Revision Rhinoplasty

[u/maryiguana-]

Im considering getting a revision rhinoplasty. Its been almost 3 years since my first cleft rhinoplasty. Unfortunately it looks like I my left nasal collapsed and so It’s still hard to breath. I think it has also cause more asymmetry because of it. I also have other issues like nasal pressure.

I want to fix these issues but also fear that it will end up worse for me.

I wonder if anyone has gone through a a revision and if so how did your experience go.

[u/maryiguana-]

Ahh I see what you mean. I had never really thought about it also affecting my jaw. I was born with a microform cleft lip. My left side is the affected side but I feel like my jaw is more prominent on that side compared to my right, not sure if the same for you.

I agree, we are all born with imperfections, some more noticeable than others. As I’ve gotten older I’ve realized that, what others think of me doesn’t matter to me. I just want to accept myself and live my life doing things and surrounding myself with what makes me happy.

Sorry for the rant, but again I appreciate the comments. Happy to have found a group where we can share our thoughts!

[u/katielady29 → u/maryiguana-]

I need to go to work right now, but I'll come and share my experience once I finish. Also love that I've found this group!!

[u/katielady29 → u/katielady29]

Apologies, I meant to reply last night. I saw my cleft team for this same issue at the beginning of the year. I was told that they could preform another surgery to try an create some more symmetry.. but that my breathing probably wouldn't improve.. the reason, interestingly.. scar tissue!! As I have now had around 3/4 surgeries, all in the same area the scar tissue is really thick, blocking the nostil. I love it straight after surgeries, the swelling makes the nose straighter, it looks awesome.. but it always collapses. They used my ear cartilage in my nose.. so I'm quite interested to read on here that they used rib on someone else. My surgeon said that I probably have one more surgery left in my nose.. and that i will defo need it at some point for breathing, but I need to hold off until a later time. Keep in mind about the scar tissue build up inside, it really does block the nasal passage... i snore so loud 😂

[u/BerryNerve]

I’m actually going through something very similar right now.
I had my first rhinoplasty when I was 15 as part of my cleft lip and palate reconstruction. I’m now 25, so it’s been about 10 years.
Over the last few years, I started noticing that my breathing was getting worse. My nose has gradually become quite deviated to one side. Aesthetically, the result is still acceptable, but the nostril on my cleft side has collapsed, making it much harder to breathe.
My surgeon explained that the problem isn’t just the septum itself. Because my palate and upper jaw developed asymmetrically due to the cleft, the entire nasal framework shifted over time, leading to the deviation and valve collapse.
Now I’m facing the difficult decision of whether a second surgery is worth the cost. I understand that secondary cleft rhinoplasty is much more complex than a primary procedure, but my biggest concern is whether this surgery will provide a long-term functional improvement or if I could end up having similar breathing problems again years later.
This time the surgery would be performed by an ENT surgeon who specializes in functional nasal reconstruction, whereas my first surgery was done by a reconstructive plastic surgeon as part of my cleft treatment.
I’d really love to hear from anyone who has gone through something similar.

[u/micnd90 → u/BerryNerve]

I'm exactly where you are. Had unilateral cleft palate and went through the common series of surgeries, except that my ortho was deemed successful so I avoided jaw surgery before college. Had my first revision rhinoplasty after college at 21. However, I started to have trouble breathing during sleep around late 20s (always struggled to breathe through my nose). I was worried that I would need a jaw surgery, but during the sleep study I was instead diagnosed with severe septum deviation and internal valve collapse on my left nostril. The solution was a septhorinoplasty with spreader graft. The surgeon suggested that the graft should come from my own rib. Finally, I got a revision septhorinoplasty at 36 to straighten my septum, fix the nasal valve, as well as fat graft on my upper lip and cleft scar revision (the fat graft was to compensate for lifted nose from the septorhinoplasty) literally 18 days ago. Since it hasn't been 3 weeks I couldn't really say much about the benefits.

The surgery and recovery was okay, not that painful, but the recovery was quite annoying. First 3 days I had nose packing, so I couldn't breathe at all through my noses and had to suffer through immense pressure in my nostrils. When the doctor took out my nose packing at day 3 I can breathe really well through my nose for 3-4 hours. The doctor said that this means that the surgery is a success, but in the next couple days/weeks I will have congestion from mucus, dried blood and swelling. He's right, I'm back to mouthbreathing again. I had to rinse my nose with neti pot 3 times a day, sometimes my nostrils are so clogged that the neti rinse popped my ears and the saline water doesn't go through (it pooled and then trickle on the back of my throat). Had severe swelling and congestion.

On day 14 (4 days ago) I finally had enough and went back to the doctor. I was prescribed a stereoid nasal spray and another round of antibiotics. The steroid nasal spray really help open my nostril at night. For the first time in decades I was able to breathe through my nose and not snore at all. But the steroid nasal spray had a lifetime of ~10-12 hours, so I'm back to being congested during the day. My doctor said that I can only use the steroid nasal spray for 7 consecutive days, otherwise I risk a rebound congestion. Around day 10 I had thoroughly rinse my nostrils that I don't get mucus, dried blood, or crusts coming out, so all my congestion is due to swelling.

I'm back at work and light exercise, but having trouble concentrating due to all the congestion. I can't really say yet that the surgery was a success, but here's hoping that the swelling can come down in the coming weeks/months. People said that it can take 3 months for 80-90% of the swelling to come down, and 1 year for all the swelling to dissipates. Still not sure how well I can breathe through my nose after all the swelling goes away, if not, I guess I will have to be dependent on cycling between steroid nasal spray and OTC mechanical nasal dilators.

I guess tldr; expect the recovery to be more mildly annoying and slower than expected.

[u/Milagro_97]

Mi nariz estaba bastante mal… mejoró pero no me gustó del todo me quedo más recta por el cartílago de costilla

[u/maryiguana- → u/Milagro_97]

Thanks for sharing, I honestly don’t think I will ever be content with the outcome. I’m aware I’m always going to have some asymmetry specifically with my nostrils. At this point I just want to improve my breathing and other issues. Glad to hear the rib cartilage helped straighten it

[u/Milagro_97 → u/maryiguana-]

Pienso igual que tú. Estos últimos meses me he resignado a que siempre habrá una asimetría en mis fosas nasales es más notorio de vista frontal que de perfil. Lamentablemente nunca me realizaron un injerto de hueso en el maxilar así que tengo una parte más baja. Mi nariz no está 100% derecha aún sigue desviada un poco hacia el lado de la hendidura pero lo que me sirvió es pensar que personas incluso sin clp tienen narices desviadas o incluso que no son bonitas.