Not Satisfied with my Rhinoplasty - Should Surgeon Perform Revision Free as Partially His Fault?

I am not happy with my rhinoplasty and I believe that my surgeon did not give me what we spoke about. My nostrils are uneven because the left one still looks swollen and has no definition, where the right nostril turned out fine and fell into it proper position. So they are disproportioned. And I feel that he should perform a quick revision surgery and fix these minor issues for free. Is this something that the doctor should do because he messed up and there is noticable scar tissue too. HELP!

Doctor Answers (10)

Revision Nasal Surgery

+3

Rhinoplasty is a complicated operation and there are always subtle differences in the nose. I cannot give you much of an opinion without photos, but small problems might be related to preexisting asymmetries or can be a result of the surgery.  Also, small surgical adjustments made during the nasal surgery can adversely affect other areas of the nose, and sometimes the surgeon must stop to prevent the creation of other problems with the procedure.

If this is related to your surgery - AND you are one year from the date of the procedure it is possible to have a revision and you should discuss this with your surgeon.  Many surgeons do offer a revision to their patients, but not all. Also, you need to have a physician who is skilled in revision surgery as this is one of the most complicated cosmetic operations we offer.  Problem scars are sometimes related to the surgery and sometimes the individual patient.  How you will heal is unpredictable.

Best of luck and be patient with your recovery.

Vincent Marin, MD, FACS

San Diego Plastic Surgeon


San Diego Plastic Surgeon
5.0 out of 5 stars 26 reviews

Revision Rhinoplasty due to dissatisfaction of Rhinoplasty

+2
Dear IslandGirl, I am sorry to hear that you are dissatisfied with your Rhinoplasty surgery. It is difficult to really have a good grasp on your exact problems without a physical examination or photograph. Correction of nostril asymmetry may require more then a "quick revision" Make sure you do not have revision rhinoplasty until all of the swelling is gone from your tip. This can take up to a full year for completely resolve. The ultimate goal in surgery is to have a happy patient and I personally would not charge for the secondary procedure. Best regards!

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 124 reviews

satisfaction for revision touchup rhinoplasty

+1
 In our practice, we feel that it's important for patients to obtain their goal of achieving the nose that they desire. Some patients do require a minor touchup revision rhinoplasty. In our practice, we charge only for the anesthesia fee,  which is approximately $200 for our own touch-ups  for a revision rhinoplasty.  The industry standard is to charge for the operating room and anesthesia fee.

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 55 reviews

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Was there a discussion concerning fees for rev rhinoplasty before surgery?

+1

Hi Islandgirl17;

Most plastic surgery practices have a policy regarding "touch up" or revision rhinoplasty.  It may have been that that discussion took place, or you were given some written information about that, so I would definitely go back and check with you plastic surgeon's business office.  Ask to speak to the business manager. 

Don't forget, any cosmetic plastic surgeon wants to be proud of your results and to have you be a happy patient. 

Sometimes, as I am sure you understand, things just do not go well.  Even in the hands of the most specialized and experienced surgeons, sometimes Nature throws us a curve ball.  We know that some percentage of patients will need a touch up and are attune to addressing that issue with the patient, ideally, before the original procedure.  It is not too late to have a frank discussion with the doctor to ask what will be done and whether or not there will be a cost.  Sometimes the surgeon will charge a minimal amount.  Remember, there is also the issue of charges for the outpatient surgery center, doctor's office, or hospital, plus fees for an anesthesiologist.  Those are charged separately generally, or "rolled into" the overall fee.  But, that facility, and additional anesthesiologist's fees have to be considered if there is going to be another trip back to the operating room. 

Incidentally, it is best to go in with a positive attitude without being too accusatory.  It will make the discussion go much smoother. 

Robert Kotler, MD, FACS
Facial Plastic Surgeon
Author, SECRETS OF A BEVERLY HILLS COSMETIC SURGEON
Author, THE ESSENTIAL COSMETIC SURGERY COMPANION

Robert Kotler, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 52 reviews

Free revision rhinoplasty

+1

Most surgeons will discount their own revisions - especially if they feel that they could have/should have done better.  Not all surgeons own their surgery centers which limits their ability to discount operating room and anesthesia fees.

