Secondary Rhinoplasty Surgeon

Surgeon with “super-specialization” in secondary rhinoplasty

Even more than the primary, secondary rhinoplasty requires advanced practical and theoretical skills. The surgeon must operate with the utmost precision, versatility, and maturity; he/she has to make the best decisions from the creation of the surgical plan to its accurate execution. When the structural support of the dorsum or tip is insufficient, he/she must be prepared to take material from other sites. The obvious consequences include increased technical complexity, risk of side effects in the sampling sites, and lengthening of the operating times. All these critical issues, more than a specialization, require surgical super-specialization.

Dr. Pietro Palma, with over 25 years of exclusive commitment to the most challenging of all plastic surgery procedures, has acquired super-specialization in secondary rhinoplasty. Despite meticulous planning and execution, surgery cannot always guarantee achieving 100% of its goals. The anatomical uniqueness of the structures determines a margin of unpredictability in all operations – and even more in rhinoplasty revisions.

Read more

Margins of unpredictability in surgery: why you should always turn to experienced operators (especially in secondary rhinoplasty)

In surgery, there is no room for approximation. However, NO operation – whatever part of the face or body it concerns – can assure 100% success in 100% of cases. Unpredictability increases when it comes to rhinoplasty, a specialty that requires expertise and talent to perform infinitesimal maneuvers over delicate osteocartilaginous structures.

Small imperfections can remain in about 8-10% of cases (even where the patient recognizes an overall improvement) due to the extent of the initial defect and other individual variables. Extensive reconstructions or multiple targets can require an approach that Dr. Palma calls “programmed second time:” the operation is divided into two or more sessions to optimize the result.

The healing process is both patient-specific and genetically determined. Healing adds further unpredictability to the primary and secondary rhinoplasty results. This means that even with identical procedures, each patient recovers in different ways and times. The margins of uncertainty increase in revisions, and even more in the presence of extreme resection of nasal tissues, reckless use of grafts and extensive cicatricial fibrosis (scar tissue formation).

Dr. Pietro Palma: secondary rhinoplasty surgeon in Milan

A long and substantial experience in rhinoplasty is crucial to minimize the risks of the procedure, preventing dissatisfaction and complications, which are a rare but always possible outcome. When the inexperienced surgeon underestimates the pitfalls and repercussions of rhinoplasty, technical problems, adverse results, and complications can follow. Dr. Pietro Palma has been practicing at the national and international level for over 25 years; his selective focus on nasal surgery (corrective, functional, plastic) is the foundation for the achievement of a super-specialization in primary and secondary rhinoplasty.

Surgery is not always recommended after the first consultation: sometimes (about 2% of the patients), both psychological and physical reasons can advise against the procedure. The preliminary phase allows the rhinoplasty/septorhinoplasty specialist to make an accurate pre-operative diagnosis. This phase is absolutely mandatory for custom-designed nose surgery or, as we call it, YOUnique Rhinoplasty™.

No rhinoplasty is routine. This is even more importantin revision cases where the surgeon’s professional skills, the maturity of his decisions and personality traits, precision and attention to detail make a real difference. The application of skills gained through years of experience enables the specialist to dominate unexpected intra-operative anatomical situations, and finalise technical steps.

Dr. Pietro Palma is available for exploratory interviews at Clinica del Viso (tel +390263611932 – and Casa di Cura La Madonnina (tel +3902.58395555 –, both located in Milan. These clinics are convenient from all over Italy and abroad. The consultation will allow the secondary rhinoplasty surgeon to assess the unsatisfactory outcome of previous nasal surgery intervention(s) and plan possible surgical repair.