Revision Rhinoplasty: Q&A
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How Many Revision Rhinoplastys is Too Many?
My nose has been operated on three times and I am still unhappy. I have trouble breathing through my nose and I do not like the way it looks. Is it possible for me to have another surgery or should I just live with it?
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31 Doctor Answers |
Asked by
Eva S
in Seattle, WA
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Revision rhinoplasty still an option
There is no finite number of rhinoplasties that one can undergo. That being said the more procedures your nose undergoes the more difficult any revision becomes due to scarring and injury to the underlying nasal framework. I would recommend consulting with an experienced revision rhinoplasty specialist who can examine your nose and determine what can be done to improve the function and appearance of your nose. I find that patients often end up having several revision...
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How many revisions too many?
There is no absolute number but what matters is the health of the tissue and whether there is unrealized potential. Also very important to make sure that your expectations are realistic and you do a good job communicating them to your surgeon.
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Revision Rhinoplasty
There are many factors that determine whether or not patients are good candidates for secondary (revision) rhinoplasty. The number of prior surgeries is less important that the quality and characteristics of the nasal skin, framework, and the amount of scar tissue present. Other factors include the extent of the deformities, the risk:benefit ratio of correcting problems without causing addtional ones, and also the patient's psychological stability.
These are all factors that must be...
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Need Yet Another Nose Procedure - Orlando, FL
I am interested in a secondary rhinoplasty. My prior rhinoplasty was performed in 1998 and...
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Revision Rhinoplasty advice
I certainly appreciate your frustration, as you have been through the surgery and recovery period three times and are still unhappy with your aesthetics and ability to breathe. In my opinion, form and function go hand in hand. That is, a nose which is well constructed and well balanced will also "work" well... Revision rhinoplasty is among the most technically challenging of plastic surgery procedures so be sure to see a rhinoplasty specialist with the training and expertise t
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+2
Revision Rhinoplasty - Look for an experienced surgeon
The ideal number of revision rhinoplasties should be zero. For this to happen you and the surgeon need to share a common goal that is realistic. The surgeon needs to make an accurate diagnosis and execute the operation well and the patient needs to co-operate with all postoperative instructions. Now that you're up to 3 surgeries with airway obstruction you need, more than ever, to see someone who can listen to your concerns and then offer a detailed diagnosis and treatment plan. You need...
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How many revision rhinoplasty is too many? "Depends"
It is possible for you to have a nose that is natural-looking and functions well. The fact that you have difficulty breathing makes the decision to do a revision rhinoplasty a good option. You should obtain your pictures and operative report and bring it with you to the consultation. The number of the previous operations is not as important as the degree of scarring, cartilage and tissue loss as well as the degree of the deformity. You probably need to have cartilage graft to correct the...
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Revision rhinoplasty can improve the nose
An experienced rhinoplasty surgeon must assess the nose to give an unbiased opinion as to the likelihood of significant improvement with the next surgery. Each procedure is successively difficult with an increased chance for a complication. The best chance for a good result is the first surgery, so choose your surgeon carefully.
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Revision rhinoplasty - breathing and aesthetic issues
Revision rhinoplasty is one of the most complicated procedures in facial plastic surgery. As such, it would require a personal examination and counseling by an experienced surgeon to determine if it is right for you. Certainly, if you are having breathing issues, a combined functional and aesthetic revision may be necessary.
After having had two revisions (three surgeries), it is best that you seek someone with extensive experience in revision rhinoplasty specifically. You may require any...
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Redo Rhinoplasty
Redo rhinoplasties are extremely challenging. In the cosmetic world they may be one of the most difficult things we do. It is impossible to say without a close examination and history if there are things that can be improved.
While a board certified plastic surgeon is always a good place to start, it is reasonable at your third surgery to go to someone with world renown experience. People like Jack Gunter in Texas or Nick Tabbal in NY - there are literally just a handful of kind of...
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How Many Revision Rhinoplastys is Too Many?
Revision Rhinoplasty is and should always, IMHO, be evaluated using the idea of diminishing returns. The more the nose is operated upon, the less quickly it heals, the more cartilage and bone that has been removed from previous Rhinoplasties, the more likely excess scar will build up inside blunting the internal nasal shape and the more narrow the benefit curve becomes.
