Rhinoplasty Revision. Should I Use the Same Doctor or Not? How Difficult is This Revision?

I had rhinoplasty 5/10 and I’m scheduled to have revision surgery in 2 weeks. I’m apprehensive as I am going back to the same doctor. How often do plastic surgeons have to do revision surgery? Obviously, my concern is if the doctor didn’t do the surgery right the first time should I trust a second. There is a dent on the front right nostril and it looks like I have a beak. The middle part of nose is too pointy and with the appearance of lots of overhang. Is this a difficult revision? Thank you.

Doctor Answers 8

Rhinoplasty Revision Plastic Surgeon

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hi  KDMatl ,

Thank you for your question.

Rhinoplasty is generally considered a challenging procedure by plastic surgeons, due to the large variety of nose types, numerous surgical techniques, and unpredictably of healing. Despite the surgeon's and patient's best efforts, a rhinoplasty procedure may need to be revised.

Generally the revision rate may vary, starting from approximately 5%, and goes higher. History of prior nasal trauma or rhinoplasty are just some factors that inherently increase the revision rate. Revision procedures range widely, from minor to major in complexity. All revision rhinoplasty surgery is considered "difficult". Revision procedures can occur anytime after the initial operation, but usually not considered for several months to years after the original operation. Rhinoplasty surgeons not only perform primary rhinoplasty, but also revision procedures. Generally, the original rhinoplasty surgeon will perform a revision, if appropriate.

Speak with your plastic surgeon. Only after a comprehensive evaluation can one help determine appropriate options for you. Best of luck.

Dr. Chaboki


Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 89 reviews

Revision Rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Hi, I would suggest you get a second and/or a third opinion. You can still use the same surgeon if you feel confident with him/her, but a second opinion is a good idea. It appears that your tip cartiages are over - projected and you have collumelar show. Also it seems that a piece of your  tip cartilage is missing creating a divit. Hope this helps. Best, Dr.S.  

Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 285 reviews

Revision rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I agree with Dr. Emerson that this appears to be a difficult revision and that your primary surgeon has the best chance of fixing things.  If your surgeon understands your concerns and can confidently explain the next approach you are probably better off staying with him/her than trying to get someone else involved.  If, however, you have lost confidence in your surgeon or have developed an unpleasnat relationship then another opinion is needed.

Revision rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Rhinoplasty revisions occur in anywhere from about 5-15%, and some quote even higher.  If you feel comfortable with your surgeon, then it may be the best thing to do since that surgeon knows exaclty what was done in the first operation.  But, sometimes patients after revision surgery wish that they did not go ahead with it afterwards.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Revision rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

All revisions are challenging and should only be undertaken by surgeons comfortable with doing them and with a variety of of operative techniques. No one knows the true revision rate since many patients do not return to their first surgeon. Most surgeons are aware of how often they redo their own patients who return to them and I have seen rates quoted fro 5-30 % even by acknowledged experts. Having been disappointed by your first surgery it is natural for you to feel hesitant about going forward with the same surgeon. There are always unpredictable factors in healing that can distort the intended result that are beyond the control of the surgeon. If you can accept that, and you have discussed with your surgeon his/her revision experience and how he/she plans to address your situation and are comfortable with the relationship then go ahead as planned. 

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
4.8 out of 5 stars 12 reviews

Answer to RealSelf.com Rhinoplasty revision question

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The need for revision after rhinoplasty is noted in the literature to vary from about 7% to 18%.  This includes even the most experienced rhinoplasty surgeons.  Most rhinoplasty revisions would be considered difficult procedures, and I feel that your revision would fit into this category.  Healing can be unpredictable and the apparent retraction of your alar rims can be quite challenging to overcome.  

Your previous surgeon has the advantage of knowing exactly what was done during your initial rhinoplasty.  I would communicate very clearly with him/her prior to the procedure and discuss your expectations.  If you have any concerns, don't hesitate to get another opinion.  Good luck to you.

Eric T. Emerson, MD, FACS
Charlotte Plastic Surgeon
4.7 out of 5 stars 29 reviews

Your revision rhionoplasty surgery will be difficult.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Greetings. I reviewed your concerns and your photos.

You appear to have an exaggerated curvature of your lobule-columella and nostril asymmetry. Your tip looks as though a shield graft may have shifted, but I could not be sure of this without examining you or reviewing your operative report.

If your surgeon explains the reason why your tip looks as it does, and offers you a reasonable approach to fix it, then you may considering going with revision surgery as planned. If you're second guessing the ability of your surgeon, then by all means, get a second opinion from a reputable rhinoplasty specialist. Your surgery is difficult in the best of hands.

I hope this is helpful for you.

Dr. Joseph.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

Revision Rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Other than minor revisions, I feel all revision rhinolasty si difficult and should be done by a surgeon experienced in this work. I think your revision will be difficult - your surgeon may be very experienced and has the advantage of knowing what was done during the primary. If there is any doubt, get a second opinion before your surgery.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

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.