Rhinoplasty
Boston, MA

Revision rhinoplasty is an aesthetic nasal surgery performed on a patient who has undergone a previous nose job with unsuccessful results. The patient may be unhappy with the cosmetic outcome, the function of the nose, or both. Commonly, this surgery represents a complex challenge to the plastic surgeon due to scar tissue, requiring advanced rhinoplasty techniques.

The initial steps of a Revision Rhinoplasty include a thorough discussion with the patient to understand desires, fears, reasons for the unhappiness and the goals of a revision rhinoplasty. The examination may reveal a wide array of possible problems. The advanced rhinoplasty techniques may include cartilage grafting to support nasal structure and reestablish strength, special internal suturing techniques, removal of scar tissue and corrective measures to the cartilage and bone of the nose.

During his training years, Dr. Fechner worked extensively with some of the world’s foremost rhinoplasty authorities at Harvard, Cornell, Columbia and NYU. Today, he lectures on rhinoplasty surgery both nationally and internationally, and is constantly monitoring new developments in cosmetic science that can help clients achieve outstanding rhinoplasty outcomes.

Dr. Fechner strongly believes that a successful rhinoplasty should result in a natural-looking nose that not only fits the patient’s facial features, but functions normally and maintains its appearance for decades to come.

Viewing our before and after pictures as well as bringing in photos of your own will help align doctor and patient, so that both parties are on the same page regarding your aesthetic sensibilities. Additionally, the doctor may use advanced 3D imaging to help you predict your outcome more accurately.

During open rhinoplasty, a small incision is created at the base of the nose, allowing the surgeon to lift the skin up and modify the nasal structure with ease and accuracy. This type of surgery is primarily for those patients who require dramatic changes both cosmetically and structurally.

Closed rhinoplasty does not require any external incisions. Rather, the work is performed through the nostrils. The benefit of closed rhinoplasty is that the technique is scarless, but the downside is that only more modest adjustments can be made to the shape and appearance of the nose.

Thanks to his unique expertise and knowledge, Dr. Fechner is comfortable with both open and closed rhinoplasty surgical techniques. He will carefully select the best approach for you based on the specific issues that need to be resolved in the nose including its shape, size, and/or structure.

Aesthetic surgery is performed to correct cosmetic issues that bother the patient and cause self-consciousness. While this type of surgery may be performed initially to improve the client’s looks, there is often a byproduct of structural improvement as well, which can help the client to breath better and achieve a more restful sleep.

In addition to investigating your cosmetic concerns, Dr. Fechner will perform an all-inclusive functional assessment of nasal allergies, nasal obstruction, nasal septum and turbinates, or issues associated with chronic sinus disease and sinus headaches.

The prominent location of the nose within the face makes it susceptible to trauma. The nasal bones are the most commonly broken bones. The consequences of nasal fracture are quite significant, often resulting in nasal bleeding, swelling and bruising around the eyes and cheek, lacerations of the nasal skin, impairment of breathing, snoring, and decreased or absent sense of smell.

In addition, the overall facial appearance can change with an asymmetrical, crooked nose or it may develop a new or larger nasal hump. This is the result of fractures of the nasal bones, the nasal septum and the nasal cartilages all together, making surgery a rather complex situation.

Dr. Fechner favors an earlier intervention to optimize results. Dr. Fechner’s thorough understanding of functional and aesthetic nose surgery helps him to achieve excellent outcomes in repair of a broken nose in Boston. He will use a combination of skin and cartilage grafting, along with traditional reshaping techniques to heal the nose internally and externally. Finally, the doctor may utilize injectables and dermal fillers as a finishing touch to create extremely natural-looking contours and minimize discoloration.

Right after your surgery – After having undergone surgery with anesthesia, you will need someone to drive you home. It may be a good idea to schedule a helper for the first week or so to assist you in performing chores, childcare and other household tasks. You will receive pain medications from the doctor as well as a detailed aftercare plan with instructions for wound care, sleeping, showering, eating, exercising and returning to work.

The first week – You will continue to take your pain medications in order to combat any discomfort. You will have a splint on your nose (perhaps an internal splint as well) that will help it to maintain its new shape as it heals. You may encounter swelling and bruising in the mirror that alarms you, but rest assured these symptoms are normal and will slowly subside.

The first month – The doctor will remove your splints and check up on you to make sure your recovery is progressing smoothly. You will be able to return to work after 3-4 weeks, provided everything looks good to the doctor. You can wear makeup to help camouflage any lingering discoloration. While swelling will now be less than right after your surgery, you may still see some, but overall you will be enjoying the positive benefits of your surgery. It’s important that you still refrain from vigorous exercise until six weeks post-op.

Full recovery – Your rhinoplasty results will continue to improve over time, as swelling decreases over the next year. Gradually, your improved nose will become your new normal, and you will be able to enjoy having your picture taken, attending social events, and dating, knowing that you look like your best and most authentic self.

When evaluating a surgeon to perform your rhinoplasty, it’s important to avoid assessing the procedure based on costs. A rhinoplasty gone wrong can result in enormous time and fees for revision surgery, so it’s best to get things right the first time by choosing an experienced, accomplished surgeon with a reputation for excellence.

That being said, costs will vary based on the facility fees, surgeon’s fees and anesthesia fees. The average cost for rhinoplasty in the Boston area is between $14,000 and $18,000. The number will depend on the extent of the work performed, and on whether the procedure is a primary or secondary rhinoplasty.

Dr. Fechner is a board certified plastic surgeon who is committed to offering cutting edge procedures with naturally elegant and personalized results. In addition to his rigorous training and artistic eye, Dr. Fechner is deeply empathetic and caring, establishing long lasting relationships with his clients based on trust and integrity.

Dr. Fechner studied at the University of Freiburg Medical School, after which he completed his surgical internship at Massachusetts General Hospital (MGH) in Boston. Dr. Fechner then continued to hone and improve his abilities with a four-year Harvard residency at the Massachusetts Eye & Ear Infirmary, where he focused exclusively on surgical procedures for the face, head and neck region.