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Nasal Problems, Asymmetry Top Reasons for 2nd Nose Job

Common requests are to make nose tip symmetrical, improve breathing, study finds

TUESDAY, Sept. 21, 2010 (HealthDay News) -- Breathing obstructions and dissatisfaction with the symmetry of the tip their nose are common reasons why people want a second operation to revise their initial cosmetic nose surgery (rhinoplasty), researchers say.

Between 5 percent to 15 percent of rhinoplasty patients want revision surgery, according to Dr. Kathy Yu, of Columbia College and Cornell University in New York City, and colleagues.

For the study, the researchers had 104 patients -- who were seeking revison surgery in 2008 and 2009 -- complete a questionnaire that asked them to explain why they wanted the second operation. The top three reasons were because of nose tip asymmetry, difficulty breathing or nasal obstruction, and a crooked middle third of the nose.

Among patients and surgeons, the most common aesthetic concerns were nose tip asymmetry, a crooked middle third of the nose and irregularities in the upper third of the nose. Nearly 80 percent of patient concerns were also identified by a surgeon who examined the patients, according to the report in the September/October issue of the journal Archives of Facial Plastic Surgery.

"The discrepancy between patient concerns and surgeon findings arose for a variety of reasons," the study authors wrote. "One of the main reasons is the surgeon's use of a conventional set of anatomical boundaries, specifically regarding the upper versus middle third of the nose. Patients often do not have intricate knowledge of nasal anatomy to properly distinguish between nasal thirds."

Sixty-four (62 percent) of patients said they had breathing problems or other issues with nasal obstructions. The surgeon confirmed problems in 60 (94 percent) of those patients, the investigators found.

"These findings emphasize the importance of physician awareness of patients' concerns, understanding the causes of postsurgical nasal obstruction and clearly explaining nasal aesthetics to patients seeking revision rhinoplasty," the researchers concluded.

More information

The American Academy of Otolaryngology -- Head & Neck Surgery has more about nose surgery.

SOURCE: JAMA/Archives journals, news release, Sept. 20, 2010.
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