A Second Revision?

I broke my nose 15 years ago and have had two surgeries (one 4 years ago and the other 1 year ago) to try to correct it. I am looking to have one final surgery, cost and location is absolutely no issue. I probably need to have multiple osteotomies to realign the bones. Who is the best surgeon for revision rhinoplasty on a crooked nose and doing osteotomies?

Doctor Answers 4

Revision Rhinoplasty

Rhinoplasty is a very technical procedure, no doubt.  Certainly, most patients never expect to need additional procedures after such a common procedure.

It has been shown in some studies that up to 15% of patients may require some type of touch up or revision after elective cosmetic rhinoplasty.  That is surprising to most of my new patients as we discuss the benefits and risks of these procedures.  This usually relates to differences in healing of the bones and cartilage after the surgery is performed.  Essentially, the scars and healing tissues may contract or heal differently in some patients. This is usually not an issue, but can cause some post-operative appearance changes that are not pleasing to a patient.

The surgeon has the most control and reliability in healing with a primary or first time rhinoplasty.  This is because there is no scar tissue, and anatomy has been undisturbed.

Revision cases should be undertaken by surgeons with experience dealing with this type of scenario.  I would recommend no fewer than three separate consultations with surgeons in your area to get a feel for your options.  It is also critical to feel that you are understood and your goals are apparent.  

The key issues will hinge upon communication and physician experience.  Please be certain that your surgeon has special expertise in dealing specifically with revision cases and performs these cases frequently.  Just be aware that these consultations and surgeries are more complicated and likely are going to require more surgery, cost, and potential down-time than first-time cases.  However, there is nothing more rewarding than feeling in balance with your body and goals.

Last piece of advice- try to get operative notes and before and after photographs before your consultation.  This could really be a very helpful thing for you and your potential physicians.

Phoenix Facial Plastic Surgeon
4.9 out of 5 stars 53 reviews

A Second Revision?

      The crooked nose can be due to multiple issues including the bony position.   Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties and rhinoplasty revisions each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

A second revision?

In general, correcting a crooked nose is a very difficult procedure and requires a specialist. It is not always possible to get the nose 100% straight, but great improvements can be made. I would recommend seeking the advice of a board certified rhinoplasty surgeon who specializes in revisions. When looking for a surgeon, you should consider the following: Credentials, board certification, experience, a great amount of before and after photos showcasing their work, fantastic patient testimonials, and the office. I hope this helps, and I wish you the best of luck. 

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 47 reviews

A Second Nasal Revision ?

I recommend that you see an experienced rhinoplasty surgeon who specializes in revision surgery. The surgery is always more challenging after trauma and previous operations. Make sure this will be the last procedure to restore normal anatomy and function.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 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.