Is There a Rule of Thumb when Deciding Whether to Have Revision Rhinoplasty?

If you don't like your nose but others say it is fine is it wise to undergo surgery or should you leave it alone because odds of bad result go up with revision?

Doctor Answers 9

Revision Rhinoplasty

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If you are truly unhappy with the results of your primary rhinoplasty, it's best to see an expert who agrees and can provide you with a successful surgery. On the other hand, if you accept the changes to your nose, an additional surgery isn't necessary. It is a personal preference. 

Beverly Hills Facial Plastic Surgeon
4.1 out of 5 stars 9 reviews

Whether to have revision rhinoplasty

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It is important to have realistic goals and expectations before undergoing a difficult surgery such as revision rhinoplasty.  It is also important to go to a very experienced surgeon who has performed thousands of rhinoplasty and revision rhinoplasty surgeries to keep any risk at a minimum.  Clear communication with your surgeon is of utmost importance prior to embarking on this difficult endeavor.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 155 reviews

Your opinion and that of your trusted physician matter most

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Friends and family will often tell you that your nose looks fine because they don't want to hurt your feelings.  It is also possible that your nose does look fine to others and you are being overly critical.  The best way to resolve whether or not you would benefit from revision surgery and more importantly if the risk reward ratio is in your favor is to visit with a surgeon who is experienced with revision rhinoplasty and will give you an honest opionion about how your nose looks now, what surgery would involve, what the chances of success are and what the risk or chance of failure are.  Once you have received an honest opinion the choice should be more clear. 

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Revision rhinoplasty

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The decision to have a revision is based partly on the same factors that initiated the original rhinoplasty, i.e. the wish to improve one's looks. Plus, what can reasonably be expected, balanced against the risks of further surgery recognizing that revision rhinoplasty is a more difficult procedure. Having said this one should wait at least one year before revision surgery and obtain several opinions.

Andrew Pichler, MD
Sacramento Facial Plastic Surgeon

Is There a Rule of Thumb when Deciding Whether to Have Revision Rhinoplasty?

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 Yes, I have performed Rhinoplasty and Revision Rhinoplasty for over 25 years and my rules of thumb for performing Revision Rhinoplasty are the following:

  1.  There must a clear and precise idea of what is to be (and can be) accomplished with the Revision Surgery.
  2. The degree of improvement that can be achieved must far exceed the risk (aesthetically) from the revision surgery.
  3. The nasal tissues and skin must be deemed suitable for the revision surgery.
  4. There must be a clear and reasonable idea of what will be done differently (from the previous Rhinoplasty), during the revision Rhinoplasty, that can reasonably achieve the planned aesthetic result.  For instance, subcutaneous scar tissue formation occurs after Rhinoplasty.  In some this can blunt and thicken the results.  Revision Rhinoplasty can remove this excess scar tissue but what is planned during the surgery or post-op care that can reasonably assume this will not happen again.  

  Following these steps with potential patients during their Rhinoplasty consultations allows me the opportunity to walk patients through this thought process and what frequently results is the startling revelation that minor adjustments rarely warrant the inherent risk of Revision Rhinoplasty.  In other instances where grafts have shifted, dissolved or created unacceptable aesthetic changes, in the nose, the room for improvement far outweighs the risks of the surgery.  Hope this helps.






Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Revision Rhinoplasty surgery

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Dear jnoland23,

  • The ultimate decision on revision rhinoplasty is with you
  • It sounds like you may have a few minor issues and you should see a rhinoplasty surgeon to see if your wishes are possible
  • The odds can be reduced with a thoughtful plan and experienced surgeon

Best regards,

Nima Shemirani

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 84 reviews

Revision rhinoplasty is often a complex deicsion to undergo

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Many patients I see for revision surgery wait many years before considering surgery again. Also, it is common for friends and relatives to say that you look fine and should not have further surgery. They do this to "protect" you and even bring up examples like Michael Jackson. Each of his surgeries were reduction and further reduction and not a good example of what the medical profession can really deliver.

You should see a revision rhinoplasty specialist to determine if surgery is for you. An honest surgeon will help discuss options and likely be able to tell if your nose can be improved.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 136 reviews

Decisions Regarding Revision Rhinoplasty

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You are the one who should decide if you want to do a revision, not friends or family members. It is your nose! Yes, there can be increased risk with revisions but this will depend on what needs to be done. An  experienced revision rhinoplasty expert should explain the procedure, the risks, and the recovery. 

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 42 reviews

Revision Rhinoplasty timiing

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First of all, the only person that should matter is you.  If you wake up every morning wishing you could do something about your nose, then it doesn't matter what other people think...there's something you can do about it.  There are risks with revision rhinoplasty, but if performed in experienced hands with realistic expectations, the likelihood of a good result is high.  Waiting at least a year before undergoing revision rhinoplasty is wise to allow the scar to mature and the swelling to subside.

Mike Majmundar, MD
Atlanta Facial Plastic Surgeon
4.5 out of 5 stars 50 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.