Will Getting Rhinoplasty for the Third Time Be Possible?

Each time a nose is operated on, it becomes more difficult. And therefore the success decreases and the goals of surgery are lowered. The first time is the best time. That isn't to say revision surgery can't be successful. Its just more difficult and takes longer. This is reflected in the cost. A primary nose job usually takes between 1 to 2 hours, while a revision takes between 2 and 5 hours. There are outliers, minor 'touch ups' or complete complex nasal reconstructions using multiple ear, rib or skull grafts.

I have recently set a new personal record of sorts. I operated on a young lady for the eighth time! She had, over the years, had 7 surgeries of one description or another by the same surgeon. I wouldn't recommend this. If a surgeon can't achieve mutually agreed upon goals after 2 surgeries, it time to move on or up. Will your nose fall off? No. Will your nose be straight? Maybe. And you increase your chances by taking the time to find the best, most experienced rhinoplasty surgeon you can find.

Revision rhinoplasty requires a significant level of precision and skill, as well as decades of experience in the hands of a specialized board certified plastic surgeon who regularly performs revision rhinoplasty.  In my practice, I often have patients who visit me in my NYC office displeased with their results from other offices.  Some are excellent candidates, requiring secondary, tertiary and even quaternary revision. For other patients, the risk/reward ratio is not worth it.  It is extremely important to recognize when a further surgery might do more damage than good, and I do not hesitate to inform patients of this, since it is in their best interests.  In summary, whether a revision rhinoplasty is possible is determined on a case-by-case basis.   

Getting a crooked nose totally straight is considered one of the more challenging tasks of a rhinoplasty. However if the deviation is significant it is not unreasonable to consider a third time revision with an experienced revision rhinoplasty surgeon. In such cases, usually application of rib cartilage graft is favored due to it’s stiffness to counteract the previously stubborn and unfavorable deviations. Obviously, this can only be evaluated with a thorough internal and external examination of the nose and on a case-by-case basis.

Yes, it is possible for a patient to seek a second revision rhinoplasty should the first two nose jobs not be up to par with his or her expectations. I highly recommend that you wait at least one year after your original revision rhinoplasty to consider this third surgery. If you are still unhappy with the results of your previous nose jobs, you may want to re-visit the same surgeon who performed your initial revision rhinoplasty, or you may want to find a new surgeon altogether. At this point, however, it is important to understand that with each additional surgery comes the possibility of increased complications and unnatural results.

Having a rhinoplasty the second or third time is very complicated and one has to look seriously at this because one can only have so many rhinoplasties before needing significant nasal reconstruction. I would definitely seek a Board Certified Plastic Surgeon that has significant expertise and experience in  secondary and tertiary rhinoplasty procedures because these are completely different operative procedures that require additional experience and judgment.

You may need revision rhinoplasty that addresses the bony and cartilaginous septum of the nose.  Simple cartilaginous tip work will not correct the problem.