively affect self-esteem, and some patients can experience embarrassment, insecurity, and even depression.
Board-certified facial plastic surgeon Dr. Marcelo Antunes performs revision rhinoplasty in Austin to help women and men from San Antonio, New Braunfels, and other Texas communities improve the results of rhinoplasty procedures performed by other surgeons. While restoring the appearance of a damaged nose may appear simple, the challenge is considerable—typically far more complex than the initial rhinoplasty.
Why Choose a Revision Rhinoplasty Specialist?
Revision rhinoplasty surgery is the most complicated procedure in facial plastic surgery. No other procedure requires as much experience or combines art and science as much as revision rhinoplasty. Mastering this procedure takes time, dedication and skill. It requires a thorough understanding of the nasal structures and how they endure the healing process, in addition to a heightened attention to detail.
A true specialist puts an extensive amount of planning into a revision rhinoplasty procedure. Dr. Antunes spends a great deal of time evaluating the appearance and structure of the nasal tissues, the strength of the cartilage, and the areas of cartilage removed during the previous operation. He also evaluates the skin thickness and quality and the presence and degree of scar tissue on the nasal tissues.
Dr. Antunes takes a lot of pride in his revision rhinoplasty work. He understands the importance of harmony between the nose and the face and how much work it takes to repair a nose after a rhinoplasty that was not successful. He has advanced surgical training in this procedure and his commitment to excellence will clearly show why he is uniquely qualified to perform your revision rhinoplasty.
Meet Dr. Antunes
Board-certified facial plastic surgeon Dr. Marcelo Antunes dedicates his practice exclusively to aesthetic procedures for the face. He can help you look your best and be confident in your appearance.About Dr. Antunes
Do You Need Revision Rhinoplasty?
Revision rhinoplasty (also known as secondary rhinoplasty) reshapes the nose following prior failed nasal surgery. This is usually done due to persistent cosmetic irregularities, breathing difficulties, or both. There are many reasons why a rhinoplasty can fail to achieve the desired result. Some of these factors are related to the surgeon, such as substandard technical performance or lack of experience. In some cases, patients don’t comply with a surgeon’s post-op instructions or they heal poorly.
Dr. Antunes uses both closed and open approaches for primary rhinoplasty, but typically performs revision rhinoplasty using an open approach. Patients undergoing revision surgery usually have already had much of the septum removed and require an alternative source for cartilage grafting—typically the ear or rib cartilage. If the previous rhinoplasty procedure was performed through an open approach, Dr. Antunes uses the same incision on the columella. The incisions typically heal extremely well and over time become nearly invisible.
During the procedure, he elevates the skin and soft tissue of the nose from the cartilage and bones to allow for their sculpture to create the new shape. The biggest challenge in revision rhinoplasty is the presence of scar tissue from the previous procedure, which varies from patient to patient. Dr. Antunes tailors the procedure based upon the patient’s goals, specific nasal anatomy, facial structure, and unique features. Typically, cartilage grafts will be required to restructure the nasal support system. A successful revision rhinoplasty improves nasal harmony in relation to other facial features.
A revision rhinoplasty procedure can take from 3 to 5 hours. Dr. Antunes uses general anesthesia or local anesthesia with sedation, depending on the case and the patient’s preference.
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Recovery & Results
Dr. Antunes places a cast on the nose and uses dissolvable stitches on the inside of the nose and regular stitches on the skin between the nostrils. Some patients may have thin splints on the inside of their noses to help secure the septum midline. He doesn’t pack the nose after surgery, minimizing discomfort during the recovery. You should have someone drive you home and remain with you during the first 24 hours after the procedure.
Nasal congestion and pressure is normal during the first few days after the operation. Discomfort varies from patient to patient, but most patients experience mild pain that can be controlled using prescribed medication. Dr. Antunes schedules several follow-up appointments during the first couple of weeks after the surgery. He removes the cast 7 days after your surgery and most patients can return to work after a week. Expect to take at least 2 weeks off from other activities, such as exercising. You may have bruising around the eyes, but it can be easily camouflaged with makeup.
Revision Rhinoplasty at a Glance
Goal: To enhance the appearance of the nose after a prior rhinoplasty procedure by refining the shape and creating a smooth, natural contour to improve the facial balance. In addition, nasal function can be improved to help the patient breathe better.
Procedure: The incisions are hidden inside the nose. In addition, a small incision is made in the columella (skin between the nostrils), underneath the nose. If the previous rhinoplasty procedure was performed through an open approach, the same incision is used on the columella. The incisions typically heal extremely well and over time become nearly invisible. The skin and soft tissue of the nose is elevated from the cartilage and bones to allow them to be sculpted into the new shape. The biggest challenge in revision rhinoplasty is the presence of scar tissue from the previous procedure, which varies from patient to patient. The procedure will be tailored to the patient’s goals, specific nasal anatomy, facial structure, and unique features. Typically, cartilage grafts will be required to restructure the nasal support system. A successful revision rhinoplasty improves nasal harmony in relation to other facial features.
Anesthesia: General anesthesia or local anesthesia with sedation, depending on the case and patient preference.
Procedure length: 4 to 5 hours
Aftercare: There will be a cast over the nose, dissolvable stitches inside the nose, and stitches on the skin between the nostrils. On occasion, the patient will have thin splints on the inside of the nose to help secure the septum to the midline. Dr. Antunes does not pack the nose after surgery, which minimizes discomfort during the recovery process. Patients go home after the procedure. The patient should have someone at home for the first 24 hours after surgery. If needed, professional in-home nursing care can be arranged.
Recovery: During the first few days after revision rhinoplasty, the patient will experience some nasal congestion and pressure. Pain is a very individual experience because patients experience pain differently. Most patients have mild pain after rhinoplasty that can be controlled with pain medications. Dr. Antunes will see the patient several times over the first couple of weeks. The nasal cast will be in place for 1 week and will be removed at the day 7 appointment. Most patients will return to work 1 week after the procedure and be back to full activities after 2 weeks. Patients may have bruising around the eyes, but it usually can be easily camouflaged with makeup.
- Day 5 to 7: Suture removal
- Day 7: Cast and splint removal
- 7 to 10 days: Return to work and social activities
- 3 to 4 months: 50% healed
- 1+ year: 100% healed
As one of the nation’s leading facial plastic surgeons, Dr. Antunes takes great pride in performing revision rhinoplasty because it demands technical expertise and an artistic eye. Request an in-person or virtual consultation using the online form to meet personally with Dr. Antunes to discuss your concerns. You can also call The Piazza Center at (512) 288-8200 to schedule an appointment.