Sam Naficy, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 132 reviews

Nearly all Revision Rhinoplasty surgery is complex, not quick and simple.

+1

I read your concern. I'm sorry you did not have a favorable experience after your rhinoplasty surgery.

Correction of nostril asymmetry may require an open approach and cartilage grafting. If your nostril is swollen, you shoud try not to undergo another surgery until all of your swelling has subsided.

In my practice, I prefer to offer a non-surgical rhinoplasty with Injectable Fillers whenever possible and keep additional surgery as a last resort.

I hope this helps.

Regards from NJ:

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
5.0 out of 5 stars 270 reviews

Not happy with Rhinoplasty

+1

Hi,

If you feel that you had a bad result from the first rhinoplasty, you should consult with another surgeon or two. I don't think it would be a good idea to look for a "quick revision " by the same surgeon. The things you mentioned are not minor and may require more than a quick revision. If it where something small, most surgeons would do the revision at no or very little cost to you.

Best,

Dr.S.

Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
5.0 out of 5 stars 209 reviews

Unhappy with rhinoplasty results

+1

Dear Islandgirl17,

I am sorry to hear that you have a disappointing result from your rhinoplasty.  It is hard to deal with a result that doesn't leave you happy after going through the whole process involved with surgery.  I believe that your line of reasoning that the doctor should perform the revision procedure for no cost  is one that, on the surface, makes a lot of sense.  After all, it is the model that all of us have come to expect from other businesses and indeed, most of us believe that, "the customer is ALWAYS right." 

However, with rhinoplasty, and facial plastic surgery in general, the process is a little bit more complicated.  There are numerous factors that can result in a poor outcome.  We (both the surgeon and the patient) try to make things as predictable as possible, but we are never 100% successful in doing so.  As a result, there are times when the outcomes are not satisfactory.  I would be completely shocked if your surgeon isn't as disappointed as you are with the result.  The surgeon doesn't have to live with the changes on their own face, but they do have to live with the disappointment and second guessing that comes with a less than satisfactory result. 

The other important factor is that the achievement of a perfect result is almost impossible.  Even in cases where the patient may be totally and completely happy, I notice things that I feel I could have improved or done a better job.  I think that this is true for most facial plastic surgeons.  In fact, it is what makes us enjoy our jobs.  Constantly trying to improve outcomes is the motivating factor and what makes medicine a rewarding field for so many of us.  This is especially true in rhinoplasty, which is the most difficult facial plastic procedure to get consistenly good results.  There are just so many factors involved in the healing process.

Due to these reasons, if every surgeon was to fix a less than perfect result, we would be fixing and refixing our patients all the time.  Doing this for free doesn't make much business sense,  Unfortunately, the business side of things is a necessary evil, which enables medicine to keep treating patients and making the necessary advancements and innovations that we rely upon.

Having said all of that, I would have a frank, honest, and open discussion with your surgeon.  Explain your concerns and disappointments and discuss what specifically you would like corrected. 

I wish you luck during this difficult time!  Let us know how it turns out.

P. Daniel Ward, MD
Salt Lake City Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

Rhinoplasty dissatisfaction

+1

Every office operates differently.  You should check with your doctor's office.  Rhinoplasty is a very difficult operation that has a high dissatisfaction rate as opposed to other procedures, possibly because it is viewed all day long.  Usually a facility fee is required for revisions. 

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 15 reviews

Not Satisfied with Rhinoplaty

+1

I'm sorry your not satisfied with your result; my comments are based on what you describe without seeing you before or after surgery and knowing what was done during that rhinoplasty. Whether or not there is any fee for the revision depends on your agreement with your surgeon and what what goals and expectations were discussed pre-op. Rhinoplasty is a very challenging operation; your surgeon may or may not have "messed up". I suggest you have a constructive conversation with him. Be patient - a " quick revision" may not be appropriate.

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