DOI: http://dx.doi.org/10.18203/2349-2902.isj20195946

Analysis of revision rhinoplasty; what is the problem and the management?

Mohamed Alhadad, Dalia El Sakka, Medhat Samy, Ahmed Fergany

Abstract


Background: Revision rhinoplasty is reported to occur in 8% to 15%. Reoperation should be performed to correct deformities that were not diagnosed or addressed in previous surgeries, such as those from poor planning, performance and poor surgical healing. The aim of the study was to evaluate the problem of each case seeking revision rhinoplasty and different modalities for management to reach satisfactory results.

Methods: This is a prospective study which was done in plastic surgery department, Menoufia University Hospitals over the period from December 2017 to December 2019. The study included 31 patients underwent previous rhinoplasty.

Results: Patients were selected from the outpatient clinic, 31 patients who had varieties of nasal deformities. Mean age of the patients was 31.7 years. Female represent the majority of patients by 80.60% and males were 19.40% with significant difference in satisfaction (p=0.05). Patient satisfaction after surgery and it was excellent for 14 cases (45.20%), good for 9 cases (29 %) and it was fair in 8 cases (25.8%). Rhinoplasty outcome evaluation (ROE) score was correlated with patient satisfaction grades as mean of ROE score in excellent group was 67.5; in good group was 58.3; while in fair group was 38.8 with significant p value (0.001).

Conclusions: Excellent patient satisfaction is related good planning, close follow up time, and less complication. Cartilage grafts especially rib cartilage is considered a lifeboat for revision rhinoplasty. We can link grades of patient satisfaction to ROE score.


Keywords


Patient satisfaction, Revision rhinoplasty, ROE score

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References


Adamson PA, Warner J, Becker D. Revision rhinoplasty: panel discussion, controversies, and techniques. Facial Plast Surg Clin North Am. 2014;22(1):57-96.

Aiach G. Atlas of rhinoplasty: open and endonasal approaches, second edition. Plast Reconstr Surg. 2005;115:1778-9.

Alsarraf R, Larrabee WF Jr, Anderson S. Measuring cosmetic facial plastic surgery outcomes: a pilot study. Arch Facial Plast Surg. 2001;3(3):198-201.

Ambro BT, Wright RJ. Depression in the cosmetic surgery patient. Facial Plast Surg. 2010;26(4):333-8.

Andretto AC. The central role of the nose in the face and the psyche: review of the noseand the psyche. Aesthetic Plast Surg. 2007;31(4):406-10.

Angelos PC, Been MJ, Toriumi DM. Contemporary review of rhinoplasty. Arch Facial Plast Surg. 2012;14(4):238-47.

Arima LM, Velasco LC, Tiago RS. Influence of age on rhinoplasty outcomes evaluation: a preliminary study. Aesthetic Plast Surg. 2012;36(2):248-53.

Aung SC, Foo CL, Lee ST Three dimensional laser scan assessment of the Oriental nose with a new classification of Oriental nasal types. Br J Plast Surg. 2000;53(2):109-16.

Bagal AA, Adamson PA. Revision rhinoplasty. Facial Plast Surg. 2002;18(4):233-44.

Ballert JA, Park SS. Functional considerations in revision rhinoplasty. Facial Plast Surg. 2008;24(3):348-57.

Becker DG, BloomJ. Five techniques that I cannot live without in revision rhinoplasty. Facial Plast Surg. 2008;24(3):358-64.

Bizrah MB. Rhinoplasty for Middle Eastern patients. Facial Plast Surg Clin North Am. 2002;10(4):381-96.

Brenner KA, McConnell MP, Evans GR. Survival of diced cartilage grafts: an experimental study. Plast Reconstr Surg. 2006;117(1):105-15.

Bullocks JM, Echo A, Guerra G. A novel autologous scaffold for diced-cartilage augmentation rhinoplasty. Aesthetic Plast Surg. 2011;35:569-79.

Bussi M, Palonta F, Toma S. Grafting in revision rhinoplasty. Acta Otorhinolaryngo lItal. 2013;33(3):183-9.

Byrd HS, Meade RA, Gonyon DL. Using the autospreader flap in primary rhinoplasty. Plast Reconstr Surg. 2007;119(6):1897-902.

Caughlin BP, Been MJ, Rashan AR. The effect of polydioxanone absorbable plates in septorhinoplasty for stabilizing caudal septal extension grafts. JAMA Facial Plast Surg. 2015;17(2):120-5.

Canbay EI, Bhatia SN A comparison of nasal resistance in White Caucasians and Blacks. Am J Rhinol. 1997;11(1):73-5.

Chauhan N, Alexander AJ, Sepehr A, et al. Patient complaints with primary versus revision rhinoplasty: analysis and practice implications. Aesthet Surg J. 2011;31(7):775-80.

Charles E, Ivor K, Saiful AH. Revision rhinoplasty: what can we learn from error patterns? an analysis of revision surgery facial. Plast Surg. 2016;32:409-15.

Ching WC, Hsiao YC. Transumbilical endoscopic costal cartilage harvesting: a new technique. Ann Plast Surg. 2014;72(4):423-7.