Nasal deformities may be whether acquired (e.g. after traumatic injuries) or congenital (cleft nose deformity).
During the correction of crooked noses mostly the correction of both the inner (nasal septum) and outer nose is inevitable to improve shape and function (aesthetic and functional rhinoplasty). The so called cleft nose is a very complex deformity, often representing a demanding challenge for the surgeon. Typical changes of the internal and external nose in an existent sequence of a lip-palate-cleft, which are gradually treated by operative corrections already at infancy, are called cleft nose. After completion of the linear growth secondary surgical correction of the cleft nose can be performed at the age of about 16/17. All required orthondontistic therapies and oral surgeries should be completed until that time-point. In order to achieve a longlasting result often additional cartilage grafts (mostly form the rib) are required for the surgical correction of this very complex deformity.
Detailed information can be obtained during our consultation in the clinic utoquai.
Medical Term: Revision Rhinoplasty, secondary and tertiary Rhinoplasty, Nasal Reconstruction
Type of Anesthesia: General Anesthesia
Surgery time: 2 to 3.5 hours
Length of hospital stay: outpatient or 1 overnight stay
Aftercare: Splints and cast for 2 weeks
Back to public: After 2 weeks
Back to work: After 2-3 weeks
Time of recovery: 6-8 weeks
Fees: starting at 16.000 CHF
Since the nose is a very complex threedimensional organ, consisting of different components such as cartilage, bone, skin and mucosa, the surgeon should have sufficient experience in this special field. Upt to one third of the patients asking for our consultation in the clinic utoquai, have had already one or more nose jobs done elsewhere. Mostly the patients are unhappy with the aesthetic and often with the functional result of the surgery, too. Especially low priced offers should be questioned by patients and urge them to obtain a second opinion elsewhere before getting operated. A primary rhinoplasty is already meticulously planned and accurately performed by a specialist in that field, which makes it time-consuming and more expensive than other aesthetic procedures.
Revision rhinoplasties often require cartilage grafts taken from the ear or the rib, in order to reconstruct the aesthetics and function of the nose. The prerequisite for a revision surgery is an accurate analysis of the existing nasal shape in combination with the realistic expectations of the patient. Often we are able to even help in hopelessly assumed cases to make the result more harmonious and acceptable by a revision rhinoplasty. However, if and what surgical improvements may be possible in particular cases completely depend from the individual clinical findings of the patient. In the clinic utoquai we offer you the entire spectrum of revision surgery.
Reconstructive nasal operations are generally performed in full anesthesia. The approach to the nose is made in an open manner (2 small incisions inside the nose and one v-shaped incision on the columella). Surgical dissection in previously operated noses is often challenging because intact nasal structures have to be meticulously freed from existing scar tissue. Frequently, additional cartilage is needed in order to restore breathing and support of the nose as well as to significantly improve the aesthetic nasal shape. The cartilage is ideally taken through a small incision in the costal arch or in the submammary fold. Rib cartilage perfectly qualifies for usage as a cartilage graft, because it is both firm and availabe in great amounts. Alternatively, cartilage grafts can be taken frome the concha of the ear.
Possible unwanted side effects in the nose after reconstructive surgery are comparable with the complications after aesthetic nasal surgery. During the first weeks after harvesting of rib cartilage additionally slight pain like after a bruised rib may occur. Infections after usage of ear and rib cartilage are rare. In very rare cases hematomas may occur, the scars generally heal without difficulty.
After reconstructive nasal surgery a cast is worn for at least 2 weeks. Additionally silicone splints are used for 1-2 weeks to stabilize the nose from the inside. In cases where rib cartilage is used return to job can be expected about 2-3 weeks after surgery. Like after other surgical nasal procedures wearing glasses should be avoided for 2-3 months, intense physical activity should be started 6-8 weeks after operation.
Complex reconstructive procedures peformed in the nose are associated with great effort and higher costs, when compared to primary and aesthetic nasal surgery. The total amount of the fee is based on the type and extent of the reconstructive surgical procedure and is individually discussed with the patient during the consultation after determining the surgical treatment plan. In rare reconstructive cases the health insurance may cover the costs for the functional part of the surgery. In order to avoid any unexpected costs, all fees including surgery, anesthesia and hospital stay are discussed and paid in advance.
Price for nasal correction after previous surgery: from 16.000 CHF