Rod J. Rohrich Discusses Secondary Rhinoplasty Incision Placement

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Following extensive review of post-operative results in secondary rhinoplasty patients, a new paper in Plastic and Reconstructive Surgery demonstrates that secondary scar placement can be considered and selected independently of the primary scar location.

Dallas cosmetic surgeon, Dr. Rod J. Rohrich, along with a team of medical students, performed an in-depth, retroactive review of 100 cases of revision rhinoplasty performed by Dr. Rohrich. The review was designed to judge the quality and perceptibility of the resulting scars, and the surgeon's decision of incision placement based on the location of the previous rhinoplasty incision site.

The paper states that, "While there has been much discussion in the literature about what transcolumellar scar design creates the best aesthetic result, placement of the scar in a previously opened nose has not been widely discussed."

The more traditional approach in secondary rhinoplasty would be for the surgeon to use the same incision that was used in the primary surgery. In his paper, Dr. Rohrich challenges this assumption.

In the review, 100 secondary rhinoplasty patients had high resolution photos of their incision sites examined by a panel of independent, board certified plastic surgeons who were blinded to the surgical details. The panel judged the scars on a 4 point scale of quality with 1 representing "Imperceptible Scar," 2 representing "Barely Perceptible Scar," 3 representing "Moderate Scar" and 4 representing "Poor Scar." The intention of the scale is to represent the likelihood that an untrained person would notice the scar during an extended conversation.

The review shows that, between the primary and secondary surgery scores, the total difference in scar quality between their first and second surgeries was 0.07 points when the secondary incision site is chosen independently of the primary incision site.

"The primary rhinoplasty incision can sometimes be in a poor location or of poor design," explains Dr. Rohrich, the paper's senior author. "I believe this study has helped to show that rhinoplasty surgeons and their patients are likely better served by choosing secondary incision placement based on the best operative plan independently of the previous incision location."

About Rod J. Rohrich, M.D., F.A.C.S.

Dr. Rod J. Rohrich holds the Betty and Warren Woodward Chair in Plastic and Reconstructive Surgery at UT Southwestern Medical Center. He also holds the UT Southwestern Medical Center Crystal Charity Ball Distinguished Chair in Plastic Surgery. Dr. Rohrich graduated from Baylor College of Medicine with high honors, and completed residencies at the University of Michigan Medical Center and fellowships at Massachusetts General Hospital/Harvard (hand/microsurgery) and Oxford University (pediatric plastic surgery). He has served as president of the American Society of Plastic Surgeons, the largest organization of board certified plastic surgeons in the world. He repeatedly has been selected by his peers as one of America's best doctors, and twice has received one of his profession's highest honors, the Plastic Surgery Educational Foundation Distinguished Service Award, which recognizes his contributions to education in plastic surgery. Dr. Rohrich participates in and has led numerous associations and councils for the advancement of plastic and reconstructive surgery. He is a native of North Dakota and is married to Dr. Diane Gibby, also a plastic surgeon. They live in Dallas with their two children.

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Department of Plastic Surgery