Revision Rhinoplasty Specialist ~ Best in the US?

As the others have mentioned, there is no one best surgeon for you. Certainly, you do want to find a surgeon who specializes in rhinoplasty and has good results. Equally important is that you find someone you trust, who you communicate well with.

Rhinoplasty, and revision rhinoplasty especially, is a very complex surgery so experience is very important. You also want to make sure that your surgeon respects the functional aspects of the nose so that this isn't compromised in the process of surgery (it doesn't have to be).

The best rhinoplasty surgeon is the experienced rhinoplasty surgeon who understands your concerns and desires and with whom you feel confident. The surgeon should be able to explain the problems and challenges with your nose. He/she should set realistic expectations for what can and cannot be achieved. It is helpful if you provide operative notes and photos prior to the initial rhinoplasty. In addition each surgeon has a different aesthetic eye, so review before and after photos to see if you and the surgeon share the same aesthetic eye.
Best of luck,
Dr. Kaniff

Open dialogue and understanding is always needed when undergoing rhinoplasty or revision rhinoplasty surgery.  Both the patient and the surgeon must  develop a trust that they are both working towards the same goal.  Revisions are very difficult surgically and emotionally.  Take your time choosing your surgeon and understanding the surgey that will be done.

There is no best surgeon for everyone. Every surgeon has good and bad results.

The qualities you should search for:

1) Someone with whom you feel comfortable. Someone who is attentive and has the same goals.

2) Someone who has experience with revision nose surgery.

3) Someone who gives you reasonable expectations. If it seems to good to be true, it probably is.

I agree with Dr. Galitz-  almost any experienced facial plastic surgeon will tell you that revision rhinoplasty is one of the most challenging aesthetic surgical procedures, so you want to find a surgeon experienced in these procedures.

You can do your homework by visiting different doctor's websites, seeing before and after photos, and speaking with or meeting with your prospective surgeon.

Rhinoplasty is often considered the most difficult procedure in plastic surgery. While most facial plastic surgeons and plastic surgeons are trained to do rhinoplasty, many have discontinued performing rhinoplasty in their practices because of the difficulty in attaining consistent results. Revision rhinoplasty is even more challenging and even fewer surgeons routinely perform significant numbers of revision rhinoplasty.
For success in revision rhinoplasty, it is imperative that patients find a revision rhinoplasty specialist who has the experience to correct both the functional and cosmetic deformities resulting from previous nasal surgery. Meet with more than one or two rhinoplasty specialists to get a better understanding of what surgery would involve and how they would correct it.

You need to do your research and choose a surgeon who does a lot and has years of experience.  Interview different surgeons and look at before and after photos.  You must feel comfortable and have a good rapport with your plastic surgeon.

I would recommend a board certified surgeon. Both ABRPRS and ABPS surgeons are board certified to perform revision rhinoplasty surgery. It comes down to experience. Here are some suggestions:
Finding the right revision specialist requires diligence. I recommend starting with an in office consultation with a specialist that can demonstrate experience in revision rhinoplasty surgery. Asking the right questions is the next steps. I would ask:
1. How many facelift surgeries have you performed in the last year? Expect a well experience surgeon to perform 25 - 50 revision rhinoplasty surgeries per year
2. What is your revision rate? Expect 10 % revision rate.
3. Can you show me before and after photos of your own patients? Expect to be shown a minimum of 100 before and after photos of the surgeon's own experience. 
4. Are you a board certified facial plastic surgeon or plastic surgeon? 
These recommendations are ones that I give personally to my patients and do not reflect opinion of other surgeons or their respective societies.

There are many good rhinoplasty surgeons available in the United States.  However, rhinoplasty is considered by many to be the most difficult operation in plastic surgery to perform well.  Revision rhinoplasty adds an additional level of complexity beyond primary (first-time) rhinoplasty, so there are fewer surgeons who feel comfortable taking on complex revision rhinoplasty cases.  Multiple previous revisions means greater scarring, which can make the surgery more complicated.  Rib cartilage is often required in complex revision cases to drastically change the shape of the nose.  The straightness and rigidity of rib cartilage is extremely helpful in correcting a crooked/deviated nose.
The structural reasons behind nasal deviation are often multifactorial, and the solutions depend on the causes.  Nasal deviation can be from facial asymmetry you were born with (congenital), trauma, or the result of previous surgery.  The deviation can be mainly bony, cartilaginous, or both.  Many maneuvers can be performed during surgery in an attempt to correct the deviation such as septoplasty to remove the deviated portions of your septum, straightening your nasal bones with osteotomies, placing asymmetric spreader grafts to fill in the sidewall, and relocation of the caudal septum from where it attaches to your face.  Due to all of these complex factors, correction of the crooked/deviated nose is one of the most challenging effects to achieve during a primary or revision rhinoplasty.  The goal is always to make the nose as straight as physically possible in each individual patient.  A well-performed revision rhinoplasty will typically make the deviation much better, but it will not always make the nose perfectly straight.  Despite all of these complex factors, revision rhinoplasty to correct the deviated/crooked nose can be extremely successful.  The majority of these patients are extemely happy with their results when performed by a revision rhinoplasty expert.  
Review before-and-after photos of revision rhinoplasty patients online and select a surgeon well-versed in revision rhinoplasty to consult with based on the results you like best in noses similar to yours.  Once you have found a surgeon whose work you like, I would recommend inquiring about a virtual consultation if the surgeon is located in a city far from where you live.  This will allow you to make sure you feel comfortable with the surgeon and to obtain recommendations regarding his/her surgical plan for you before traveling for surgery.  I would then recommend planning to arrive in the surgeon's city a few days before your anticipated surgery for a formal in-person consultation so that he/she can thoroughly examine the inside and outside of your nose from different angles, feel the tissues, better understand your goals, and make more specific recommendations to achieve the natural look your desire.  Plan to stay in the destination city for at least a week after your surgery to allow for splint removal and adequate follow-up before traveling back home.  Best of luck!
Ziyad Hammoudeh, MD

The crooked nose can be difficult to repair for any surgeon but a combination of precise osteotomies, advanced septoplasty techniques, and spreader grafts will usually result in a good outcome.  Sometimes camouflage techniques with cartilage grafts can be added.  Look for someone experienced and ideally who is respected by his or her colleagues. See if the surgeon has written or lectured on revision rhinoplasty.  There are many good surgeons in each region of the country.  This may be straightforward or quite complex and there is no way to tell without a detailed examination.