According to the number of attempt of Rhinoplasty Surgery:

According to the rhinoplasty society – https://www.rhinoplastysociety.org/secondary-rhinoplasty

1. Primary Rhinoplasty:

The primary nasal shaping procedure is conducted when no previous nasal operation has been done. The existing nasal structure is altered to achieve the desired result.

2. Secondary Rhinoplasty

The secondary nose shaping/nose job is conducted when someone is not happy with the result of the primary rhinoplasty. In some cases, there may not be enough septal cartilage left for the reconstruction.

3. Revision Rhinoplasty:

This broader terminology can apply to rhinoplasty required beyond a secondary operation, such as a third or fourth operation.

Common Problems that Require Secondary/revision Rhinoplasty:

Nasal airway obstruction

Collapse of cartilage or nasal bones

Artificial cosmetic appearance to nose (“Overdone nose job”)

Internal and external nasal valve collapse

Worsened asymmetry

Over reduction or inadequate reduction of dorsal height (bridge height/hump)

Incomplete shaping (not enough of a cosmetic change)

Excessive or inadequate tip projection

Excessively narrowed nasal tip (“pinched tip”)

Excessive internal and/or external scarring (thickened scar tissue)

According to Ethinicity

It is vitally important to understand an ethnic patient’s aesthetic goals. Some request cosmetic enhancements that preserve their unique ethnic characteristics; others will seek a more Western or white/European standard. Fastidious patients may voice their concerns using accurate terminology, whereas others will have difficulty identifying features they like and dislike. For the latter, photographs of desirable noses will help to get desired planning

Hispanic Heritage

Hispanic groups exhibit varied features combination of their individual Spanish and American Indian descent.

One spectrum, Castilian nose, with long nasal bones, a high dorsum, and normal tip projection is essentially a white nose. Another spectrum is the mestizo’s nose, and overall a short and a broad nose, with thick skin, wide alae, a retracted columellate, under the projected tip. Any anatomic combination along this continuum may be seen.

African Heritage

It is characterized by a wide, low dorsum and broad, under-projected tip, and broad middle vault. Thick skin, fat layer leads to the bulbous tip. Anacute nasolabial angle is caused by both an under-rotated tip and bi-maxillary protrusion.

The nasal base is often wider than the inter-alar distance, and the under-projected tip contributes to excessive alar flaring.

The goal of rhinoplasty in a patient of African descent include achieving, straight dorsum, improved tip projection and definition, decreasing alar flaring andalar base width and narrower. Tip definition is improved by suture techniques and cartilage grafting. Improvement of low nasal dorsum require cartilage graft or silicone implant.

Asian Heritage

Typically, it is a low radix, low dorsum, and broad, under-projected, round, blunt tip. Thick, sebaceous skin contributes to poor definition. The columella and soft triangle are retracted. They have an acute nasolabial angle and protrusive premaxilla. The radix of Asian patients typically lies at the midpupillary level.

Cartilage is overall weak and soft. Dorsal graft placement thus depends on the degree of ethnic characteristics the patient wishes to maintain.

Middle Eastern Heritage

Skin is thick and sebaceous and is most prominent at the supra-tip. The radix may over-project, the bony and middle vaults are wide, and the large dorsal hump is common. Tip is poorly defined; under-projected droopy tip. There may be an acute columellar labial angle. The tip deformities may be exacerbated by hyper dynamic action. Nasal deviation and nostril asymmetry are also common.

The goal of rhinoplasty in a Middle Eastern patient is moderate dorsal hump reduction, narrowing of the wide nasal bones, debunking of soft tissue, correction of the nasal tip potion, improvement of tip definition and correction of nostril asymmetries.

Septorhinoplasty

It is also called septorhinoplsty, when the nose job is done to correct the septum, the structure inside the nasal cavities is deviated or shifted thus obstructing proper breathing. Along with cosmetic correction, Septoplasty is done by making a small incision on the nasal inside on one side. After that, the misaligned cartilage and bone is then removed, which allows to sewing the skin lining back to itself using a quilting type suture. With the deviated cartilage and bone removed the skin lining can lay much straighter, which then allows for smoother airflow while breathing.

Rejuvenation Rhinoplasty

This type of nose shaping/nose job addresses nasal appearance related to aging, including a deterioration of the cartilage, and a thickening of the skin in the lower portion of the nose. In the procedure, the surgeon gently lifts the nasal tip, restores the shape of the nostrils to give a youthful look to the nasal area.