title: Revision Rhinoplasty: What Can We Learn from Error Patterns? An Analysis of Revision Surgery.
abstract: Of the many challenges in rhinoplasty, achieving a satisfactory outcome at the first operation is important. There are multiple reasons for secondary surgery, and generally revisions can be broadly classified into minor (often one area of deficit) or a total redo. Understanding the common technical reasons for failure in primary surgery by analyzing the deformities has resulted in various error patterns emerging. Understanding these patterns means we can modify techniques in primary surgery to reduce the incidence of revision. This article describes our prospective revision rhinoplasty experience over 5 and then 2 years, highlighting the main error patterns encountered. We also describe a stepwise analysis of four frequently encountered key problem areas alongside techniques to address them and offer pearls to help prevent further revision. Comparison of two cohorts of patients from a teaching hospital setting and private practice with the same operating surgeon indicates an increasing tendency to the open approach for revisions. The re-revision rates for these groups are 15.7 and 9%, respectively. Revision rhinoplasty is a difficult operation to perform to the satisfaction of both the surgeon and the patient. Understanding the common technical reasons for failure in primary surgery by fully analyzing the deformities means we can modify techniques in primary surgery to reduce the incidence of revision.
authors: Craniofacial Service, UCLH Hospitals London and Rhinoplasty London, London, United Kingdom.
authors: Charles
authors: C
authors: East
authors: Royal National Throat Nose and Ear Hospital, UCLH Hospitals; Imperial College London Trust, London, United Kingdom.
authors: Ivor
authors: I
authors: Kwame
authors: Royal National Throat Nose and Ear Hospital, UCLH Hospitals; Imperial College London Trust, London, United Kingdom.
authors: Saiful Alam
authors: SA
authors: Hannan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009666:Nose / Q000473:pathology*; D009667:Nose Deformities, Acquired / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000009:adverse effects* / Q000379:methods; D055815:Young Adult