For Dr. Bentkover, Rhinoplasty is a Passion.

Operating in Worcester and Boston, Dr. Bentkover has dedicated his career of over 28 years to the art and science of rhinoplasty.  Because Dr. Bentkover is so committed to this specialty, he accepts difficult and challenging revision rhinoplasty cases (also known as secondary rhinoplasty) and commonly sees patients from all over New England. 

You should make a careful list of the cosmetic features and functional problems with your nose.  The marriage of form and function is just as important here as it is with primary rhinoplasty.  The difference is that with a revision operation, especially if it is one a series of operations, there are limiting factors that may make it impossible to achieve all your goals.  The most common limiting factors are the amount of scar tissue under the skin (which increases with each operation) and large amounts of missing cartilage in the nasal tip and nasal septum.  It may not be reasonable to expect any surgeon to achieve all of your goals.  Therefore, before coming for your consultation, you should prioritize your surgical objectives.  It will be very helpful for Dr. Bentkover to know what really bothers you about your nose.   

At your initial consultation Dr. Bentkover will carefully and realistically evaluate your nose. If he thinks he can help you, he will work with you to come up with a realistic plan. If you come to Dr. Bentkover for an opinion on a revision rhinoplasty, you must bring a copy of the operative note (s) from your previous operation (s). These notes are essential in determining what specific changes have been made to your nose and where to start to discuss and plan a revision operation.

Rhinoplasty is the most technically challenging of the facial plastic surgical operations, and the surgeon cannot always control all the changes that occur in a nose after surgery.  Your nose actually continues to heal for about 18 months after surgery and may show some further changes as you age.  An outcome that you may consider unsatisfactory is not necessarily a reflection on your surgeon.  Even the most expertly performed operation, by the most experienced surgeon, can never be perfect.  Many experienced rhinoplasty surgeons agree that the outcome of the initial operation is about 80%-90% predictable.  Despite the fact that there is no such thing as a “perfect rhinoplasty”, most patients find there noses much improved and are very pleased with the results.  

The best chance to correct cosmetic or functional problems with your nose is at the first procedure. However, much can still be corrected by an expertly performed revision operation.  You may have changes after a rhinoplasty that you think make your nose look distorted or interfere with your breathing so much that you might consider having a revision rhinoplasty.  Nationally, About 10-20% of patients may choose to have some secondary surgery.  This may range from just filing down or trimming some degree of a persistent bump on your profile (secondary hump removal) under local anesthesia to a major revision of your nasal tip and profile. Repair of these problems may require a revision rhinoplasty along with a septoplasty (to straighten the nasal septum - the cartilaginous and bony wall in the middle of your nose that separates the air passages) and a repair of your nasal valve system.  The nasal valve system does much to control the amount of air that flows through your nose and may have been weakened by the removal of cartilage at the time of the original procedure.  The repair of the nasal septum and nasal valve system may require cartilage grafts from the nasal septum or from the ears. 

Dr. Bentkover will carefully discus all the details of his recommended procedures with you so that you can understand the reasons for his recommendations and the likely outcome of the surgery.  He will draw sketches of the proposed procedure for you and “morph” your images on the computer to try to simulate the outcome.

In the Before and After section we have posted just a few of our patients.  We have more to show you in our office.  Some of our patients prefer not to have their photos posted on our website.