Why Can't I Have an Early Rhinoplasty Revision?

I had Rhinoplasty overseas, and asked the surgeon to minimize my tip about 2-3mm, to soften my look. When I woke up and the splint was removed, I noticed he gave me more than what I asked for. He took half my nose, left me with a bulbous tip, short nose deformity, and a pig snout! Since then, I've been depressed, confined myself at home, and just feel violated and very unnatural looking. I can't look at myself in the mirror anymore. I've asked for second opinions, and surgeons want me to wait from 6 months to a year. I don't understand WHY; my nose is not getting any longer in 6 months, that's very clear. I understand the healing process takes up to a year, but why prolong my misery when swelling clearly isn't going to resolve my nose issues?

Doctor Answers 15

You are right about the nose not getting longer!

The reason we make patients wait 6 months or more is to let the tissue soften and return to its final shape. However, I think there are exceptions to this rule based on how far along you are in the healing process. You do not want to compound the problem. You should see a revision rhinoplasty specialist with a great deal of experience.

A short, overdone nose is a very challenging problem and should only be undertaken by a surgeon who is familiar with this problem. He should be able to show you before and after revision noses like yours.


Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 17 reviews

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You don't have to wait that long for a revision rhinoplasty

Dear Lostnose,

First, let me say it's important for you to try to get back into your normal life with the knowledge that this can be improved.

That being said, there is a general rule in facial plastic surgery and with rhinoplasty that revision should be held off for at least 6 months to a year. The reasons are varied but most importantly to allow for your skin to have adequate time to heal, especially in regards to the blood supply. Others will say that it allows for all the swelling to settle to give a better sense of what needs to be accomplished during the revision. Still more, when the nose is re-operated before that time there is more inflammation present which results in a bloodier and thus more difficult procedure.

All this being said, we do not think that this rule is dogma. Individual cases should be viewed as such and a plan for moving forward can then be made. For cases where we may think that time will only make things worse we do occasionally intervene sooner.

I hope the knowledge that this can be made better will bring you some sense of relief and solace. If we can be of any further help, please feel free to call or email us.

Warm Regards.

Peyman Solieman, MD
Beverly Hills Facial Plastic Surgeon
3.0 out of 5 stars 3 reviews

Early Rhinoplasty Revision

Sorry to hear about your distress.  Your experience underscores the dangers of overseas surgery. The general reasons to wait include:

1) providing adequate time to heal, especially in regards to the blood supply

2) ensure swelling has settled in order to better understand the objectives of the revision

3) any inflammation existing may complicate the surgery

 

However, each case is different. Consult with 3 - 4 board certified plastic surgeons to determine whether you can proceed with the surgery earlier.

 

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 21 reviews

Wait for proper healing before Revision Rhinoplasty

I understand Rhinoplasty patients that didn't get what they wanted are impatient to have Revision Rhinoplasty but...the skin, of the nose is not properly healed and doing a Revision Rhinoplasty could cause damage to the skin of your nose that is permanent.  Wait the full 6 months and don't risk it.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 12 reviews

Wait 9 - 12 months before considering revision rhinoplasty

Typically most of the swelling in the nose resolves within the first few weeks following rhinoplasty but there is a small residual amount which can take up to 12 months or longer to resolve. There is also a gradual process of contracture as the nose becomes increasingly refined, particularly at the tip. Going in too early for revision surgery is not advised because there may be other issues with the nose which haven't yet become apparent. Additionally, the surgeon may be addressing issues which are still evolving. Revision rhinoplasty is among the most challenging of plastic surgery procedures and should be performed by surgeons with extensive training in this area. It is particularly important to have patience in these cases, to optimize the chance of success when the revision surgery does take place.

Umang Mehta, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 32 reviews

Surgery can result in unfavourable results

It is generally accepted that a 5-10% revision rhinoplasty rate occurs in the best of experienced rhinoplasty surgeons.  Waiting 6-12 months allows the tissues to fully heal so that the surgeon can assess what needs to be done to correct the problem.

Robert Mounsey, MD
Toronto Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Much better to wait

You will likely need cartilage grafting to your nose which will require the skin of your nose to be back to normal to allow the nose to expand.  Seek an experienced surgeon for your revision.  Unfortunately this could cost you a great deal more than the cost of your primary surgery performed overseas.

Sam Naficy, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 153 reviews

Waiting after rhinoplasty surgery - healing after rhinoplasty

Optimizing results with a secondary rhinoplasty requires patience on the part of the patient and the physician. Early in the postoperative course (first 6 months to one year) there is moderate swelling that may obscure full visualization of the underlying structural integrity of the nose. It is always best to wait at least 6 months to one year prior to revision. Although one year is a classically described time period, 6 months may be appropriate for specific cases.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 57 reviews

Wait one year for revision rhinoplasty (in most cases)

Trying to perform a revision rhinoplasty during the healing period is like trying to hit a moving target.

The maneuvers we perform as surgeons are based upon what the nose looks like at the time of surgery; we cannot anticipate how things will end up necessarily. Thus, we may add or subtract too much, rotate too much or too little if we do the surgery while the nose is still healing.

Best to wait until this is complete. I know this is difficult to do, but to get the best possible long-term outcome, waiting is probably best. Make sure you communicate your feelings/concerns with your surgeon, who can help guide you through this process.

Hope this helps,
Dr. Sam Most

Sam Most, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 37 reviews

Wait at least 6 months for your revision rhinoplasty if not 1 year

I will give you an analogy. Going back into a nose that has been operated on is very difficult. It is like trying to peel a stamp off of a letter that has been on there for a while.  We want to be able to get that stamp off in one piece without ripping or tearing it. The longer you wait (up to a year) the easier that is to do. You already had a bad experience now you want to give yourself the best opportunity to get the results you desire and your problem is very complex and will require a rib graft to elongate your nose appropriately.  Don't let anyone jump in there too early because if this revision doesn't go well, the third time will be even that much more difficult.

Jason B. Diamond, MD
Beverly Hills Facial Plastic Surgeon
4.0 out of 5 stars 5 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.