Revision Rhinoplasty in Turkey : Cost 2024 & Reviews

Nose aesthetic surgeries provide both aesthetic and functional improvements. However, some situations may require secondary interventions after the operation. Therefore, it is essential for surgeons to have deep anatomical and physiological knowledge. In rhinoplasty practice, secondary operations are often preferred to address complications arising from previous surgeries.

There are two different approaches: open and endonasal. Advocates of both methods emphasize the superiority of their techniques. Experienced surgeons choose the most appropriate method for each patient, also benefiting from information in the literature.

Table of Contents

Nasal Anatomy and Physiology: What Should Be Known in Revision Rhinoplasty?

The complex anatomy of the nose requires a detailed examination of each of its regions. This structure is divided into three main sections, each playing a significant role in the success of rhinoplasty operations.

Bony Vault

It is the pyramidal structure of the nose.
Functions as the main supporting structure.
The side walls consist of the frontal processes of the maxilla and nasal bones.

The bony vault is an important component that provides aesthetic and structural support. The maxillary processes joining towards the midline and connecting to the frontal bone form the basis of this vault.

Upper Cartilaginous Vault

Consists of upper lateral cartilages (ULC) optimally angled to the dorsal edge of the septum.
These cartilages are among the main supporting elements of the nasal structure.

The upper cartilaginous vault is a critical structure that directly affects the aesthetics and function of the middle part of the nose. The upper lateral cartilages are positioned harmoniously with the septum and control the openness of the nasal cavity.

Lower Cartilaginous Vault

Contains a pair of lower lateral cartilages and caudal septal cartilage.
These cartilages form the basis of the nasal tip and valve mechanism.

The lower cartilaginous vault has a significant impact on the shape of the nasal tip and the functionality of the airway. The structural characteristics of the lower lateral cartilages determine the shape of the nasal tip and the airflow. Additionally, the nasalis muscle controls the opening of the nasal valve during inspiration.

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The Importance of the Internal Nasal Valve and Its Role in Secondary Rhinoplasty

The internal nasal valve plays a critical role during breathing. This structure is a triangular shape formed by the caudal edge of the upper lateral cartilage, the septum, and the base of the nose. The internal valve narrows during inhalation and widens during exhalation, causing the Venturi effect. This mobility supports the aerodynamic functions of the valve and regulates nasal airflow.

The normal angle between the caudal edge of the upper lateral cartilage and the septum is 120 degrees.
This angle is vital for the proper functioning of the internal valve.
The optimal angle between the septum and the upper lateral cartilage (ULC) is 15 degrees.

In secondary rhinoplasty cases, these angles are often disrupted. These disruptions, causing breathing difficulties, negatively affect the functionality of the internal nasal valve. Secondary rhinoplasty aims to correct these structural deformities.

Atresia can be seen in four degrees of severity, disrupting the integrity of the internal nasal valve.
Correcting this condition is usually challenging.

The use of spreader grafts is important for regaining the normal divergence angle between the dorsal septum and the upper lateral cartilage. When correctly placed, these grafts support the integrity of the internal valve, helping normalize nasal functions. Thus, the patient’s aesthetic and functional recovery process is supported.

Revision (Secondary) Nose Surgery: Which Grafts Are Used?

Grafts used during revision rhinoplasty are crucial for providing both aesthetic and structural support. These grafts are selected to overcome challenges arising from previous surgeries. Various graft types play critical roles in reconstructing nasal anatomy. Spreader grafts are used to regain the natural angle between the septum and the upper lateral cartilage, while columellar strut grafts are preferred to support the medial crura.

