How Soon After a Rhinoplasty Can Revision Be Done?

Question

I had a Rhinoplasty 2 weeks ago, where the tip was trimmed, the nostrils were narrowed, and nose was set back a little. But it's too subtle and I want it done again. However, I don't want to wait until a year later after the procedure.  There is hardly any swelling now. I will see my surgeon in 6 weeks.  Can I have another Rhinoplasty sooner than a year? How soon after a Rhinoplasty can revision be done?

C. Spencer Cochran, MD · Answer

In general, most rhinoplasty surgeons prefer to wait for one year before performing a revision rhinoplasty because it can take as long as a year for the swelling to subside and for scar tissue to mature.  
Often, some problems after rhinoplasty will resolve with time and a revision can be avoided. 
Other times, waiting a full year may allow for other problems that are not readily apparent in the early healing phase to become visible and all of the problems can be addressed with a single surgery.

Caner Kacmaz, MD · Answer

Thank you for your question. I highly recommend you to wait at least one year between surgeries. This will give your nose enough time to heal and swelling to subside. 
During the healing period, your nose will continue to change, dramatically at first and then more gradually. Good luck

Sam Rizk, MD · Answer

Considering that you are still only two weeks into recovery, I would say it is still too soon to judge how your new nose will look. Swelling is most apparent at this stage in your healing, and will be a major factor in how your new nose looks for about another 1-2 months. That being said, I typically advise my patients to wait at least one full calendar year before considering getting a revision rhinoplasty. This way, you will be able to see how your recovery proceeds and really have the chance to think about your decision before committing to a second surgery.

Anil R. Shah, MD · Answer

Most patients should wait one year before seeking a revision rhinoplasty. In order for a revision surgeon to properly assess the nose, swelling must be reduced. At 2 weeks after a rhinoplasty, it is difficult to assess the final result of the nose.

Corey S. Maas, MD · Answer

Generally, we advise patients to wait one year before considering revision surgery to address any problems. This is due to the ongoing healing process of the soft tissues and final results can't be determined until that time.  If the problem is restricted to the bone (ie persistent deviated nasal bones), then it is reasonable to intervene earlier. For example, if a deviated nasal bone is noted in the early postoperative period, one can attempt to medialize the bones.  
Within the first 10 to 14 days, it may even be done in the clinic. Your surgeon may also discuss using sedation in an appropriately credentialed facility. If a problem with the nasal bones is noted after two weeks, one can still intervene sooner than a year but may need to recut the bones in order to solve the problem.

David Shafer, MD, FACS · Answer

After Rhinoplasty, it takes about 1 year for the the tissues to completely settle and the swelling to completely resolve.  It would not be a good idea to undergo a revision before this time.

Michael A. Persky, MD · Answer

Hi Taff,
You do still have swelling and healing going on in your nose only two weeks after your rhinoplasty.  You should wait at least 6 months before having a revision surgery. 
Certainly your surgeon is the best person to discuss when the best time for revision will be. When you get too impatient, remember these two words....Michael Jackson.
Good luck and be well.
Dr. P

Manish H. Shah, MD, FACS · Answer

At two weeks postop, you have a significant amount of soft tissue swelling even if you can't feel it.  The body resolves swelling on its own time table which is typically 6-8 weeks after surgery.  Even when the swelling is gone the underlying scar will take a minimum of 6 months to mature.
Repeat surgery too early (less than one year after the first surgery) usually results in excessive scar formation and thicker overlying skin.  Any finesse that you were hoping to find will more than likely not manifest itself under that situation.
Finally, the vascularity/blood supply to the nasal tissues needs time to heal.  If surgery happens too early, you may not have enough blood supply to heal properly and lose portions of your nose.
You have to be patient!  A surgeon worth his/her training won't touch you for at least a year.  Just go back to your surgeon and work with him/her.  Dr. Shah

William Portuese, MD · Answer

Do not have any revisional surgery within the first year of the rhinoplasty to make sure that indeed full healing has taken place. Surgery sooner than that may not be required because of the edema that persists for a long time after the rhinoplasty procedure.

Peter E. Johnson, MD · Answer

I know this is  not exactly what you would like to hear, and there are some reasons to revise a rhinoplasty procedure sooner. Two reasons to consider an earlier revision are irregularites of the bridge of the nose seen through the skin, or a tip that somehow became over rotated upward and the now appears too short for your tastes. In the first case it is unlikely that the irregularities will go away over time, and in the latter it can be more difficult to bring the tip down and add length if it has set in well.If there has been no grave mishap however the best time to revise is when the tissue has regained softness and is again pliable enough to allow shaping in the most predictable way. After all, you are less that satisfied with your result and want every chance for success the second time around.Finally if you haven't done so, request computer simulation with your surgeon as this gives you a good idea of how you look presently, and how future changes may enhance your result. You will then be confident your surgeon knows what you expect.When the tip of your nose is fully soft its time to proceed.Best of luck.

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