Why Can't I Have an Early Rhinoplasty Revision?

The reason we make patients wait 6 months or more is to let the tissue soften and return to its final shape. However, I think there are exceptions to this rule based on how far along you are in the healing process. You do not want to compound the problem. You should see a revision rhinoplasty specialist with a great deal of experience.
A short, overdone nose is a very challenging problem and should only be undertaken by a surgeon who is familiar with this problem. He should be able to show you before and after revision noses like yours.

It is strongly recommended to wait at least one full year before considering a revision rhinoplasty. After the removal of your splint, your nose will be swollen and will remain so for several weeks. In fact, it takes at least one year for all swelling to subside. By going back for a revision rhinoplasty too soon, you could turn what would have been a minor fix into a major complex revision nose job; so be patient. Nonsurgical rhinoplasty can be an alternative to revision rhinoplasty.

This is a great question. Certainly the issues with your nose do not seem to be improving and in many ways are not likely to improve without revision. The reason to wait is for the nose to "settle" and for all of the swelling to resolve.  This will give the revision surgeon the best chance to correct and improve the nose, and will help you have a shorter, less difficult recovery after the second surgery. Best of luck!
 

Typically most of the swelling in the nose resolves within the first few weeks following rhinoplasty but there is a small residual amount which can take up to 12 months or longer to resolve. There is also a gradual process of contracture as the nose becomes increasingly refined, particularly at the tip. Going in too early for revision surgery is not advised because there may be other issues with the nose which haven't yet become apparent. Additionally, the surgeon may be addressing issues which are still evolving. Revision rhinoplasty is among the most challenging of plastic surgery procedures and should be performed by surgeons with extensive training in this area. It is particularly important to have patience in these cases, to optimize the chance of success when the revision surgery does take place.

You will likely need cartilage grafting to your nose which will require the skin of your nose to be back to normal to allow the nose to expand.  Seek an experienced surgeon for your revision.  Unfortunately this could cost you a great deal more than the cost of your primary surgery performed overseas.

Optimizing results with a secondary rhinoplasty requires patience on the part of the patient and the physician. Early in the postoperative course (first 6 months to one year) there is moderate swelling that may obscure full visualization of the underlying structural integrity of the nose. It is always best to wait at least 6 months to one year prior to revision. Although one year is a classically described time period, 6 months may be appropriate for specific cases.

Looking at your photo it is obvious that the surgery was only a few weeks ago. It is not uncommon to have an over-rotated tip this early on. It is also not uncommon to have a significant amount of tip swelling that makes it look bulbous. The airplane flight home also probably increased your swelling even more. These early changes can be normal, depending on what was done.
While 6 months may be a long time to wait, only the original surgeon knows exactly what was done. Any new surgeon has to wait for the swelling to go down in order to determine what needs to be fixed. I agree with the comments of the other experts. Try to be patient so that, if you ultimately need another operation, you can have the best result possible. You may even find that the longer you wait, the happier you get with your outcome.

Hi Lostnose,
I am so sorry that your overseas rhinoplasty experience has resulted in a nose that you did not desire. Rushing ahead too soon after a your first operation can result in compromise of blood vessels to your nose, permanently damaged skin, increased bleeding, and increased scar tissue formation, not to mention a much more difficult operative field for your surgeon to work in.
Ideally you would like to have only one more revision rhinoplasty, and you optimize that likelihood by waiting at least 6 to 12 months after your initial rhinoplasty. Also by waiting there may be other defects that manifest themselves over time (the next few months) that would require yet another surgery.
You can easily find surgeons willing to operate on you sooner, but I would strongly advise you to wait 6-12 months. I know how anxious you must be to have your nose repaired, but patience will only benefit you in the long run.
Use the time to consult and meet prospective revision surgeons until you find a doctor that you feel most comfortable with.
Good luck and be well.
Dr. P

Sorry to hear about your distress.  Your experience underscores the dangers of overseas surgery. The general reasons to wait include:

1) providing adequate time to heal, especially in regards to the blood supply

2) ensure swelling has settled in order to better understand the objectives of the revision

3) any inflammation existing may complicate the surgery

 

However, each case is different. Consult with 3 - 4 board certified plastic surgeons to determine whether you can proceed with the surgery earlier.

 

It is generally accepted that a 5-10% revision rhinoplasty rate occurs in the best of experienced rhinoplasty surgeons.  Waiting 6-12 months allows the tissues to fully heal so that the surgeon can assess what needs to be done to correct the problem.