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.