The nose should always, IMO, be evaluated aesthetically to create something that is refined...
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Revision Rhinoplasty
As rhinoplasty is the most difficult and complicated operative procedure that we do in aesthetic plastic surgery, revision rhinoplasty is even more difficult. In my opinion, revision rhinoplasty should only be done by rhinoplasty surgeons with significant amount of these operative procedures. Not only are they difficult procedures, but the patient can only do so many revisional rhinoplasties without significantly and permanently deforming the nose. It would behoove a patient to take...
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How many rhinoplasties is too many?
The more rhinoplasties you have, the more difficult each is. 3 rhinoplasties may or may not be too many, depending what was done with each surgery. Most rhinoplasties today increase the nose's strength by adding cartilage, so you don't have to worry about getting a Michael Jackson look. If you are still having trouble breathing and don't like the way your nose looks, find a skilled surgeon who has done a lot of revision rhinoplasty, get several different...
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Manhattan Facial Plastic Surgeon
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Multiple Rhinoplasty Challenging for Surgeon and Patient
You have had several surgeries already without complete success. Have you had some benefit from the previous procedures? Even with an expert Revision Rhinoplasty surgeon it is exceedingly difficult to make improvements on a nose that has been operated on this many times. It is always difficult for a surgeon to tell a patient to ”just live with it” but in the end that may be the best advice.
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Too many rhinoplasties???
The answer to your question is that it depends on the patient and the examination. Part 1 of the problem is to determine if revision is possible. Some of the factors that affect the answer to this question are: 1. How tight is the skin envelope? 2. How much cartilage is present. 3. Are there any functional problems 4. Is their any cicatrix of the nostrils, etc
The next part of the question is the psychological aspect of rhinoplasty. What are...
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Revision Rhinoplasty
One key tenet in your situation is to not try to redo the whole thing a 4th time. Pick some specific areas to fix, for example breathing, etc. and get it done. After so many surgeries, the cartilage framework of the nose is at risk of being compromised and the soft tissue covering is at risk of having a lot of scar tissue. Both of these issues introduce high degrees of variability in healing.
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You should have another surgery
It would be possible for you to have another surgery. You are not only having functional, breathing, but also cosmetic issues with your nose. Revision rhinoplasty is a technically challenging surgery and should be preformed by a highly skilled surgeon.
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Revision Rhinoplasty Limitations
There are a variety of factors that go into deciding whether or not you can have additional revision rhinoplasty surgery. One of the most important considerations relates to your skin integrity. If you have natively thin skin and/or your skin was made thinner as a result of the prior rhinoplasty procedures, the risks of further surgery might outweigh the benefits. Other considerations include how much cartilage was removed and whether or not you need grafting performed. All of these...
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Revision difficult after each previous surgery
I’m sorry to hear you are unhappy with your nose after having gone through three surgeries. Thirty percent of Rhinoplasty surgeries are a revision with a previous Rhinoplasty with another surgeon. Nationwide, 20% of Rhinoplasty patients required a revision surgery to obtain their goals. In our practice, about 8% of our patients required a revision surgery. That said, there is no real limit to how many Revision Rhinoplasty surgeries you can have, however, with every Rhinoplasty...
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Third revision rhinoplasty can help certain patients
I am sorry to hear that you are still having problems after three nasal surgeries. It does become harder to provide good, functional nasal breathing and a nice aesthetic outcome each time a revision rhinoplasty is performed. Your facial plastic surgeon is not only fighting against scar tissue and wound healing forces but trying to counter whatever maneuvers were previously performed and did not provide the outcome you were looking for. With that said, another revision rhinoplasty should not...
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How many revision rhinoplasties are too many?
The number of revision rhinoplasty procedures which a patient can have depend on a variety of factors:
Vascularity and integrity of the soft tissue envelope. Over multiple rhinoplasty procedures, the skin tends to thin, making subsequent procedures more difficult.
Anatomic issue requiring revision- Some issues are more easily corrected than others. A frank and open discussion in regards to what can be expected and what is possible should be entertained
Goals-...
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Achieving satisfactory revision rhinoplasty
Revision rhinoplasty requires a surgeon with experience and expertise to undertake this rather difficult procedure. It is not just the three surgeries that you've had, but the state of your nasal tissues that matters. A nasal specialist would assess the degree of scarring, residual nasal cartilage, need for additional cartilage (ear, rib, homologous) and prepare an appropriate surgical plan. Make sure you see a rhinoplasty specialist who can properly asses your condition to see...
