If my primary was a “preservation rhinoplasty” does that mean I won’t need rib for my revision?

It is less likely but the let questions are how much septal cartilage you have remaining and what the goals of the revision are. Different surgeons have different approaches. In most revision rhinoplastiesI do not use rib, and can generally rely on septal cartilage for grafts even in many patients with previous septoplasty.

The answer to your question would depend on the condition of your nose presently and what was actually "preserved" in your first rhinoplasty. Minor to moderate defects with a full septum still intact may result in no need for rib. But a collapsed nose with no septum might be a different story. Be sure to see a rhinoplasty specialist for consultation.

What needs to be done depends on what the particular problem is. Bone grafting rarely needs to be done but it would help to see photos

Every nose is different and unique to that individual. If the appearance of your nose concerns you enough to do something about it, it can be improved with a natural artistically performed rhinoplasty. What would be the best option and exact procedure would depend on an examination and discussion about desired outcome. Excellent results can be achieved with either a closed or open technique.

Keep in mind that following advice from a surgeon on this or any other website who proposes to tell you exactly what to do without examining you, physically feeling your tissue, assessing your desired outcome, taking a full medical history and discussing the pros and cons of the operative procedure would not be in your best interest. Natural appearing results need to be individualized and what is appropriate for one patient is not necessarily the best for someone else. I would suggest that you find a surgeon with extensive rhinoplasty experience certified by the American Board of Plastic Surgery and one who is ideally a member of The American Society for Aesthetic Plastic Surgery (ASAPS). If you live outside of the United States, the surgeon should ideally be a member of the International Society of Aesthetic Plastic Surgery (ISAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, M.D., FACS

La Jolla, California