Revision Policy on a Rhinoplasty or Chin Implant. Why Do Some Patients Have to Be Repay Fees to Fix Their Surgeons Work?

I have read of people getting a rhino or chin implant where the surgery did not turn out the way intended. A polly beek deformity, book spine deformity, chin implant malpositioned, a hanging columnella, and other unexpected outcomes. Should the patient have to pay more money to the same surgeon to fix their work? They already paid for the OR/anesthesiologist, is it fair to ask them to cover those fees again when its not their fault? Shouldn't the work be done correctly the first time?

Doctor Answers (9)

Who pays for a revision after rhinoplasty or chin implant

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There are two big factors that influence your result with rhinoplasty- one is surgical technique, and the other is how your body heals. The surgeon can control the surgical technique, but each patient heals differently and this can change the result in less than desirable ways. Occasionally despite making the nose look "perfect" during surgery, your body has in inherent healing properties or scar forces from prior injury that can distort the result over time. Sometimes based on the patient history the surgeon can inform the patient that they are at higher than average risk for needing some type of revision, but every rhinoplasty has a chance of needing a revision, and that is simply a known risk of having surgery. It does not mean an error was made by your surgeon. Often surgeons will do revisions without charging an additional surgeons fee, even though it is costing them both time and lost income by spending that time operating for free. The reason most surgeons do this is not because they made a mistake, but because they want their patients to be happy. You would however have to pay for the operating room and anesthesia services, since the facility and anesthesia provider are not willing to offer free services even if your surgeon does. So basically the bottom line is that neither the patient nor the surgeon is at fault for the way your body heals. That is not to say surgical technique is never at fault, so in these cases a good place to start is a discussion with your surgeon, and also getting a second opinion from a board certified plastic or facial plastic surgeon with experience doing both primary and revision rhinoplasty.


Beverly Hills Plastic Surgeon
4.5 out of 5 stars 10 reviews

Payment for Revision Surgery

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It is not a question of fault. A surgeon does not have total control of the healing process. Having said that, I tell patients pre-operatively that if we don't achieve the established goals I will make the necessary corrections which are minor. They are only responsible for a reduced anesthesia charge: these professionals are independent contractors.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

Policy for revision fees

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Results after surgery are determined by many factors which are uncontrollable such as unpredictable healing factors, postoperative infection, asymmetric swelling affecting the underlying cartilaginous structure. These factors can cause a perfect result at the time of surgery to become slightly imperfect. The work was still done correctly during surgery and professional fees only covered this work. Additional work that needs to be done for the revision may not necessarily be covered. Every surgeon has his or her own policy for revisions. Some surgeons will not charge additional professional fees for revisions if the result did not match agreed expectations while others will charge a small additional professional fee for this revision. Most surgeons will charge, however, for OR costs or anesthesia fees because these are costs that cannot be controlled by the surgeon. 

Kristina Tansavatdi, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

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Office policy on surgical revisions

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No one wants to perform corrective or secondary surgery.  Slight imperfections in healing can lead to changes in the nasal shape.  Failure to meet expectations can be due to the oddities of healing as well as technical problems.  When a plastic surgeon has to perform a revision it is not exactly free.  He is devoting time to your revision surgery that could have been spent on another patient.  Unfortunately there are costs associated with a surgical procedure.  You should make yourself aware of the office policy on revisions.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 7 reviews

The Risk of Revisional Surgery Is An Avoidable Consideration For Any Plastic Surgery Procedure

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Plastic surgery is as much an art form as it is a science and how any patient's body heals is not always predictable. Thus no surgery can be guaranteed as to the exact outcome. The vast majority of revision work is not done because the plastic surgeon did a 'bad job' or did anything less than their best effort.  

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
5.0 out of 5 stars 26 reviews

Fees

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I do not charge for a revision surgical fee; but the patient does pay for the facility and anesthesia fee.  That is the way most surgeons do.  Surgery is unpredictable and sometimes results do not turn out as expected and it is not necessarily  anyone's fault.  Donald R. Nunn MD  Atlanta Plastic Surgeon.

Donald Nunn, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 5 reviews

Revisional surgery is part of any aesthetic procedure.

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Most surgeons that I know do not charge an additional professional fee for revision work. When necessary there will be auxiliary fees for the facility and anesthesia.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 7 reviews

Fees for Revision Rhinoplasty

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Rhinoplasty is widely considered the most complex cosmetic procedure, so understandably, even in the best hands, touch ups are occasionally necessary. Most experienced surgeons will charge a fee to cover your anesthesia or surgical supplies (O.R. fee). The amount is often minimal, because your surgeon will want you to look your best.

Roy A. David, MD
San Diego Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

Revision Policy on a Rhinoplasty or Chin Implant. Why Do Some Patients Have to Be Repay Fees to Fix Their Surgeon's Work?

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            Every surgeon will have a different policy on this.  I do not charge anything in the rare event that a revision is necessary.   I will tell you though that a nose or any surgery can look perfect on the table, and the healing will be imperfect.  It is easy to blame the surgeon in these cases, but many times this is not the result of poor planning or execution.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 180 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.