Paige,
Thanks for your question regarding revision rhinoplasty. We perform about 75 rhinoplasties per year and about 150-200 nasal reconstructive cases per year. Of the 75 rhinoplasties about 15-20% are revision cases. So while I haven’t actually worked the numbers, over the years we have plenty of experience. I received my initial training in rhinoplasty in my residency in Galveston, TX where we had an excellent experience with rhinoplasty. I then performed a facial plastic surgery fellowship with Edwin Williams, M.D. in Albany,NY. Dr. Williams trained with one of the most world famous rhinoplasty surgeons to date, Gene Tardy in Chicago. I sought to obtain a fellowship with Dr. Williams because of the strong exposure to rhinoplasty. We performed several hundred nasal cases that year. Since the end of my fellowship I have continued to refine my techniques and participate in constant education in rhinoplasty. Rhinoplasty is my favorite procedure and I strive to achieve excellent results on every case. Our website has many rhinoplasty cases, both primary and revision. Please take time to look through them and please give us a call anytime.
Ed Buckingham
Wendy,
During our rhinoplasty consultations we take digital images of our patient and then import them into a program which allows us to alter those images in order to reflect the changes the patient desires. We attempt to generate a reasonable outcome based upon the patient expectations. The imaging program for rhinoplasty isn’t perfect, but it is a great communication tool and allows an open dialogue between myself and the patient as to what can and can’t be achieved. Please feel free to give us a call if we can be of any further assistance and please take some time to review our before and after gallery of our rhinoplasty patients.
Ed Buckingham
Sarah,
The columella is made up of what is called the medial crural footplates. These are part of the cartilage that makes up the tip of the nose and is intimately involved in all aspects of tip rotation and projection as well as the amount of nostril show. The part you are referring to hanging. The columella as well as the nasal tip dimensions can all be precisely controlled in rhinoplasty by placing grafts onto the nasal septum and suturing the medial crura to this graft in what is referred to as a tongue and groove fashion. We routinely use this type of maneuver in primary and revision rhinoplasty to achieve the appropriate tip dimensions. Please take some time to review our rhinoplasty photo gallery. I think you will get a good feel for what words have a hard time expressing. Please feel free to call with any further questions.
Ed Buckingham
Shelly,
We definitely perform revision rhinoplasties. About 20% of the rhinoplasty surgery we perform is unfortunately on patients who had surgery elsewhere and for one reason or another do not have an optimal result. Rhinoplasty is probably the most challenging cosmetic facial procedure to perform and so it is extremely important to select a surgeon with extensive rhinoplasty experience for both primary and revision cases. Revision rhinoplasty is more difficult than primary rhinoplasty because of scarring in the nose and because the septum has often times been removed and so there is not a readily available source of cartilage. Often we need to harvest cartilage from either the ear or a portion of a rib to complete the procedure properly.
To answer your second question, we perform around 200-300 rhinoplasties and reconstructive nasal procedures per year. I’m not sure what the total over the years is, but we have extensive experience. Even with that experience, I still believe that each rhinoplasty procedure has its challenges and that it is the most intricate and therefore the most rewarding procedure I perform.
We have many rhinoplasty examples on our site. Please take some time to review the rhinoplasty section. We would love to hear from you in person and look forward to your call.
Ed Buckingham
Jane,
Thanks for your questions, sorry I have taken so long to reply. I have been out of the office and your questions were specific enough that my staff could not answer. Regarding your questions on rhinoplasty we can under most circumstances add length to a previously shortened nose. Usually in that case the nose has also been over-rotated. The limiting factor is when the nose has been very over-shortened and the skin has contracted so much that it prevents expansion to the degree that we would want. Usually though this is not the case. We may utilize ear cartilage for the repair or possibly rib depending on the amount of cartilage I determine is necessary to accomplish the best result. We have extensive experience with revision rhinoplasty and would be happy to see you. The cost for revision surgery is between 6,000 and 7,000 including facility fee and anesthesia.
Regarding Fat Transfer it depends on how you do it and where you do it. If your previous transfer was in the lips or perioral area then is was likely to fail and is likely to fail again. If you perform the transfer in the correct manner and are utilizing it to rejuvenate the peri-occular area, cheek area and jawline then it is usually successful on one attempt. All of the results on our website for fat transfer are after only one transfer. Not one patient on the site has had any more than one procedure and many of the results are longer than two years. In fact I just presented my long-term results for fat transfer at a facial plastic meeting. I encourage you to review the results and we look forward to the opportunity to meet you.