Spreader Grafts: These grafts ensure the nasal wings stay at the correct angle and improve nasal breathing.
Columellar Strut Graft: Placed vertically between the medial crura, providing strong support to the nasal tip.
Septal Dorsal Augmentation Grafts: Ideal for cases requiring multilayered grafts and elevate the nasal dorsum.
Tip Grafts: Placed on the domes, helping to make the nasal tip more pronounced.
Onlay Crushed Grafts: Fill gaps and depressions in the nasal cartilages.
Rib Bone and Cartilage Grafts: Used in cases where local grafts are insufficient, providing solid structural support.
Homografts: Suitable for patients who have undergone septum resection and require special storage conditions.

The use of these grafts is a determining factor in the success of secondary rhinoplasty surgeries. Each graft type is carefully selected to solve specific problems and meet the patient’s aesthetic and functional expectations. Experienced surgeons aim to achieve the best result by using these grafts tailored to the unique condition of each patient.

What Suture Techniques Are Used in Revision Rhinoplasty?

During the revision rhinoplasty process, a series of special suture techniques are applied. Each technique targets a specific anatomical correction, allowing for both aesthetic and functional results. Before diving into the details, it is necessary to provide an overview of how and why these techniques are used.

Transdomal Suture:

Narrows and raises the dome or medial leg of the lower lateral cartilage.

Interdomal Suture:

Brings the cephalic edges of the narrowed domes together, ideally creating a 30-degree convergence angle.
Defines the three-point projection of the tip.

Columella-Septum Connection Suture:

Controls the upward or downward rotation of the nasal tip to achieve the ideal nasolabial angle.
Provides an ideal angle of 90-95 degrees for men and 95-100 degrees for women.

Horizontal Mattress Suture:

Transforms concavity into convexity and vice versa.
The needle passes through one side of the depressed cartilage, exits, and returns to the opposite side.

Differential Suture:

Moves the deviated straight septal cartilage to the midline.
Multiple sutures may be needed to correct this deviation.

How Does the Recovery Process After Revision Rhinoplasty Take Place?

The recovery period after revision rhinoplasty is a critical phase for success. Patients may observe slight swelling in their noses for a week after the operation. To facilitate the recovery process, absorbable sutures are used, eliminating the need for suture removal. Additionally, surgeons minimize the use of nasal tampons for patient comfort by employing advanced techniques.

Sutures: Made from absorbable material, eliminating the need for suture removal.
Tampon: Reduced use optimized for patient comfort.

During the initial recovery period, patients are usually advised to wear a nasal splint to protect the newly shaped nasal structure. This splint supports and protects the nose. Pain relievers are prescribed by doctors to reduce discomfort. Patients also receive appropriate wound care guidelines. Regular follow-up appointments are scheduled to evaluate the recovery process and detect possible issues early. These follow-ups ensure the recovery process progresses successfully.

Nasal Tip Drooping After Revision Rhinoplasty: Risk Factors and Effects

Doctor and female patient after nose surgery check-up

Nasal tip drooping can occur after revision rhinoplasty. This complication varies depending on the amount of tissue removed and the techniques used during the surgery. When too much tissue is removed, the supporting structures of the nasal tip weaken, increasing the likelihood of drooping. The surgeon’s experience plays a critical role in reducing the risk of drooping. An expert surgeon can properly analyze the nasal structure and apply the most appropriate techniques:

Tissue Removal: The more tissue is removed, the greater the risk of support loss for the nasal tip.
Support Structures: Preserving or strengthening the support structures minimizes the risk of drooping.
Techniques Applied by the Surgeon: The accuracy of the applied techniques is another factor affecting the risk of nasal tip drooping.

When Should Revision Rhinoplasty Be Performed?

Revision rhinoplasty should be considered after the primary nose aesthetic surgery. This process requires waiting for the tissues to fully heal and stabilize. Typically, a six-month period is recommended for tissue healing after the first operation. During this period, the tissues return to their healthy structure, and the results of the surgery become clear. Thus, the surgeon has a better opportunity to evaluate the current situation. To determine the earliest time for revision rhinoplasty, the following factors should be considered:

Time elapsed since the first surgery: At least 6 months
Tissue healing status
The overall health of the patient

What Type of Anesthesia is Used in Revision Rhinoplasty?

