Is 7 months too soon for a revision rhinoplasty?

Rhinoplasty is considered to be the most difficult of all cosmetic surgical procedures. Even the best surgeons have revision rates of 3-5%. Bad nose job results are usually due to many factors, the most important of which is choosing your surgeon carefully. I am continually amazed that many patients are more careful, and spend more time picking out the color and model of their new car than they are in selecting the surgeon who will operate on their nose.
As we know, the nose is smack dab in the middle of our face, and cannot be covered by clothing when things go wrong.

You need to discuss with your surgeon what bothers you about your nose during the initial consultation.
Your surgeon needs to make the proper diagnostic evaluation in order to correct what bothers you.
You need to be assured that your expectations are realistic.
Look at before and after pictures.
Ask to be scheduled when other post-operative patients are in the office so that you can see and speak with them.
Look at the before and after photos.

Once the surgery has occured, one needs to wait 6-12 months before correcting the bad result. If you still have confidence in your surgeon then schedule a revision surgery. You may want to get one or two other opinions from respected rhinoplasty surgeons (in the Chicago area, Dean Toriumi, M.D. is among the finest in the world).
Fillers may temporarily help particular problems, but truly bad results will need surgical correction.
Remember that the best chance for sucess is the first time, so choose carefully.

Hello and thank you for your question. Timing for Revision Rhinoplasty depends on many factors and is very dependent on your individual anatomy. Whereas in some patients I will recommend waiting over one year, in other patients as soon as eight months may be acceptable. The most important aspect is to find a surgeon you are comfortable with. 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

Hello,You are describing an excessive reduction of the nose for length and projection. Restoring the shape requires rebuilding the support and puts the skin under tension. It often requires rib cartilage for the construct to be stable.The main limiting factor is related to the tightness of the lining of the nose and to this effect I would strongly advise waiting for at least 1 year before any surgery. At that point the tissues are stronger and you would have safer surgery.

I am very sorry to hear about your dissatisfaction with your rhinoplasty results. Have you spoken with you surgeon? Revision rhinoplasty cases are challenging and I wouldn't be able to give you an answer without carefully and thoroughly reviewing your results. Swelling may still be present, making it unwise to move forward with a revision this early on. I would recommend looking for a surgeon who specializes in revisions.To learn more about revision rhinoplasty cases, check out this short video. Best of luck,

I'm truly sorry about your bad rhinoplasty result. A very high percentage of my practice is revision rhinoplasties. I know how you feel having treated many "botch" patients for over 30 years. Without seeing photographs, it appears your dorsum was over resected which may require cartilage grafting (more than simple fillers) for augmentation. I prefer to wait a year but have done revisions earlier on select patients and special situations. I have photographs of similar patients on my web site and on Real Self.

In my NYC practice, I frequently see patients who are displeased with their results from other surgeons. While the rule of thumb is to wait a full year to determine whether or not a patient is a good candidate for revision rhinoplasty, the truth is that determination is done on a case-by-case basis.  In other words, there are some outcomes that are obviously not going to improve with time, whereas other cases that require waiting.  Revision rhinoplasty is widely known as one of the most technical and challenging procedures to perform. Your surgeon should be board certified, specialize in revision rhinoplasty, have an extensive knowledge of nasal structures, be meticulous and thorough, and have decades of experience. There are circumstances where revision rhinoplasty can actually cause more damage than good, so it is important to seek a skilled board certified plastic surgeon who is able to identify what’s best for you. 

Revision surgery can be considered as early as 12 months post surgery but it is vital that you seek help from plastic surgeon or facial plastic surgeon who performs a large number of both primary and revisional surgery Please also get copies of your original surgery operating records and pre surgery photos  to better inform the potential surgeon 

Unfortunately, with increasing demands for the surgery, poor rhinoplasty results are not very uncommon and that speaks to the complexity of this surgery. However, with more advances in the field and newer techniques available, solid improvements in a more predictable fashion with revision rhinoplasty can be expected in the right hands. Most experts believe that at least one year should be given for the results to settle before committing to the second surgery, and that should give you ample time to do find the right revision surgeon for you, based on their credentials, photo gallery and rapport. It is a great idea also to ask the candidate surgeon for you to be connected to some of his/her previous revision patients if possible too. 

I have unfortunately seen many many patients like you in my practice. Im positive your treating surgeon did not want you to feel this way. Even in the best of hands, complications do arise. In my practice complications usually arise from a good procedure that was performed on the wrong anatomy ad for the wrong reasons. Experience with cause and effect is necessary in this field. Patience is mandatory as it often takes a year, if not longer, to decide which reconstructive procedures to perform. What you have to do now is research those individuals who specialize in such procedures in your area. A large percentage of their practice should be devoted to aesthetics and function of the nose. Ask to see pictures and ask the number of such cases they perform a month. Ask to see a typical surgical schedule for the surgeon, if there are procedures on there that have nothing to do with plastic surgery (like tonsillectomy and ear tubes) then most often these individuals are not specialists nor do they perform high volumes. Revisions are extremely comple, do your homework. Good luck to you. 

Thank you for your question about revision rhinoplasty.  There may be an alternative to surgical rhinoplasty called a "liquid rhinoplasty".  It is the use of hyaluronic acid fillers such as Juvederm Voluma to build up the bridge of the nose.  This procedure typically lasts for 2 years.  It is easily reversible if you do not like it, or if there are any complications.  This might be something you can do temporarily until you have a revision of your nose.  
To be sure, see two or more experienced, licensed and board-certified providers in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have treatment. I hope this helps.

The revision rhinoplasty is a more difficult operation than the primary rhinoplasty and waiting for optimal conditions will favor a successful outcome. In most cases revision rhinoplasty is done after twelve months, so that swelling is minimal. In patients with thick skin it may be prudent to wait even longer, since swelling takes longer to resolve in noses with thicker skin. Occasionally it may be acceptable to perform a revision rhinoplasty in less than twelve months such as for obvious deformities associated with breathing problems.
Best of luck.
Dr. Kaniff