Must I Wait 6 Months Before Revision Rhinoplasty?

These photos are of my 3-month post-first-septorhinoplasty. I have contacted several of you as I read carefully through this board. I respect my surgeon for taking on this complex surgery, but I will definitely need revision/reconstructive surgery. I turn 40 2-days before my 6-month healing period. I would like nothing more than to have a surgery done before or for my birthday. I'd love your opinions on my case and any recommendations.

Doctor Answers 9

The Decision To Operate Rests On the Exam-- Not Just Time

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Dear Chicago friend,

I trained in Chicago and my teacher taught me the following: "No two patients are the same. Decisions regarding revision rhinoplasty must be very carefully made. You make the decision based on the examination, as well as how long since surgery. Feel the tissues. Are they still firm? Has sensation returned, or are parts still numb? Is there any soreness when you touch the various parts of the nose? Has the swelling continue to reduce or has the appearance stayed the same? How is the breathing?"

Those are the questions that go through my mind after reading your post and viewing your photos.

The nose appears to be leaning to one side and that should be corrected. The operation will not be an easy one. But, it must be " fully-ripened" before a second operation is done.

My suggestion is to consult with several very experienced rhinoplasty surgeons at the 9-month mark and ask for their evaluation. Don't be surprised if they suggest waiting longer. Just last month we saw a patient who had a very complex primary rhinoplasty by us. We saw her at the one-year mark and she looked decidedly better than at the six- and even the nine-month marks.

Your patience will be rewarded.

I am sure your surgeon has read a great piece of advice from one of the great plastic surgeons, Dr. Kazanjian: "Never do today what can be honorably put off until tomorrow." However, generally, younger surgeons forget that, more experienced and more specialized surgeons remember that.

I am from Chicago, a  conservative Midwesterner. The above aphorism is correct, believe me. Hold tight.

Robert Kotler, MD, FACS

Beverly Hills, CA

Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 90 reviews

Wait Time before Revision Rhinoplasty

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You're correct when you say you'll need a revision. If the surgery will involve the nasal tip, I wait 9-12 months. Do not rush this - you want to do this only one more time. I'm sorry, but Happy Birthday.

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

You may consider revision rhinoplasty surgery 6 months after your original operation.

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I read your concern and reviewed your 3-month post-op photos.

6 months is the earliest I would suggest revision surgery. I agree with your assessment regarding the necessity of further surgery and reconstruction.

Please choose your revision rhinoplasty surgeon carefully. Check many photos. You should get a copy of your operative report to see if any septal work was performed. If you had a septoplasty, you may need rib-cartilage for an aesthetically pleasing reconstruction.

All the best from NJ.

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

Usually I advise waiting at least a year before considering Revision Rhinoplasty

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Sometimes reasons for needing revision rhinoplasty become evident far before this one year date. However, the nose continues to heal for a year or more. There may be residual swelling, scar tissue that needs to soften as well as settling of the cartilages. It is frustrating to wait but for the best result I feel this is important.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 141 reviews

Revision rhinoplasty

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A revision rhinoplasty is best done at least one year after previous surgery so that the tissues are supple.

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

Timing of revision

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First - thanks for posting the pictures which are invaluable in any attempt to answer your question.  Although you could do a revision in 6 months or less, and the outcome would likely be better than what you now have, in order to get the best long-term outcome you should wait close to 1 year.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Wait a year before rhinoplasty revision.

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You should wait a year before rhinoplasty revision.  Not sure if you are planning to return to your original surgeon, there are great plastic surgeons in the Chicago area that can help you. 

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Wait 1 year before revision rhinoplasty

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It is very important to wait at least a year prior to embarking on revision rhinoplasty surgery. Full healing continues to take place upwards of a year. There is scar tissue and fluid retention present in the subdermal portion of the skin, more so in thick, oily, olive complexion than in fair skin.  

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Rhinoplasty Revision

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You need to discuss this with your plastic surgeon.  Often it is best to wait for 6 months or more for the swelling to diminish and for the scar tissues to start softening up.  However you may be an exception in my practice.  I would encourgae atleats 6 months though. 

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