Revision rhinoplasty: physician–patient aesthetic and functional evaluation

Heloisa Nardi Koerner Vian, Cezar Augusto Sarraff Berger, Danielle Candia Barra, Ana Paula Perin

Approximately 5-15% of patients submitted to rhinoplasty operations undergo revision surgery. Those patients have varied functional and esthetic complaints that should receive a detailed assessment that includes all the expectations the patient had before the previous procedure. To draw the profile of the main esthetic-functional complaints reported by patients to be submitted to revision rhinoplasty and to correlate them with the internal and external objective nasal evaluation performed by the surgeon. A prospective study was conducted with 43 patients to be submitted to revision rhinoplasty and their respective surgeons, by applying a questionnaire about the patients' epidemiological questions and subjective esthetic-functional complaints as well as the respective functional deformities observed by the surgeons. Subsequently, these data were correlated with the purpose of observing the frequency of congruent reports between physicians and patients. The presence of drooping tip and residual bridge hump were the patients' main complaints, confirmed by the surgeons. The correlation between subjective obstructive symptoms and the intranasal evaluation performed by surgeons was shown to be present in 87.5% of the cases. Among the patients with respiratory symptoms, the main deformity identified was residual septal deviation in 56.25% of the cases. The drooping tip followed by residual hump were the main complaints reported by the patients and confirmed by the objective examination by the physicians. The presence of nasal obstructive complaints in 37.2% of the patients shows that greater attention needs to be paid to functional deformities during the first surgical procedure. The differences observed between patients' complaints and surgeons' evaluations confirm the need for detailed assessment and clarification to the patients regarding their expectations and actual surgical possibilities.