Revision Rhinoplasty Portland Oregon
Rhinoplasty is acknowledged as one of the most challenging cosmetic procedures, necessitating acute surgical precision and ability. Consequently, it carries higher revision rates compared to other surgeries. Navigating a successful revision demands a surgeon with exceptional skill and acumen to rectify a previous rhinoplasty procedure.

Revision Rhinoplasty: A Second Chance for Nasal Transformation
In your initial consultation, Dr. William Portuese and Dr. Joseph Shvidler will focus on understanding your goals and expectations. Beyond your nasal concerns, they strive to understand you as a person in entirety. They employ advanced imaging tools to give you a projection of an anticipated post-surgical look—often, patients underestimate the extent of change a rhinoplasty can deliver.
The Surgical Process
Revision rhinoplasty involves a subsequent surgical intervention on the nasal anatomy to heighten the nasal aesthetics. Your nasal structure comprises two nasal bones, two upper lateral cartilages, two lower lateral cartilages, the nasal septum, and the skin soft tissue envelope. A revision rhinoplasty emphasizes manipulating these elements to achieve a natural-looking outcome for the patient.
Performing a revision is decidedly more complex than a primary rhinoplasty due to pre-existing scar tissue and modifications brought by the previous surgery. Such alterations often aren’t discernible until the procedure is ongoing. Seasoned rhinoplasty surgeons like Dr. Portuese and Dr. Shvidler meticulously strategize their surgical approach before subjecting the patient to general anesthesia, which is performed by board-certified physician anesthesiologists for maximum safety and comfort.
With remarkable cosmetic results of a revision rhinoplasty depicted in various before-and-after photos, it’s essential to remember that our facial plastic surgeons take a holistic approach. They understand that although patients primarily focus on their nose’s appearance, functionality is equally crucial.
Addressing Specific Nasal Concerns
Patients requiring inward movement of outward-deviated nasal bones, a remnant of previous surgery, may need a revision procedure. Some patients may be left with a subtle dorsal hump which can be effectively filed down using a rasp. Irregularities over the bridge line, comprising of either cartilage or bone, are frequent post-primary rhinoplasty anomalies. In case of a concave upper lateral cartilage or an inverted V. deformity, spreader grafts are positioned under the affected area.
Cartilage grafting procedures are also available to address asymmetrical tip cartilages following a rhinoplasty. Reduction techniques applied to the lower lateral cartilages near the nose tip effectively reduce the width of the tip for those struggling with a bulbous nasal tip.
Men struggling with significant broadening of the nose tip due to thick skin and substantial scar tissue can benefit from an alar rim graft. This helps restore the architecture of the alar rim and mitigate alar rim collapse during inhalation. Another evident rhinoplasty surgical indicator is a dangling columella, making the nose appear “bottom heavy.” Excess cartilage and skin can be removed from this area to address this concern.
In addition, the nose tip can be either lifted or dropped based on the removal sites of skin and cartilage. If there are persistent large nostrils even after a primary rhinoplasty, an alar-plasty is performed. This procedure reduces the nostrils’ width by removing a skin wedge from the base of the nostrils. Depending upon the surgeon’s preference and the patient’s unique needs, revision rhinoplasty can be conducted via open or closed rhinoplasty methods.
Breathing Issues and Nasal Obstruction
Board-certified facial plastic and reconstructive surgeons Dr. William Portuese and Dr. Joseph Shvidler ensure optimal nasal functionality in every revision rhinoplasty they perform. In specific instances, they can even improve a patient’s breathing by addressing a deviated septum or other functional issues. Even if the primary concern is cosmetic, patients typically appreciate the secondary advantage of smooth, comfortable breathing.
If a previous nose job has hindered your ability to breathe adequately through your nose, a consultation with Dr. William Portuese and Dr. Joseph Shvidler for revision rhinoplasty might be due. Even when the objective is to enhance the nasal airway without altering the nose’s appearance, the surgeons’ techniques are comprehensive and meticulously tailored
Revision Rhinoplasty
- Procedure can be performed with or without grafting
- Utilization of ear, septal, or rib cartilage grafts
- Restoration of Vestibular Collapse or Narrowing
- Installation of cartilage grafts that aim to widen and harden nasal passages
- Employment of alar batan, spreader, or butterfly graft
- Rhinoplasty Accompanying Cleft Lip and Palate
- Amendment of nostril and tip asymmetry