Is there such a thing as waiting too long for a revision rhinoplasty?

I had a bad outcome from a primary rhinoplasty, 20 years ago.....I am left with an over-rotated nose, hanging columnella and a large amount of nostril show. But, I "got on" with my life and didn't obsess over it. Now, I have trouble breathing out of my right side, and have been told I have a deviated septum and my valves have collapsed. I am wondering if waiting this long will contribute to a poor outcome? Im in my 50's, in great health. Thanks for your replies.

Doctor Answers 7

Revision Rhinoplasty

Quite the contrary, the results are better when the nose is completely healed and the edema gone, and the contractures and scarring has matured. At this point we know what is there and what needs to be corrected. You seem to have a mature attitude with realistic expectations. Now you need to find a experienced expert in revision  rhinoplasty . Best of luck.


Chattanooga Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Revision rhinoplasty in patients in their fifties

It sounds that you may be a good candidate for revision rhinoplasty with septoplasty, which means that the outside appearance of your nose and its function are improved at the same time.  Take note that age is not the "end all be all" factor.  In fact, "older" patients often have a well imprinted body image that they tend to have more realistic expectations and more conservative (and achievable) goals than younger patients who often ask for more drastic results, which are not always possible due to anatomical limitations. 

The general rule of thumb is to find a board-certified plastic surgeon (ABPS certified and member of reputable plastic surgery affiliations) who regularly performs revision rhinoplasty, which is often more complex than primary nose job. 

For photo reference, feel free to visit the link below.  

Good luck and I hope my advice can be of help. 

Revision Rhinoplasty

Dear Peony, Waiting a long time between a primary and secondary rhinoplasty is not a problem. It sounds like you had a bad experience the first time around and often this leads to patients insecurity and concerns of having a secondary procedure. You need a full examination during consultation to diagnose whether you are suffering from a deviated septum or other problems (i.e. turbinates) that may need addressing during secondary surgery. Once you have a consultation and examination the surgeon can discuss with you in detail what needs to be done to attain your desired results. These results should be inclusive of a nice natural looking nose that balances well with your facial features and also a fully functional nose to enhance your current breathing difficulties. Your age is not a concern for rhinoplasty and I have many patients who come in over 50 seeking rhinoplasty and this is a very rewarding procedure for both patient and surgeon alike. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 199 reviews

Revision rhinoplasty at any time

 A revision rhinoplasty can be performed at any time one year after the primary rhinoplasty. At age 50, is not to old to undergo the revision procedure as long as your in great health. The nose can be de-rotated, a hanging columella reduced, valve collapse can be repaired with spreader grafts and any functional breathing work  can be performed at the same time.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 reviews

Waiting too long for revision

It sounds like you are a prime candidate for revision.Your age is not a factor.
You have diagnosed your problems and all but the "over rotated nose" should  not be difficult to correct. I would guess when the columella is corrected, the tip wont attract too much attention anyway.

Dennis Barek, MD
Great Neck Plastic Surgeon
5.0 out of 5 stars 6 reviews

Is there such a thing as waiting too long for a revision rhinoplasty?

Dear Peony
In general, there is no harm in a delayed procedure. In your case, you can have a septorhinoplasty that is partially covered by your insurance, your surgeon can create new support for your valves, straighten your septum and improve your breathing (covered by insurance), at same time, he or she can revise your nostril show and columella.
Look for expereicned and properly trained Plastic Surgeon certified by the American Board of Plastic surgery (or Facial). See more than one consult. Make a well informed decision.

Afshin Parhiscar, MD
Bay Area Plastic Surgeon
4.9 out of 5 stars 49 reviews

Revision rhinoplasty

In terms of timing you have nothing to worry about.  The nose settled a long time ago.  Whenever you're ready to improve the breathing function and appearance to your nose consult with a revision rhinoplasty specialist whose photos you like and move forward.  I would be hesitant to undergo surgery with anyone who is not a revision specialist as the revision rate for a first time rhinoplasty is between 5-15% amongst the best surgeons in the country 

Ben Talei, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 36 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.