Should I trust my original surgeon with revision rhinoplasty?

I hear a lot of people ask if they should go to their primary surgeon for a revision rhinoplasty or if they should find a new surgeon because they were unhappy with the first surgery. The answer to this question is different for every patient. Ultimately the decision should be based on trust between patient and surgeon. If trust exists then yes, if not, I would recommend looking for a new surgeon to perform the revision rhinoplasty. Revision surgery is more complex than primary rhinoplasty, so no matter who you choose to perform the surgery, it is very important they have extensive experience in revisions surgery. 

The answer is you should go to your original surgeon provided you still have a strong working relationship with them, and continue to trust their care.  The rate of revision surgery for rhinoplasty is often quoted as 5-15%, so even in the best of hands, there are times when the results are not optimal.  Because of that, and as a matter of professional integrity, most surgeons would like to see their unsatisfied patients in order to set things right.  Many don't charge additional fees in order to do their own revisions, or charge a modified fee for only anesthesia/OR.  And as you pointed out, the primary physician knows exactly what was done, how easily the steps were performed, and where pitfalls most commonly occur with their technique.If you have lost faith, however, or are met with resistance to your concerns, then a second opinion and outside surgeon involvement is a better course.  And make sure that opinion comes from someone who does a lot of revision rhinoplasty.

Under most circumstances it is better to return to the previous surgeon for variety of reasons as long as there is a  complete level of comfort by both the patient and the surgeon. First, the primary surgeon is more familiar with what was done. Second, it is likely that the previous surgeon will not charge for the revision surgery but the new surgeon is going to have to charge a secondary rhinoplasty fee which often is higher than the primary surgery fee. However, it is important to make sure that the surgeon understands the problem and whether the breathing problem is related to the residual deviation of the septum, enlarged turbinates, valve dysfunction or various combination of the these factors. Additionally, the patient and the surgeon will have to be on the same page in relation to the aesthetic flaws. Finally, the initial surgeon's experience is another factor to be considered.

Typically, I would recommend returning to your prior surgeon as revision work is typically done at little to no cost to the patient.  However, do your research on the particular doctor, ask to see before/after photos of previous revision rhinoplasty cases he/she has performed and ask for telephone references.  The goal is for your next nasal surgery to be your last. My best to you as you make your decision.Mark Petroff, MD.

It is important to  find a surgeon whose comfortable with both functional and cosmetic rhinoplasty whether it is your primary surgeon or  your new rhinoplasty surgeon. make sure you're revision surgeon has lots of  experience  performing rhinoplasty, septoplasty and revision rhinoplasty procedures.

I'm sorry you are dealing with issues after a revision surgery. Revision rhinoplasty is a very difficult operation and if I were your surgeon, I would like to know about any problems you are having. I think it is fair to let your original surgeon and discuss your specific issues. If they feel comfortable addressing them, and you feel comfortable having them address by that surgeon, I would try. If you are not on the same page after your meeting, I would ask them for a recommendation of another surgeon to consult with. Anyone who performs revision rhinoplasty should be able to at least give you an honest evaluation of your options.

Some photo would be helpful to be able to comment on the specifics of your case. If the revision is very minor you can consider the original surgeon.