Revision Rhinoplasty with Dr. Taylor DeBusk

Dr. Basu (00:08):
Hello and welcome. I'm Dr. Bob Basu. Today on Behind the Double Doors, we're talking about revision rhinoplasty or nasal surgery with our newest member facial plastic surgeon, Dr. Taylor DeBusk. Welcome Dr. DeBusk.

Dr. DeBusk (00:19):
Yeah, thanks for having me.

Dr. Basu (00:21):
So, Dr. DeBusk, you're now seeing a patient who's had a rhinoplasty one to two years ago and they're still not happy with the result. What are some of the options you have available to revise a nose that's already been operated on?

Dr. DeBusk (00:36):
Yeah, so number one, obviously I wanna address kind of the, the concerns or or areas that the patients are displeased with. And then two, in revision rhinoplasty, I always have to prepare patients for the need to borrow cartilage from somewhere else, particularly the ear or the rib, because when you, you know, had a previous rhinoplasty, I don't know what they did, I don't know if you have extra cartilage on the inside of the nose. I don't know if I have to rebuild the underlying framework of the nose. So I always talk to patients about the need for using cartilage to help create that end desired goal.

Dr. Basu (01:13):
So Dr. DeBusk, you specialize in revisional rhinoplasty as well as primary rhinoplasty. So what are the usual reasons someone might need to consider a secondary or revisional rhinoplasty?

Dr. DeBusk (01:26):
Yeah, so one of the main things is the, the bridge of the nose. A lot of times, uh, traditionally the bridge is brought down too low or too much of the cartilage or too much of the bone was removed. So a lot of times we have to build that back up as well as the tip placement. So sometimes the tip of the nose is a little too elevated or pointed upwards. So that's another thing that we have to address usually in revision rhinoplasty.

Dr. Basu (01:50):
Got it. So how often is a secondary rhinoplasty needed?

Dr. DeBusk (01:56):
People typically quote, 10% of the time patients will need a revision rhinoplasty. So that's usually what I tell patients in the initial consultation.

Dr. Basu (02:07):
So what if you see a patient who's had a rhinoplasty elsewhere, it's now six months, they're still not happy. How would you advise them?

Dr. DeBusk (02:16):
I still tell patients to wait that till you hit that 12 month mark. Now it just depends, you know, on what the patient's concerns are. If it's a little fullness in one area of the nose that may be too much scar tissue that have developed in the post-op setting, then you could do small things like steroid injections to kind of help reduce some edema or scar. But overall, as a general rule of thumb, I, I don't operate on anybody until they've hit that 12 month mark after their original surgery. 

Dr. Basu (02:45):
So if someone has to wait at least 12 months, can that patient consider a non-surgical rhinoplasty or, or a liquid rhinoplasty in the meantime? If you're waiting to have a revision, is this a good idea or a bad idea?

Dr. DeBusk (02:57):
I advise against it to be honest, because if you know that you're gonna, that you want to have a, a secondary surgery to address specific concerns with the nose, you don't wanna put filler in the nose because again, you have to wait until that filler dissolves before we proceed with your second surgery.

Dr. Basu (03:17):
So typically revisional surgery of any sort is more complex. Is that the case in revisional rhinoplasty and why is it more complex?

Dr. DeBusk (03:25):
Definitely number one is, is the scar tissue that you develop. So the natural planes, the soft tissue planes of the nose are completely disrupted. So you're having to combat scar as well as the augmented anatomy that you had from the, the prior surgery. So it, it can, it's much more challenging because it's not nearly as predictable as a primary rhinoplasty.

Dr. Basu (03:48):
And is the recovery since revision surgery is more complex, is the recovery similar to the first surgery or how, how can a patient prepare for the recovery better?

Dr. DeBusk (03:57):
Overall, the recovery's relatively the same, but you, the swelling does take a little bit longer to resolve. So usually I say instead of four months is when you get a good idea of what the final result is. It can be six up to eight months until all that initial swelling has completely gone away.

Dr. Basu (04:15):
So after a revision rhinoplasty, when can they start going out and when are they cleared to start resuming activity as tolerated, like going to the gym?

Dr. DeBusk (04:23):
I say typically three weeks, one week after surgery, you're kind of down and out. You're just, you resting and recovering. The second week after surgery, I say don't do any heavy lifting, still nothing heavier than 15, 20 pounds, but once you hit week three, you're good to go back to the gym, full cardio, uh, you're pretty well healed at that point.

Dr. Basu (04:43):
And for patients that are considering a secondary or revisional rhinoplasty, how long does that take in the operating room?

Dr. DeBusk (04:49):
Yeah, so that, that's gonna be longer because the tissue planes have been augmented or changed, but usually three up to four hours. Uh, it also depends whether or not we're taking rib cartilage or ear cartilage, but in general, it's usually a little bit longer than a primary rhinoplasty.

Dr. Basu (05:05):
So typically for a primary or first time rhinoplasty about a two hour case in a revisional rhinoplasty can be three, four hours plus, depending on what Dr. DeBusk needs to do. And where can patients find information about the cost of rhinoplasty?

Dr. DeBusk (05:20):
Yeah, so every rhinoplasty is different and, and everyone is unique to that specific patient. So I think in regards to cost, uh, the best thing to do is give the, the office a call at (713) 799-2278.

Dr. Basu (05:33):
And for the cost, what's really common for patients to help break down the costs are, are some popular financing options, which, so patient consultants can walk you through if that's an option for you. So Dr. DeBusk, where can our listeners see before, after photos of your past patients?

Dr. DeBusk (05:51):
Yeah, so you can see the before and afters on basu plastic surgery.com, the Basu Plastic Surgery website or on Instagram at Basu Plastic Surgery, or at Dr. Taylor DeBusk on Instagram as well. And the links to these, uh, websites and Instagram are in the show notes.

Dr. Basu (06:08):
Thank you, Dr. DeBusk. And if you wanna learn more about Dr. DeBusk, please visit us at basuplasticsurgery.com or follow his results on our Instagram at Basu Plastic Surgery.

Dr. DeBusk (06:19):
Thanks for having me.

Speaker 3 (06:23):
Basu Aesthetics and Plastic Surgery is located in Northwest Houston in the Towne Lake area of Cypress. If you'd like to be a guest or ask a question for Dr. Basu to answer on the podcast, go to basu plastic surgery.com/podcast. On Instagram, follow Dr. Basu and the team at Basu Plastic Surgery. That's B A S U Plastic Surgery. Behind the Double Doors is a production of The Axis, T H E A X I S.io.