In revision rhinoplasty, general anesthesia allows the surgeon to work carefully and in detail while the patient feels no pain. This method is preferred, especially in long and complex interventions. For shorter and less invasive procedures, local anesthesia or sedation may be used as an alternative. In the application of local anesthesia:

Only the nasal area is numbed.
The patient remains awake during the procedure.

In the case of sedation:

The patient is in a light sleep state.
Full loss of consciousness does not occur.

The choice of anesthesia is based on several factors:

The overall health of the patient.
The complexity of the surgery.
The patient’s personal preferences.

Formation of Permanent Scars After Revision Rhinoplasty

Revision rhinoplasty operations, especially when using the open method, can leave scars on the nasal tip. However, the closed technique makes the scars less visible. The formation of scars varies depending on many factors. The type of skin is an important factor; especially with thick and oily skin, the risk of scarring is higher. Additionally, an individual’s genetic wound healing characteristics can also affect the visibility of the scars. Measures to minimize scars include:

Choosing an experienced surgeon: The surgeon’s experience and technical skills can minimize scar formation.
Post-operative care: Careful wound care and adherence to the doctor’s recommendations positively influence the healing process.

What is the Ideal Rest Period After Revision Rhinoplasty Surgery?

The rest period after revision rhinoplasty surgery is critically important for the patient’s quick and effective recovery. Medications recommended by the doctor during the first few days help control pain. Resting during the first 24-48 hours minimizes pain and swelling. By the end of the first week, most patients can gradually return to their daily activities. However, the full recovery process typically takes between six months to a year.

During the recovery period, the following measures should be observed:

Avoiding strenuous physical activities
Taking care to protect the nose from impacts
Avoiding direct exposure to sunlight
Refraining from smoking

What Are the Risks Encountered During Revision Rhinoplasty?

Patients may face various risks during revision rhinoplasty. This intervention after the first surgery is more complex and may lead to more challenging complications. Due to the nature of the surgical process, bleeding can become a serious concern for patients. Additionally, the following risks should be considered:

Infections have direct effects on health.
The wound healing process may be prolonged, increasing recovery time.
Aesthetic results may not meet expectations, affecting patient satisfaction.
Breathing problems can reduce the quality of life.

Finally, risks associated with anesthesia are always present. Each risk should be discussed in detail with the doctor. Patients need to be well-informed and have clear information about possible outcomes.

How Much Does a Revision Rhinoplasty in Turkey in 2024 ?

The cost of a Revision Rhinoplasty in Istanbul, Turkey, typically ranges between €5,000 and €7,000. The price can vary depending on several factors, such as the surgeon's experience, the complexity of the procedure, the clinic's reputation, and additional services included in the package.

Average Revision Rhinoplasty Cost (in Euros) in 2024
United Kingdom	€16,600 – €19,000
United States	€14,200 – €23,400
Canada	€16,000 – €19,000
Australia	€23,800 – €37,800
South Korea	€9,400 – €17,200
Ireland	€13,000 – €15,000
Germany	€11,000 – €13,000
Netherlands	€11,000 – €13,000
France	€11,000 – €13,000
Turkey	€5,000– €7,000

Frequently Asked Questions

Is nose revision surgery difficult?

The difficulty of nose revision surgery is generally higher for the surgeon. For patients, this surgery is usually not more difficult than the first surgery. However, if there is not enough cartilage tissue in the nose, tissue may need to be taken from the ear or rib. This creates a second wound area for the patient, making the recovery process a bit more complex.

When is a revision performed after nose surgery?

A revision procedure is usually waited for a year after nose surgery. During this period, the tissues complete their healing and maturation. Therefore, revisions performed before a year carry more risks due to the tissues not being fully healed. Additionally, factors such as tissue stiffness and adhesion can cause problems in early intervention. Therefore, it is ideal to wait a year for a revision.

