revision rhinoplasty



Dr. Binder has performed rhinoplasty, including revision surgery for three decades. The nose is a complicated organ and is easily one of the most difficult and challenging procedures in facial plastic surgery. A surgeon must go through the long process of learning and understanding the nose and the complexity of the procedure to realize the complexity of the procedure.

Dr. Binder has years of experience and has received extremely high rates of success which allows him to tell his patients – “I can, with confidence, obtain a successful result even in the most extreme cases”. His years of experience and his attention to the smallest of details are what provide his patients a happy outcome.

Reasons for Electing Revision Rhinoplasty

Many times after rhinoplasty the nose looks great, but after some time many patients report having a collapsed nose, pinched nose, or a “skeletonized” – artificial looking nose. Unfortunately, this problem is not rare, it is estimated that between 5 – 15% of patients who undergo “nose jobs” will need revision surgery, some needing minor and others more major procedures.

Other Reasons for Revisions

  • Breathing Problems
  • Collapsed Nose
  • Unhappy with First Rhinoplasty Results
  • Structural Damage

The nose is an extremely complex breathing organ and is the focal point of the face. Maintaining or improving its function while simultaneously creating a natural shape is crucially important for patients’ physical and psychological well-being and takes an experienced and highly skilled surgeon to accomplish just that.

On The Rise: Rhinoplasy Procedures

Correcting Bad “Nose Jobs”

Dr. Binder believes that the optimal techniques required for mastering revision rhinoplasty procedure are so demanding that relatively few surgeons have, in fact, mastered them at all. Those cases often require revision rhinoplasty surgery in our Los Angeles office.

Although not every surgeon can guarantee perfect results every time, additional procedures after a primary or secondary revision surgery should be no more than a minor adjustment that, in most instances, can be performed under a local anesthetic. However, only in the most complex cases, a secondary or two-stage procedure may be needed.

Why so many “botched” nose jobs?

There is an overabundance of surgeons with limited experience or limited training in rhinoplasty which lead to alarming percentage of botched nose-jobs that are neither functionally efficient nor aesthetically pleasing.

The end-products of less-than-masterful rhinoplasty include cases where the tip of the nose appears snubbed or cut off or what we refer to as lacking tip projection. Surgeons often attempt to solve this problem and lengthen the short or bobbed nose with the use of only a tip graft procedure.

This is commonly performed in the open rhinoplasty approach. However, this technique, by itself, yields results which often look and feel equally unnatural. Dr. Binder’s unique methods include grafting procedures to reinforce the natural cartilages which will actually form the shape of the nasal tip. This is a major difference in conceptual thinking between the two techniques.

Understanding Revision Rhinoplasty

The definition of revision rhinoplasty embraces the concept of “reinforcing noses” that have been structurally weakened by previous surgeries or require further aesthetic correction. In most cases, a good portion of revision rhinoplasty demands a clear understanding of the functional or breathing problems that are often simultaneously associated with these revision cases.

Training in both specialties of Otolaryngology and Facial Plastic Surgery becomes so important in understanding and being able to diagnose and correct the problems contributing to the functional breathing problems associated with many of the revision surgical cases. The goal is to restore the normal anatomical components of the nose using the patient’s own cartilage either obtained from the septum or ear. In extreme cases where there is no available septal or ear cartilage, rib cartilage may then be used as an alternative.

Many times problems arise only years after the initial procedure, however after rhinoplasty has failed for the second time, plastic surgeons would not open the nose again to prevent any further damage.

With the collaboration of several surgeons from across the country, Dr. Binder and his colleagues developed a solution to this problem. When revision rhinoplasty is attempted once again, facial plastic surgeons now use a closed approach when reconstructing the nose. For more information on how this procedure is performed, please contact our Los Angeles office.

Since revision rhinoplasty is a complex procedure, we accommodate all out of town patients before their visit in our Los Angeles office. Out of town patients can start out with a brief history of the problems as well as the aesthetic concerns. Photographs sent via email or mail is helpful in determining your revision procedure.

During the consultation, a thorough review of your history and a physical examination, including any problems in breathing, will be examined. Dr. Binder will provide a step-by -step explanation of the procedure and what steps will be taken to correct the problem.

Today, the techniques discussed in the plastic surgical literature include terms such as cartilage repositioning, structural grafting, and suturing techniques, spreader grafts, nasal valve reconstruction with alar batton grafts and supporting rim strips, and many more. Dr. Binder understands that although these procedures are now becoming commonplace amongst those skilled in rhinoplasty, they are only mastered through extensive experience over a long period of time.

Understanding this evolutionary process within your own practice and being part of the transformation of rhinoplasty provide the experienced surgeon a huge advantage over the novice surgeon (no matter how well trained) in treating the most challenging cases. Equally important from this perspective, the experienced surgeon must have knowledge and understanding of what cannot be accomplished. Thus, the surgeon is able to empower the prospective patient with a sense of confidence and equip him or her with realistic expectations of what is and what is not possible.

How To Get Started

Dr. Binder’s office in Beverly Hills is often considered the best option for correcting the most difficult problems in revision rhinoplasty. Our office is dedicated to establishing proper communication with prospective patients. Contact us today to   schedule a consultation for your revision rhinoplasty surgery in our Beverly Hills office.