Secondary Rhinoplasty

Dr. med. Axel Arlt

  • Specialist in Plastic Surgery
  • Specialist in ENT medicine

Secondary nasal operations (revisions) - challenging procedures that require a true specialist

Revision operations on patients who have previously undergone nasal surgeries elsewhere are one of our specialties, and have represented over half of our nasal operations for many years now. These “revisions,” as they are called, are in no way comparable to initial operations: they are considerably more difficult and represent their own special field of expertise. 

Such operations pose unique challenges not only during surgery, but also even in preliminary examinations and surgery planning. This is because the previous operation(s) has/have changed the anatomy of the nose, and the previous healing process(es) has/have left scar tissue. 

Oftentimes, the exact situation is only visible once the anatomy is revealed, which means that the surgeon needs to be able to react immediately and adjust the surgical strategy. Only a highly experienced surgeon who has mastered a wide variety of surgical techniques will be in a position to do this. 

Before performing secondary nasal surgery, first of all the decision must be made whether or not an additional operation is possible, and to what extent. Assessing the options and risks involved requires a thorough personal examination and detailed knowledge of your surgical history, which is why we ask you to invest the same amount of care in preparing for your consultation appointment as you can expect from us during your operation. 

Please bring the following information with you to your consultation: 

  1. Photographs of your initial diagnostic findings, prior to your first operation—this is absolutely necessary!
  2. A complete list of all your previous nasal operations in chronological order, including the date, type, and scope of the procedure.
  3. Surgery reports from previous operations (if on hand or acquirable).

If you have already undergone nasal surgery in the past, it is absolutely essential that you bring complete photographic documentation of your “before” nose to your consultation appointment here. Oftentimes, important details regarding your previous operation(s) are unclear, and even surgical reports do not provide sufficient informations. 

This is why before photos are particularly important to us!

By “before” photos, we mean photos taken before your first operation. Photographs taken by your previous surgeon are very helpful, but if you do not have those available, we will at least need your own personal photos of the original situation, prior to surgery. 

Considering opportunities and risks carefully is especially important when it comes to secondary nasal surgery. We can only make decisions regarding the operation properly if we can evaluate what is realistically possible, and comparing against pre-operation photos helps us do that much more effectively. We will also need these photos later, when doing detailed surgical planning.

We can perform corrective rhinoplastic and septoplastic operations without needing nasal packing. 

This is possible thanks to our “chondroplastic” nasal surgical technique that we use (sophisticated reshaping of the nasal cartilage, rather than resection). Used in combination with certain special internal stitches, this surgical method offers far superior stabilization during the post-operative healing phase.

On top of that, this procedure is also much more pleasant, because not needing nasal packing means we can save our patients the associated pain and thus make the post-operative period a great deal easier for them. 

Also pleasant: our internal stitches are self-resorbing and do not need to be taken out. 

Click here for more information related to corrective nasal surgery without nasal packing.

Proper medical treatment requires solid knowledge and extensive experience. Optimum treatment processes also require sufficient time.

And we take that time for you. Our practice in Hamburg always schedules generous amounts of time in for each treatment, so that we can ensure that we are not under time pressure with any of our patients.

This is one reason why our consultations are divided up into two separate appointments. In your first appointment, we will discuss your wishes, and talk you about possible treatments and their limitations.

Should you decide to undergo surgery/treatment, we will go over the essentials with you again during the second consultation (also called the surgery planning meeting). Our surgical and anesthesia teams will help you prepare for surgery in order to ensure your safety.

After treatment, our experienced surgical team or night team will personally take care of you. You will receive important information and patient guides on post-surgical care, and we will work with you directly to set up additional examination or treatment appointments.

Dr. Arlt has two medical specialist qualifications: one as a plastic surgeon; the other as an otolaryngologist additionally specialized in cosmetic operations, special head and neck surgeries, and allergology. His Hamburg-based practice is specialized exclusively in the face. 

His personal specialties are nasal surgery (functional and aesthetic) and secondary rhinoplasty (revisions and follow-up procedures on patients who have previously undergone surgery), 

So we perform an accordingly large number of corrective nasal procedures at our practice in Hamburg. More than half of the procedures we perform are revisions on patients who have already undergone surgery elsewhere. 

First-time nasal operations (primary rhinoplasty) should/must combine functional and aesthetic corrections into one procedure. Follow-up nasal operations (secondary rhinoplasty) involve special surgical techniques, and thus require a reconstructive nasal surgeon with particular experience in this area. Corrective rhinoplasty is a job for specialists. Dr. Arlt’s specialist certifications in both plastic surgery and ENT medicine lay a perfect foundation for this specialization; his more than 25 years of experience and mastery of modern, structure-preserving surgical techniques round out the package. 

Click here for more information related to primary corrective rhinoplasty.


Dr. Axel Arlt
Practice community

Esplanade 31 / Ecke Stephansplatz
D - 20354 Hamburg