Is revision surgery paid for after nose aesthetics?

Revision rhinoplasty surgeries involve corrections made after the previous nose aesthetic operation. These surgeries are usually performed to respond to the patient’s unique aesthetic demands. Therefore, these interventions are generally paid for by the patient. Especially these surgical interventions are shaped according to the patient’s expectations, making the cost of revision surgery inevitable. Patients should check whether their private health insurances cover these costs.

Is revision rhinoplasty risky?

Although revision rhinoplasty is usually more complex than the first surgery, it does not carry great risks when performed by an experienced surgeon. Complications encountered in the first rhinoplasty operation can also be seen in this intervention. These include swelling and bruising around the nose and eyes. However, these complications can quickly heal when managed according to the doctor’s recommendations. In unexpected situations, such as excessive bleeding, swelling, or bruising, the patient should immediately inform their doctor.

Will the nose droop after revision?

Nose drooping after revision rhinoplasty can occur during the surgical intervention. Especially removing too much cartilage tissue can lead to this problem. Therefore, choosing an experienced surgeon for nose aesthetic operations is important. Additionally, similar problems may arise as a result of changing the natural structure of the nose. These complications are usually due to surgical errors. The success of nose surgeries largely depends on the surgeon’s competence.

Is it risky to have two nose surgeries?

There should be at least six months between two nose surgeries. During this period, the tissues heal and mature. Early second rhinoplasty reduces the chances of success. Especially in cases requiring cartilage tissue transfer, adequate recovery time is of great importance. Corrections made shortly after the first operation can lead to undesirable results. Therefore, doctors usually do not recommend secondary rhinoplasty before six months.

Can a nose be operated on three times?

A nose can be operated on three times. Each additional surgery after the first may be more risky. Moreover, repeated operations become more complex as previous interventions create scar tissue and structural changes that complicate the procedure. In addition, the success rate of each new operation depends on the surgeon’s experience and the techniques applied. Therefore, choosing an experienced surgeon is crucial for multiple nose surgeries. Repeated operations require comprehensive evaluation and careful planning.

With which technique is nose revision surgery performed?

Nose revision surgery is performed with closed or open techniques depending on the characteristics of the case. The open technique is generally preferred when large structural changes are needed. This method allows the surgeon direct access to the nasal skeleton. On the other hand, the closed technique is suitable for minor corrections. The closed technique involves incisions in the internal walls of the nose and does not leave external scars. When evaluating the advantages and disadvantages of both methods, the surgeon’s preference and the patient’s condition are determining factors.

What conditions after the first nose aesthetics require revision?

Revision nose aesthetics are usually necessary for several reasons. Deformities occurring after the first surgery are the most common reasons for revision. Additionally, unmet aesthetic expectations may also direct patients to revision. Functional problems, such as breathing difficulties, that arise after a failed first operation, also increase the need for revision. Sometimes patients may want revision for minor corrections. However, significant deformities require major revision. Therefore, patient dissatisfaction and functional problems are the main indications for revision surgery.

How are revision nose aesthetics surgery prices determined?

The prices of revision nose aesthetics surgeries vary based on several factors. Firstly, each patient’s condition is different, so costs are determined individually. Additionally, these surgeries require a high level of experience, so the choice of doctor is an important factor in pricing. The selected hospital also affects the price; each hospital demands different fees based on the quality of the service provided. Therefore, the cost of revision nose aesthetics surgery is shaped based on these three main factors.

Is the use of grafts necessary in revision rhinoplasty?

The use of grafts is often necessary in revision rhinoplasty. The insufficiency of the nasal septal cartilage due to previous surgeries creates this need. Ear cartilage or rib cartilage is usually preferred. This situation may extend the duration of the surgery. Therefore, the use of grafts is an important factor for achieving a successful result. The need for grafts may vary for each patient and depends on the surgeon’s evaluation.