Best Revision Rhinoplasty Surgeon in the USA?

You cannot go wrong with Dean Toriumi (Chicago), J. Regan Thomas (Chicago), Rick Davis (Florida East Coast), Jack Gunter (Texas), Peter Adamson (Toronto), Toby Mayer (Beverly Hills), and Rod Rohrich (Texas).  All have a wealth of experience and specialize in revision Rhinoplasty.

Hello and thank you for your question. You should select your surgeon with a careful consideration of their overall body of work on their before and after gallery. You should be able to see hundreds of pictures there with noses similar to yours. Based on your photograph, you may benefit from tip derotation with extended spreader grafts and release of scar tissue. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

From what I can ascertain from the side view you have provided, and without having the opportunity to examine you in person, you appear to present with a short, blunt, bulbous-tipped nose, with poor tip projection. I see this commonly in patients requiring secondary and tertiary rhinoplasty who come to me after having had an unsatisfactory experience elsewhere. Your dorsal line looks fine. To improve your nasal profile, you would need tip work with suturing techniques, as well as graft material harvested from your own septum, in an effort to produce a handsome, more detailed and projected nasal tip.  All results should have a keen eye towards looking natural, and fitting your specific facial anatomy.

There is no such thing as the “best “ but there are a lot of good choices David Kim in California is excellent , dean Toriumi in Chicago is also good , many patients also travel internationally for revision surgery and you should consider both the UK and Australia as many of us have huge revisional Rhinoplasty practices 

There are many surgeons with a great focus on rhinoplasty and revision rhinoplasty in USA. First you should check their credentials and make sure they have a good number of before/after photos so you can judge their work and compatibility of their sense of aesthetics with yours. Rhinoplasty should be the main surgery that they perform, not breast, body or even other facial surgeries as nasal surgery in modern age has become almost a sub- subspecialty. At last, it is your rapport, personal connection and sense of care that you feel with your doctor that could be different for different patients with different doctors. If you are interested to know just from an academic standpoint, Dr. Dean Toriumi in Chicago has probably contributed the most in advancing the field in recent decades.

Kazim
Good candidates for revision rhinoplasty have realistic expectations regarding the potential improvements. Some patients may want their breathing improved, asymmetries improved, nasal tip refinement or changes to their nasal bones. Every revision rhinoplasty is different. In some cases small subtle changes are all that is needed. Other cases may be more extensive requiring grafting of cartilage from the ear or rib. Previous operative notes, photos from prior to the initial procedure and a physical exam are used to determine the extent of work needed and possible improvements. Providing the operative note and photos prior to the consultation can be helpful to determine if you are an appropriate revision rhinoplasty candidate.
Best of luck,
Dr. Kaniff

Your question is common, I see that some respondents on this forum have given you names of individuals.  I am sure that you should have excellent rhinoplasty surgeons in England that are capable to both evaluate, and possibly commit to performing a revisionary procedure for you without leaving the country.  I would start with your primary surgeon and see who he might recommend.  In addition forums such as this may help you also locate a qualified surgeon.  As a rhinoplasty surgeon myself, who performs many revisionary rhinoplasty procedures, I feel that what you should look for is a surgeon that can understand your concerns, be able to visualize your goals, and have the technical ability to deliver a change that would provide you with a more satisfactory result. When visiting a surgeon for this I suggest that you provide a set of your pre-op photos, current post-op photos, your operative note, and some images of what you feel is more in concert with your ideal.  I hope this helps,Sergio P. Maggi, MD, FACSdrmaggi.comAustin Plastic Surgery Center

Unfortunately you are in good company. Most rhinoplasty patients out
there are very unhappy with their results in 1-2 years. The explanation
for this is very simple: Most surgeons performing rhinoplasty do not
have advanced training or experience, they perform the rhinoplasty of 50
years ago. Decades ago thought process of rhinoplasty was to remove
cartilage to refine the shape of the nose and perform it through an open
approach. An open approach makes it easy for neophyte surgeons to
access visualize and manipulate the structures but also unnecessarily
destroys two arteries and veins that are important for nasal
vascularity. The open approach thus ensures that patients have 1-2
years of risidual swelling which hides the final result. Most
rhinoplasties out there I consider cartilage robbing thus when the
swlling resolves there is inadequate structure to provide aesthetic
appearance and fight the cicatriacial forces or the continued scarring
that results from the lowered oxygen tension and fibrosis of tissues.
One additional problem it that most rhinoplasty surgeons out there
inadvertently break the connection between the bony nose and the
cartilagenous nose. this can cause irregular narrowing and what we
calll "the inverted V deformity" which means the outline of the nasal
bone becomes visible through the skin particularly in flash photography
under certain lighting conditions.In my opinion, an expert
level rhinoplasty is always performed in a closed technique and ALWAYS
involves grafting to add to the structural integrity of the nose. The
act of opening the nose even under the closed technique causes healing
and some contraction, thus for a long term beautiful result the nose
must be left more structurally sound than it was found. This is missed
upon most rhinoplasty surgeons. In secondary cases such as
yours it is even more crucial that sound grafting techniques are used. 
Definitely do not consider any rhinoplasty procedure that does not
include grafting preferably by an experienced Plastic and reconstructive
training with ddition fellowship level craniofacial and aesthetic
training. Of course this is my bias because it is my training but I
think this level of training is very necessary for success in secondary
and tertiary rhinoplasty because there is delicate nuance involved and
every patient requires different maneuvers. I hope this helps!All the best,Rian A. Maercks M.D.

There many of us who specialize in revision rhinoplasty. You can go the The Rhinoplasty Society website and look up the founding members. You can go to the related websites to see who teaches rhinoplasty, who has written a book about rhinoplasty, review the information about the surgeon and the photo gallery to see how the noses are matched to the faces and they do not all look exactly alike (prototyped) and how natural they look. You can then set up a Skype, FaceTime or phone consultation with a few and choose the one that you are most comfortable with.

There is no "Best" surgeon in any particular surgical category.  I have seen a surgeon who was mentioned by many other colleagues on this post as one of the Best, have a complication during a live surgery at a national meeting.  Did he correct it?  Yes.  Could it have been avoided?  Yes.  There are many highly qualified surgeons and it is important that you find one that suits your financial and geographical needs, understands your surgical goals, and provides a safe and clear path to achieving those goals.  Be wary of any Surgeon who claims to be the Best -- usually anyone who does this is far from it.   Choose a surgeon that has a large gallery of before and after photos to see their particular outcomes, that is boards certified, that has a clean history and has good reviews from peers and patients alike.  The surgeon you choose will have an impact on your life and should be someone you feel comfortable with.  Good Luck!

There are several great rhinoplasty surgeons in the US.  I would say the best surgeon suited to revise a nose would be one that has knowledge about not just the outside but also the inside of the nose.  You don't want to have another surgery for the inside.  Finding a surgeon who specializes in rhinoplasties and has a background in Ear, Nose, and Throat surgery would be most helpful for you.  The best in America will also be the most expensive but you do get what you pay for when it comes to rhinoplasties.  I would say Dr. Dean Toriumi, Dr. Russ Kridel, Dr. J Regan Thomas, Dr. Peter Adamson, and Dr. Rohrich.