Is rhinoplasty riskier the second time?

Question

I had a rhynoplasty then i had revision rhynoplasty under local anesthesia. Now I think of another revision as I am unhappy with the result. I want a cartilage on my nose bridge to be shaved. Is it risky. The cartilage was placed during my revision.

Manish H. Shah, MD, FACS · Answer

Hello Marina1122,Thanks for your question.Revision rhinoplasty in itself is no riskier than your first two operations.  Your surgeon needs to be extra careful with the tissues to minimize risk of wound healing problems.  You as the patient need to have very reasonable expectations.  Each additional rhinoplasty procedure tends to bring less change than the previous ones because the nasal tissues respond less and less favorably to surgery.I would recommend that you seek out a revision rhinoplasty expert in NYC such as Dr. Tabbal for a second opinion before you have any further procedures.It is certainly possible to shave some more cartilage off your bridge under local anesthesia, but you need to be seen in person for this determination to be made.Good luck,Dr. Shah

Tanveer Janjua, MD · Answer

Rhinoplasty is a risky surgery to begin with every revision carries more risk is the deformity is minor.  You can try fillers before you embark upon another surgery.  Having said that in most hands a revision surgery can be done safely as long as proper expectations have been discussed.RegardsDr. J

Michael S. Godin, MD · Answer

The short answer is: Yes, always. Revision rhinoplasty is more complicated because there is scar tissue present and the natural structure has been changed. Having said that, sometimes it is the best thing to do. Look for an experienced surgeon who has done alot of revision rhinoplasty to advise you. Best of luck.MIchael Godin MD

Ciro Adamo, PhD, MD · Answer

A revision of a cartilage graft is tricky, and it does come with a risk of further revisions needed. In fact, while the original (primary) rhinoplasty has a revision risk of 5-20%, any subsequent revision will have an increased chance of needing further touch ups.

Steven Wallach, MD · Answer

Anytime you do a revision and in your case multiple revisions, there arre always more risks with healing and skin issues.

William Portuese, MD · Answer

A full set of pictures are required before making any determination about being a candidate for a revision rhinoplasty. In addition, an in-person consultation and examination is required, since revision rhinoplasty is probably the hardest operation to perform correctly in the entire field of cosmetic surgery. Choose your surgeon very wisely based on experience

Richard Mark Winters, MD · Answer

Although serious systemic complications from rhinoplasty (like other elective outpatient procedures on low risk patients) are exceptionally rare as they should be, the risk of an unsatisfactory result and local problems are always a consideration. These issues are significantly mitigated by a realistic patient, a manageable problem and a surgeon with expertise, skill and judgment.In my practice, nearly all revision rhinoplasties are done under general anesthesia and all but the simplest of secondary deformities require opening the nose. The best chance of getting things right hinges on exposing all critical structures and being able to examine all of the component parts of the nose and how they interact with one another. All patients want THIS revision to be their last and as such it should be treated seriously unless the problem is a simple minimal one.

Is rhinoplasty riskier the second time?

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