Is revision rhinoplasty always harder?

Question

I only had bridge rasping in my primary and found the results undewhelming. I'm looking for osteotomies in the revision. In cases like this would the revision really not be more like a primary and should I only be paying primary prices if I go with a new surgeon?

Michelle R. Yagoda, MD · Answer

Dear MichaelV,Since you did not include a photo, it is difficult to give you a specific opinion.  In general, revision rhinoplasty is harder because when there had been a prior trauma (either a planned surgery or an accident), there is disruption of the normal anatomy and scar tissues form where normal separation planes existed previously.)  What may seem like a small thing to you as a layperson, may be technically difficult to achieve, or may result in other structural or functional problems.  It is best to have a consultation in person.  And, then, trust your gut.  You will know when you find the right surgeon.All the best,Dr. Michelle Yagoda

William Portuese, MD · Answer

A revision rhinoplasty is always harder than a primary rhinoplasty so it takes longer to perform the procedure. Because it takes longer amount of time in the operating room, anesthesia and for  the surgical  procedure, the  revision rhinoplasty surgical fees are higher than a primary rhinoplasty. Shop quality, not price, since the nose is the most prominent feature on your face and experience really does matter.

Richard Bloom, MBBS (Hons), FRACS · Answer

Hi there and thanks for you question.I assume the rasping was done via a closed approach. Whilst I certainly agree that in most cases a revision procedure is more difficult, if that is all that was done, I don't think it should have too much impact on further surgery.It is unusual to reduce a hump and not require an osteotomy or other procedures to your nose, so not entirely surprising that your found the results underwhelming.Most rhinoplasty surgery done today is done via an open approach.As to costs, I don't think your previous surgery will impact on the surgical fee, it would not in our practice,  however this is obviously up to each individual surgeons practice.CheersRichard

Steven Wallach, MD · Answer

A secondary is usually  more difficult because inevitably one is dealing with more scar tissue and work done by someone else. Best of luck.

William B. Rosenblatt, MD · Answer

It is always more difficult than a primary. Usually you would want to go to an experienced surgeon. As far as cost is concerned, a new doctor will charge for any secondary surgery. don't expect any discounts from them.

Tae Ho Kim, MD · Answer

Rhinoplasty and revision rhinoplasty are difficult to do well.  A lot of doctors think they are good at these operations but they are not.  The anatomy is very complex and the decisions that a surgeon makes during the operation is very complex. Sometimes, a person needs less work than someone else and the fees may be adjusted accordingly.  However, I would advise you to seek quality first, then price.  I would also advise you to get a second opinion by a board certified plastic surgeon with a lot of experience in rhinoplasty and revision rhinoplasty.  Good luck!

Dennis Barek, MD (retired) · Answer

Not all, but most revisions are more difficult  than primaries. We don't know your specific case other than a slight rasp. To get the rasp in , the whole dorsum of the nose was undermined, leaving a trail of scar tissue. If just oseotomies are truly all that is required, which I doubt, then it is not a difficult revision. But sometimes after osteotomy, the dorsum has to be smoothed out as elevation of some upper lateral cartilage or nasal bone, can occcur.Pricing is up to the surgeon. It is after all a revision and you never know 100%, what you are going to find.

Geoffrey Keyes, MD (retired) · Answer

Dear Michael,
Thank you for your question. The amount of work that was done to a nose previously determines the level of difficulty with the revision surgery. I would recommend that you seek a consultation with a Board certified plastic surgeon who is experienced with revision rhinoplasty surgery to evaluate your needs. Based on the information that you’ve provided about your procedure, it sounds like a minimal amount of work was done to your nose, so hopefully this may have a factor in pricing the surgery closer to a primary rather than a secondary procedure. Of course this decision would be made by the surgeon, depending on his policies with revision surgery.

Is revision rhinoplasty always harder?

Answers (8)

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