Secondary rhinoplasty causes: Analysis of 277 cases

Abstract

Introduction: Secondary rhinoplasty is becoming increasingly common due to the growing popularity of cosmetic surgery and also by higher expectations of the patient and the surgeon. Secondary rhinoplasty has become an evolving field with unique cha- llenges. To repair the surgeon must properly analyze and understand the specific concerns of the patient and the anatomical causes of why you need a new operation. Aim: To identify anatomical problems most frequently found in 277 secondary and systematize rhinoplasty for better preoperative evaluation and surgical planning. Material and method: Retrospective analysis of 1160 rhinoplasty operated by oto- laryngologist Dr. Luis Villarroel between January 1, 2006 and March 31, 2015, of which 277 are secondary rhinoplasty (24%). In this study we found 1197 problems or deformi- ties (average 4.3), They were classified into upper, middle, bottom third, and endonasal, with an individual deformities subdivision within each group. The results are compared if the primary surgery was another surgeon (secondary rhinoplasty of others) or by the same author (revision rhinoplasty). Results: 85% of patients had problems in the lower third. The most common indivi­dual problems identificated were deviated septum (56%), drop tip (47%), bone dorsum deviation (34%), and cartilaginous dorsum desviation (30%). The author presents a higher percentage of insufficient bone resection and less cartilaginous dorsum narrow. Conclusion: There are different reasons why a patient seeks a secondary rhinoplas- ty. It is important to know the most frequent causes in order to identify the mistakes made in the first instance and avoid them. It's preferable one conservative primary sur- gery because it avoids difficult problems. This classification helps us to systematize the preoperative analysis and better results.