When Is The Soonest To Get Revision Rhinoplasty?

Question

The moment my cast was removed I stared into the mirror and hated what I saw. My nose looked too flat and big on my face, far from what it looked like before. Prior to my surgery, my nose had a huge bump and was thinner. He removed excessively off the bridge and my bridge now looks fat and my tip looks huge. I really need a revision because im so depressed. Before the surgery I used to be a happy, straight A student, but now I feel like im going down hill :/

Jamil Ahmad, MD · Answer

At 4 months following rhinoplasty, you still need more time to recover from your surgery. Recovery after rhinoplasty will vary based on the person, characteristics of the nasal tissues and what was done during surgery. It can take somewhere in and around 12-18 months to see the final results. The areas with thicker skin in the nose such as the tip, alar rims and radix will require longer to settle. Also there appears to be a linear decrease in swelling for the first several months followed by a period where the swelling fluctuates (sometimes little or no swelling and other times more swelling) before the nose settles. It is important to be patient during your recovery - it will take a while to see the final results. If you decide to have revision rhinoplasty, you should typically wait at least 1 year for swelling to resolve and also for scar tissue to mature and soften. This will give you the best chance of achieving the result you want after revision rhinoplasty.

Eric M. Joseph, MD · Answer

I read your description and reviewed your photos. It's not clear when you had your primary rhinoplasty surgery:

	 Your profile photo looks markedly improved. You have a gentle curve on your nasal bridge, and your tip has been rotated: your facial profile looks better after your rhinoplasty.

	I did not see a frontal view before your surgery. Your post-op frontal view looks acceptable. I agree that your bridge may be a bit wide. If narrowing your bridge on your frontal view would make you happy, you should wait at least 6-12 mos. from your initial rhinoplasty: repeating your osteotomies is fairly straightforward and may lead to a narrower appearance.

	Your tip does not look huge, and your eyes do not look too spread apart.

	I'm sorry you're dissatisfied with your results, but you do not appear to have a horrible nose job. You may benefit from consulting another reputable rhinoplasty specialist to see what would be best for you from a surgical standpoint.

	If your depressed mood is dominating your life and negatively affecting your academic performance, you may wish to discuss these feelings with your PCP or a psychiatrist. Depression is treatable and something you do not have to live with.

	I hope this is helpful for you, and I wish you all the best in your future endeavors.

Kelly Gallego, MD, FACS · Answer

Like most surgical procedures, it takes at least a year for the nose to completely heal after a rhinoplasty. During the first year the edema (swelling) slowly resolves, any external scars go from being pink to the normal skin color, and many firm areas will soften. Unfortunately, about 10% of rhinoplasty patients will be dissatisfied with their results even after a year. This mostly has to do with the prominence of the nose, and the inability of the patient to camoflauge or hide small imperfections. Although, most dissatisfied patients are in a real hurry to have their nose revised, operating too early can lead to catastrophy. I always advise dissatisfied rhinoplasty patients to wait at least 12-18 months before proceeding with any secondary or revision surgery.

Edward Farrior, MD · Answer

Dear yama,It is advisable to wait 6-12 months prior to performing a revision rhinoplasty.  If you are comfortable with the primary surgeon then a waiting period closer to 6 months can be considered appropriate because he is familiar with the initial surgery and will be more comfortable with what is necessary to correct the problem.  If you are not comfortable with the primary surgeon then used to should wait at least 12 months.  A rhinoplasty can evolve significantly over that length of time correcting some abnormalities and possibly revealing others that might not be apparent earlier.  Time also allows for a more stable skeletal structure within the nose which gives the revision surgeon a better framework to work from.  In my practice I insist patient's wait a full 12 months prior to performing a revision rhinoplasty.  It is the best and safest approach.

Michael L. Schwartz, MD · Answer

I'm sorry you are having so much trouble. I would recommend that you wait at least a year so that you have complete healing and an accurate judgement about the amount of correction can be made. Also consider having a consult with computer imaging so that you and your surgeon can be sure to be on the same page about how much to change your nose.

Richard W. Fleming, MD (retired) · Answer

In general, we advise waiting 6-12 months before having revision surgery. Having said that, it is not too early to consult with a revision specialist who can follow your progress and help you to determine when surgical intervention is appropriate.

Francis R. Palmer, III, MD (retired) · Answer

Revision Rhinoplasty should not be performed for at least 6 months after your prioir Rhinoplasty.  This allows adequate time for the blood supply to re-establish to the nasal tissues.

When Is The Soonest To Get Revision Rhinoplasty?

Answers (7)

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