Can a plastic surgeon tell if I had a rhinoplasty before when performing one?

Sometimes, rarely, you might be able to convince the surgeon during the consultation that you've not had surgery on the nose before. Perhaps you can convince him that some scars in your nose are from a septoplasty, if the outside of the nose really seems as though nothing at all was done.But he'll be able to tell 100% when he gets inside, and that's when you're in big trouble. Revision rhinoplasty is an extremely difficult operation, and the great majority of surgeons who perform rhinoplasty can't handle a revision. So now you've put your surgeon in the position of doing something that he doesn't know how to do, and you'll be the loser in that transaction. You'll be looking for yet another operation a year later.Probably not worth it, although I'm really curious why you would want to withhold that information. So the cost of the operation would be less? Something else?

Yes, an experienced Surgeon will know once your nose is examined. You should reveal the entirety of your past medical history before proceeding with any additional surgery. Intentionally, withholding medical information from your medical team- is grounds to be dismissed as a patient and surgery cancelation. 

  Yes, it is possible to determine whether or not somewhat has had a rhinoplasty while examining the external and internal portion of the nose.  Any type of rhinoplasty in the nose has made alterations to the normal anatomy along with scar tissue that is present.  A revision rhinoplasty is more difficult than a primary  rhinoplasty,  so it is important to tell your surgeon what you have had done on the inside of your nose.  

Yes, the surgeon can often figure out that a rhinoplasty was done previously either during the consultation or during the surgery. Please do not hide this information from your surgeon. You need to plan together to obtain the best outcome for your nose and so he or she needs to have all information available about your nose and why it looks or breathes in the way that it does.

You are setting yourself up for failure if you hide this information from your surgeon. This is not a secret that you can keep. Why would you want to? The reasonable expectations and risks of a revision surgery need to be discussed. Be honest with your surgeon. He/she needs to be able to trust you (just as you need to be able to trust them), and an experienced rhinoplasty surgeon is going to find out sooner or later. You do not want that to be in the OR when you're asleep.