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!

+3

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 14 reviews

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

+3

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
5.0 out of 5 stars 1 review

Wait one year for revision rhinoplasty (in most cases)

+2

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 32 reviews

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What's Wrong with Early Rhinoplasty Revision?

+2

Hi Lostnose,

I am so sorry that your overseas rhinoplasty experience has resulted in a nose that you did not desire. Rushing ahead too soon after a your first operation can result in compromise of blood vessels to your nose, permanently damaged skin, increased bleeding, and increased scar tissue formation, not to mention a much more difficult operative field for your surgeon to work in.

Ideally you would like to have only one more revision rhinoplasty, and you optimize that likelihood by waiting at least 6 to 12 months after your initial rhinoplasty. Also by waiting there may be other defects that manifest themselves over time (the next few months) that would require yet another surgery.

You can easily find surgeons willing to operate on you sooner, but I would strongly advise you to wait 6-12 months. I know how anxious you must be to have your nose repaired, but patience will only benefit you in the long run.

Use the time to consult and meet prospective revision surgeons until you find a doctor that you feel most comfortable with.

Good luck and be well.

Dr. P

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 23 reviews

Why wait for a revision rhinoplasty?

+1

This is a great question. Certainly the issues with your nose do not seem to be improving and in many ways are not likely to improve without revision. The reason to wait is for the nose to "settle" and for all of the swelling to resolve.  This will give the revision surgeon the best chance to correct and improve the nose, and will help you have a shorter, less difficult recovery after the second surgery. Best of luck!
 

Evan Ransom, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 37 reviews

Early Rhinoplasty Revision

+1

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 15 reviews

Wait for proper healing before Revision Rhinoplasty

+1

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

Revision Rhinoplasty and why you have to wait?

+1
First of all I would like to express my sincere empathy for your situation. I have performed Rhinoplasty surgery for over thirty years and it always discerning to me when I see a poor result from other surgeons and the emotional trauma this causes can be quite significant. With this said, please try and resume your life and know that your situation can be improved upon with a Revision Rhinoplasty. I understand your urgency in the matter however waiting the appropriate post operative time is important. This time may vary from patient to patient and the procedure originally done. It is a good time to start looking for a surgeon, discussing all of your concerns, reviewing their post operative photographs and determining that they have a lot of experience in revision rhinoplasty surgery. I wish you the best and remember you only want one more procedure, so choose wisely!

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 127 reviews

Wait 9 - 12 months before considering revision rhinoplasty

+1

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 26 reviews

Surgery can result in unfavourable results

+1

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

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.