Complications from Second Rhinoplasty to Thin the Nose?

I had a closed rhinoplasty in 2008 to remove the hump. Now, I think my nose looks too bulbous and wide. I'm considering having a second rhinoplasty to thin it. However I am worried about it having complications due to it being a second surgery. I would like for it to look as natural as possible, so if it is something that has a high probability of going wrong, I'd rather leave it be. I don't want it to be too thin or to collapse. How would I find a surgeon that's well qualified in complicated procedures such as mine?

Doctor Answers 15

Preventing complications in revision rhinoplasty

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It sounds as if you had certain issues with your nose in 2008 that were addressed but, other issues that were not addressed at the time of your original rhinoplasty that now bother you. Although revision rhinoplasty is often times more complicated than a first time rhinoplasty, the fact that you only had your hump lowered and no other changes were performed on your nose during your prior surgery, may make for a less complicated revision rhinoplasty. I would have the operative note available for any surgeon with whom you may consult and an experienced revision rhinoplasty surgeon should be able to suggest to you the changes and procedures needed to correct your nose, as well as the risks of having further rhinoplastic surgery.

Risks of Revision Rhinoplasty

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Revision rhinolasty is usually a much more difficult procedure than the original operation. Therefore, find a surgeon experienced in revision surgery, be specific about your concerns, and establish reasonable goals.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews

Seek out rhinoplasty specialist for revision surgery

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Secondary rhinoplasty is more difficult than the primary rhinoplasty. It is important to seek out a rhinoplasty surgeon who has performed thousands of rhinoplasties and revision rhinoplasties. Critically look at before and after photos of the surgeon, he/she should be well qualified, board certified in ear, nose, and throat and facial plastic reconstructive surgery. In addition, make sure the surgery center is accredited and the anesthesiologist is board certified. Get at least three opinions regarding whether the benefit of revision rhinoplasty is worth the risks.

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Second Rhinoplasty

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It would be best for you to find an experienced, competent aesthetically oriented nasal surgeon who has substantial experience performing revision rhinoplasty. In good hands, you should not experience significant complications. The most important questions are: Would a revision procedure be worthwhile? Would it improve the contour of your nose? Would it make you happy? These are the questions that need to be answered during your consultation. 

Second Rhinoplasty

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Secondary rhinoplasty is more complex than primary rhinoplasty .

The results depend very much on what you find when you open the nose and look at the cartillage. Depends also on what was done in the first surgery. But it is very much achievable and carry minimal risks with a Board certified plastic Surgeon with experience

Samir Shureih, MD
Baltimore Plastic Surgeon

Complications from rhinoplasty are very rare.

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In more than 30 years of doing revision rhinoplasty, the results may be more difficult to obtain perfection--but these noses can be vastly improved. Before having the nose revised seek out an experienced revision rhinoplasty surgeon and look at their before/after photos. We have our patients meet with previous revision rhinoplasty patients since these patients have a great deal of anxiety with a bad experience from the first rhinoplasty.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Correction of wide nose after hump reduction

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There are a few reasons why a nose may appear wider after reduction of a nasal hump.

1. your tip was not treated / altered during the first operation. This can leave you with an imbalance in the appearance of the nose that makes your tip appear to be more bulbous. A simple tip rhinoplasty (assuming that your bridge is aesthetically acceptable) may be all that is necessary to correct this issue.

2. there may be an open-roof deformity. This occurs when the hump reduction is preformed without breaking the nasal bones comprising the sidewalls to move them closer together at the center of the bridge. This can also be easily corrected by preforming the fractures necessary to close the open-roof, thereby narrowing the bridge.

3. optical illusion. This occurs when a large hump is reduced in the bridge, leaving the "pyramid" shorter than its original dimensions. When looking straight at the face, you are looking from the top of the pyramid. This looks wider from this perspective because of optical illusion caused by the shadows cast by the height of the bridge. In the event that your hump was over-reduced, or if there is a concavity in the bridge, augmentation of the bridge may help this area to look narrower.

In general, many revision rhinoplasty procedures require attention to correcting a combination of the above problems. After discussing these issues with your original surgeon, decide if he/she is the right person to correct the problems. If not, then seek an experienced rhinoplasty specialist in your area.

Dr. T

Behrooz Torkian, MD
Beverly Hills Facial Plastic Surgeon
4.3 out of 5 stars 17 reviews

Complications from second Rhinoplasty to thin the nose

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The easiest way to get a good rhinoplasty surgeon is to interview 3 boarded surgeons. Than yiu can compare. If these 3 are not enough than continue until you are happy.

For revision rhinoplasty, you must seek out an expert

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Complications can occur with primary as well as revision rhinoplasty. However, the likelihood of getting a good result goes up if the surgeon you choose is experienced in both procedures. There is an old saying "performing a rhinoplasty is easy...getting consistently good results is difficult." Revision specialists are versed in what might have gone wrong in the first place and be better prepared to fix it. For example, depending on the evaluation of your nose, tips can get more bulbous from a primary rhinoplasty instead of narrower if you have weak cartilage. This is one of many things that need to be evaluated to get you the nose you deserve.

It is relaly not related to closed or open. Analysis is key.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 134 reviews

Secondary rhinoplasty

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Secondary rhinoplasty is techinically more difficult because there tends to be a fair amount of scar tissue. This means that the surgery itself is more demanding, and that you are more likely to be swollen longer after surgery. It's hard to give you an estimate of the chance of a complication without examining you, so I'd recommend that you see an experienced rhinoplasty surgeon in your area. When you call for an appointment, ask specifically about the doctor's experience with revision rhinoplasty. Good luck and best wishes.

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.