Revision rhinoplasty is perhaps one of the most difficult procedures performed. Most surgeons who perform revision rhinoplasty will do so through an open rhinoplasty approach. Endonasal rhinoplasty is where incisions are made entirely within the nose. In some cases, endonasal revision rhinoplasty will be preferred to open rhinoplasty for revision rhinoplasty. This must be determined on a case by case basis. Dr. Shah is one of the few surgeons in the world who performs revision rhinoplasty through both open and closed techniques at a high level.
Case example. Patient who has had 5 previous rhinoplasties performed by outside surgeons. Due to the amount of surgeries she has had she is left with a very poor scar along her columella. She desired more nasal tip projection and a better profile.
When she came to the office she complained of recurrent pain and drainage from her nose. A silicone implant which was placed by an outside surgeon was removed and found to be surrounded by a pocket of pus and bacteria. One of the reasons Dr. Shah has never used an artificial nasal implant stems from his belief that foreign materials do not belong in the nose.