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Each revision rhinoplasty is harder and less predictable than the one before.
I really find revision rhinoplasty a challenging operation particularly when the 1st operation was done by another surgeon. Each subsequent procedure introduces more scar tissue and less opportunity to change appearance. After one revision, most patients are going to have real problems.
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Too many rhinoplasty revisions
It certainly is possible to have more revision rhinoplasty procedures - as long as you have a nose to operate on! But, you are losing tissue and creating more scar with each operation, which makes each attempt more difficult and the result less predictable. You need to see an experienced surgeon who, after examining you and discussing your concerns and desires, can give you proper advice regarding additional procedures.
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The risks in multiple revision rhinoplasties
When a patient has had a previous rhinoplasty or several previous rhinoplasties the next rhinoplasty can be exceedingly difficult. This is because the surgeon not only needs to perform techniques to help you meet your aesthetic goals, but must also battle the scar tissue and the deformities from the previous surgeries. Many times your tissue has suffered extensive trauma after all of the surgeries and may not be pliable enough. It is often necessary for surgeon to bring in healthy tissue...
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When is enough, enough?
It the law of diminishing returns. Each revision surgery is more difficult and the success is increasingly remote. Patients wish more and more they had only left it alone and they begin to wish for their old nose again. A secondary rhinoplasty occurs in 5 to 15%. The exact percentage can be argued and is really unknown.
A third surgery is probably less than 5%, although data again isn't available. There are few surgeons who have operated on a nose for a fourth time and...
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+1
Revision rhinoplasty numbers
There is no way to know how many revisions are too many. Every patient is different and every operation sequence is different. Obviously, the more rhinoplasty that is done the more scar tissue that forms and the more damage that is done to the skin of the nose. I find that the skin envelope is what really limits the results in rhinoplasty more so than the cartilage framework or bones. The patient that I operated on that had had the highest number of operations on...
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+1
Revision rhinoplasty is very safe and effective
The most important factor in making the decision to undergo a revision rhinoplasty is your breathing status. If you have difficulty breathing then by all means you should strongly consider revision rhinoplasty. Keep in mind I would need to examine your nose and see operative reports form previous procedures as well as photos of your nose before and after each procedure to really be able to give precise and accurate information. I can tell you that with the appropriate techniques that we...
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+1
Mulriple Rhinoplasties have a diminishing return
The balance of desired result versus functional deformities is always of prime concern when considering a rhinoplasty. If a nose with a wide open airway is made smaller, then the airway is made smaller as well. The smaller the nose the less air flow. It is just common sense. Also, as more and more surgery is performed the scar tissue makes it more difficult to achieve a desired result.
In other words, there are added risks to additional surgeries, but as long as you are fully aware and the...
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+1
Rhinoplasty Revision Surgery
Hi Buffy,
Your question is difficult to answer without examining your nose. The best chance for a great rhinoplasty result is the first operation. Revision rates vary among rhinoplastic surgeons anywhere from 2 to 10 percent. Usually each successive revision is more difficult and risky.
As with any cosmetic and functional (breathing) procedure, if it bothers you enough then it is worth exploring your options. You should consult with a nasal surgeon with extensive experience in revisions....
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Secondary rhinoplasty
Repeat rhinoplasty is a tough decision for both the patient and the surgeon. I often find that patients that have had multiple rhinoplasties often wish they had the result of the first or maybe second one. However, this being said, if there is a reasonable request and the problem can be fixed than it certainly can be considered. There are many things that may limit the ability to perform further rhinoplasty. This can include:poor quality skin envelope, lack of cartilage material to build...
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Practical guidelines for revision rhinoplasty: Unhappy nasal surgery
The decision to pursue a redo rhinoplasty is based on several important criteria:
Quality of the overlying skin.
The quality and presence of underlying structural support (cartilage and bone).
Quality and condition of the inner nasal lining.
Functional airway problems.
Aesthetics of the external nose.
When evaluated by a qualified plastic surgeon, the decision to recommend additional nasal surgery is based on whether there is sufficient chance of actually improving the functional and...
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