Not Satisfied with my Rhinoplasty - Should Surgeon Perform Revision Free as Partially His Fault?

I am not happy with my rhinoplasty and I believe that my surgeon did not give me what we spoke about. My nostrils are uneven because the left one still looks swollen and has no definition, where the right nostril turned out fine and fell into it proper position. So they are disproportioned. And I feel that he should perform a quick revision surgery and fix these minor issues for free. Is this something that the doctor should do because he messed up and there is noticable scar tissue too. HELP!

Doctor Answers 12

Revision Nasal Surgery

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Rhinoplasty is a complicated operation and there are always subtle differences in the nose. I cannot give you much of an opinion without photos, but small problems might be related to preexisting asymmetries or can be a result of the surgery.  Also, small surgical adjustments made during the nasal surgery can adversely affect other areas of the nose, and sometimes the surgeon must stop to prevent the creation of other problems with the procedure.

If this is related to your surgery - AND you are one year from the date of the procedure it is possible to have a revision and you should discuss this with your surgeon.  Many surgeons do offer a revision to their patients, but not all. Also, you need to have a physician who is skilled in revision surgery as this is one of the most complicated cosmetic operations we offer.  Problem scars are sometimes related to the surgery and sometimes the individual patient.  How you will heal is unpredictable.

Best of luck and be patient with your recovery.

Vincent Marin, MD, FACS

San Diego Plastic Surgeon

Revision Rhinoplasty due to dissatisfaction of Rhinoplasty

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Dear IslandGirl, I am sorry to hear that you are dissatisfied with your Rhinoplasty surgery. It is difficult to really have a good grasp on your exact problems without a physical examination or photograph. Correction of nostril asymmetry may require more then a "quick revision" Make sure you do not have revision rhinoplasty until all of the swelling is gone from your tip. This can take up to a full year for completely resolve. The ultimate goal in surgery is to have a happy patient and I personally would not charge for the secondary procedure. Best regards!

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 214 reviews

Revision Rhinoplasty Takes Extra Expertise

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It is difficult to give you a definitive answer without evaluating you in person or at least seeing photographs. If it is less than one year since your surgery, you still have healing to do. You cannot yet evaluate your final results or consider a revision yet.

After one year, if you are still unhappy, you can discuss a revision with your facial plastic surgeon. However, some of your dissatisfaction may be related to your own healing process and anatomy – rather than surgical error – and may not be fixable. One caveat: if your unsatisfactory results are actually due to the surgeon's error, as you suggest, a “free” revision might not be a bargain, as revision rhinoplasty demands even more expertise than the first rhinoplasty.

While I understand your frustration and your wish to avoid spending more money, if you are truly unhappy with your results after you have healed, then maybe you need to work with a different facial plastic surgeon who already has expertise in revision rhinoplasty.You need someone with superb skills. But first, give yourself that year to heal. I hope this helps.

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Revisions to Rhinoplasty Accountability

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I am sorry to hear that you are not happy with the results of your surgery. You individual situation is difficult to assess without photos or a physical examination. It is important to remember that it can take up to a year for final results to show. Generally, when the error is the surgeon’s fault, he or she will take responsibility and perform a revision to correct the mistakes. This will vary from surgeon to surgeon and will also depend on individual circumstances. In most cases, if it is the surgeon’s fault you can expect to pay only small administrative or medication costs that correspond with the procedure. However, please note that revision rhinoplasty is never simple and only an exceptionally experienced plastic surgeon should be trusted to perform a secondary nosejob.

Sam Rizk, MD
New York Facial Plastic Surgeon
4.7 out of 5 stars 77 reviews

satisfaction for revision touchup rhinoplasty

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 In our practice, we feel that it's important for patients to obtain their goal of achieving the nose that they desire. Some patients do require a minor touchup revision rhinoplasty. In our practice, we charge only for the anesthesia fee,  which is approximately $200 for our own touch-ups  for a revision rhinoplasty.  The industry standard is to charge for the operating room and anesthesia fee.

Was there a discussion concerning fees for rev rhinoplasty before surgery?

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Hi Islandgirl17;

Most plastic surgery practices have a policy regarding "touch up" or revision rhinoplasty.  It may have been that that discussion took place, or you were given some written information about that, so I would definitely go back and check with you plastic surgeon's business office.  Ask to speak to the business manager. 

Don't forget, any cosmetic plastic surgeon wants to be proud of your results and to have you be a happy patient. 

Sometimes, as I am sure you understand, things just do not go well.  Even in the hands of the most specialized and experienced surgeons, sometimes Nature throws us a curve ball.  We know that some percentage of patients will need a touch up and are attune to addressing that issue with the patient, ideally, before the original procedure.  It is not too late to have a frank discussion with the doctor to ask what will be done and whether or not there will be a cost.  Sometimes the surgeon will charge a minimal amount.  Remember, there is also the issue of charges for the outpatient surgery center, doctor's office, or hospital, plus fees for an anesthesiologist.  Those are charged separately generally, or "rolled into" the overall fee.  But, that facility, and additional anesthesiologist's fees have to be considered if there is going to be another trip back to the operating room. 

Incidentally, it is best to go in with a positive attitude without being too accusatory.  It will make the discussion go much smoother. 

Robert Kotler, MD, FACS
Facial Plastic Surgeon

Robert Kotler, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 89 reviews

Free revision rhinoplasty

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Most surgeons will discount their own revisions - especially if they feel that they could have/should have done better.  Not all surgeons own their surgery centers which limits their ability to discount operating room and anesthesia fees.

Not Satisfied with Rhinoplaty

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I'm sorry your not satisfied with your result; my comments are based on what you describe without seeing you before or after surgery and knowing what was done during that rhinoplasty. Whether or not there is any fee for the revision depends on your agreement with your surgeon and what what goals and expectations were discussed pre-op. Rhinoplasty is a very challenging operation; your surgeon may or may not have "messed up". I suggest you have a constructive conversation with him. Be patient - a " quick revision" may not be appropriate.

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

Nearly all Revision Rhinoplasty surgery is complex, not quick and simple.

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I read your concern. I'm sorry you did not have a favorable experience after your rhinoplasty surgery.

Correction of nostril asymmetry may require an open approach and cartilage grafting. If your nostril is swollen, you shoud try not to undergo another surgery until all of your swelling has subsided.

In my practice, I prefer to offer a non-surgical rhinoplasty with Injectable Fillers whenever possible and keep additional surgery as a last resort.

I hope this helps.

Regards from NJ:

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 429 reviews

Not happy with Rhinoplasty

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If you feel that you had a bad result from the first rhinoplasty, you should consult with another surgeon or two. I don't think it would be a good idea to look for a "quick revision " by the same surgeon. The things you mentioned are not minor and may require more than a quick revision. If it where something small, most surgeons would do the revision at no or very little cost to you.



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.