Nose is the most important symbol to your figures, even to your face. Especially for local people, most of them have a wide and flat facial shape of southern ethnicity, so there are many people who have received rhinoplasty or have thought of receiving it. This pushes rhinoplasty to the second highest in the cosmetic surgery chart, only next to the eyelid surgery. However, in traditional rhinoplasty only a simple nasal implantation can be offered, but in restrictions of elemental conditions of individuals, one's own desire or needs may not be fulfilled under many circumstances. Hence, after open (Korean) rhinoplasty surgery is introduced into Taiwan, more and more people are willing to receive revision rhinoplasty to reshape their ideal nose shape.

According to the author’s observation, it is found that the main reason for revision augmentation rhinoplasty is dissatisfaction on effects of the first surgery, and then the issues of shaken nasal bones or nasal deviation. The followings are the major reasons for receiving revision augmentation rhinoplasty:

1. Subjectively believe that the nose looks unnatural or undesirable
2. The head of nose appears crooked or can be shaken by external force
3. Experience a flaming external lateral nose or pain for more than 3 months
4. Symptoms of incidental inflammation at the lateral nasal wall or a doubtful case for rejection to the artificial nasal membrane occur
5. The lateral nasal wall appears irregular or sense of alien substances such as a doubtful calcified nasal polyps

The greatest difference between revision augmentation rhinoplasty and traditional rhinoplasty is that almost all patients are restricted to choose the open rhinoplasty. The reason is that by this type of rhinoplasty, not only blind-spots that can not be overcome by traditional rhinoplasty, such as the over-tighten head of nose, crooked lateral nose or uneven nasal bone can be fully corrected during surgery, open rhinoplasty is able to thoroughly clean out the nasal capsules and scar tissues formed in the first surgery. This step is the key to the head of nose shrinkage and extension, and is also what a revision rhinoplasty needs to pay attention to. Hence, a revision augmentation rhinoplasty need to include following items:

1. Un-stuff scar tissue in the nose and clean up the nasal capsules. Thin the nasal wall if necessary.
2. Replace graft materials used for augmentation rhinoplasty. Regardless how long the period stands between the first operation and revision rhinoplasty, it is best to discard the original nasal bone and replace a new nasal implant or Goretex to lower the risk of infection.
3. To pad the nose with autologous cartilage, the best cartilage materials come from self-donated cartilage of nasal septum. Not only the amount of cartilage taken out can be quite large, but also the cartilage taken out will be even and firm, which is a better material to make a perking small “nose pearl.”
4. Shrinkage of the lateral nose and nostrils needs to be done concurrently with operations on the head of nose, so as to make the triangle at the head of nose to be more three-dimensional and to make the head of nose look smaller.

As for whether to use nasal implant or replace with Goretex instead in the revision augmentation rhinoplasty, it is not definite. It requires a doctor’s advice according to individual conditions. Generally speaking, if you adapt to the previous nasal implant quite well and no complications occur what so ever, then replacing a new nasal implant will be just fine. However, if you experience a flaming external lateral nose or a nose deviation, or if your original conditions of nose are not good, changing to Goretex may resolve the above problems. However, Goretex has stop its production line manufacturing products for cosmetic purpose and the material has uncertainties regarding to easiness of taking out or modification after six months. Consumers should take these into account before they choose this material

Recent revision augmentation rhinoplasty can improve shortcomings of traditional augmentation rhinoplasty due to progressing surgical procedures. There is even a chance to create your ideal nose shape without accommodating to your own condition or materials, not to mention receiving strange attention from by-standers. It can help you to restore full confidence when facing public. However, this reshape plan can not allow another failure, and the recovery period can last longer than the first operation. Hence, if you are interested, you must take your time to speak with your surgeon before the operation to make good communication, so as to get a nose of your ideal!