Will It Be Safe to Do Corrective Rhinoplasty 11 Months After the First Operation?

The general consensus among rhinoplasty specialists is that a patient wait for 12 months before proceeding with any revision. The reason for this is that it can take 12 months (or longer) for the majority of the post-operative swelling to subside and for scar tissue to mature. However, this time-period is somewhat arbitrary and there should not be any significant difference in waiting 11 versus 12 months. Speak with your surgeon about your concerns regarding the timing and your insurance/cost. He should be able to come up with a plan that will be agreeable to both of you.

Waiting one year to do revision nasal surgery is not a rule set in stone.  Your surgeon should be able to thoroughly examine your nose to asses how it looks and how the tissues feel to palpation, then be able to assess if in fact the timing is right.  Furthermore, the timing of revision depends on the extent of revision work required.  As I said, there are no hard and fast rules for revision.

You have described quite a few changes that you'd like to occur.  An experienced and wise surgeon should be able to carefully asses your result and your wishes and only then make determination as to appropriate timing for your revision rhinoplasty.  Although it is quite tempting from financial perspective to proceed at this time, if you trust your surgeon that you should heed his advise. You might find it insightful to read my article "The Art of Sculpting the Nose" which can be found on my web site under "publications"
 

While surgeons say 6-12 months for a revision, I see no problem at 11 versus 12 months. If the doctor still wants to wait until January, tell him
"OK-you pay my deductible". I'm sure he'll see the light!

There is no significant difference between 11 and 12 months in my opinion. The surgery is safe at this point and there is enough reduction in swelling to know what needs fixing.
If your problem is alternating nasal obstruction, then you might need a turbinate procedure. The turbinates naturally swell every 3-12 hours in an alternating fashion throughout the day. This nasal cycle, which is a normal reflex that is present in 80% of patients, should never be severe enough to create uncomfortable breathing. Invariably, a turbinate reduction procedure, rather than revision septal surgery, solves the problem when alternating nasal obstruction is the primary issue.
Good luck!

Hi Eric,
You should discuss your financial and insurance concerns with your surgeon.  It is perfectly fine to have a revision surgery at 11 months.  It is safe to do at this point.  Good luck.
Dr. P

While 6 - 12 months is the rule of thumb, each patient is different in terms of how he/she heals.  If the surgeon is uncomfortable in performing the surgery earlier, then you should respect his/her opinion.  The surgeon should clearly explain his/her reasoning so you can make an informed decision.

The nose takes time to heal from an initial operation.  The tissues need to settle out and the skin envelping the nose "contracts down" like shrink-wrap.  The time for this to take place and the extend to which it takes place depends on things  like skin thickness, how glandular the skin is, whether or not there are cartilage grafts in place (and their thickness as well) and what layer the surgeon dissected in the first time.  Some noses are "settled out" by 9-12 mos others with thick skin may take up to 1.5 yrs.  There is a tremendous amt of variability.

 

Normally a month difference when you are approaching a year out iwill not make a huge difference.  Its much more important when you are more "fresh out" from the first surgery.  I would re-vist the situation with him and ask what elements of your nose will make the extra four weeks critical to the success of the operation.

Waiting another month beyond the 11 months you have already waited will make little to no difference from a surgical persective.

Mario J. Imola, MD, DDS, FRCSC.

While most surgeons agree that one year is an appropriate amount of time for healing, collagen remodeling, and edema (swelling) to resolve, I would think that the difference between 11 and 12 months is negligible.  Unless something more complex is going on, which only your surgeon would be aware of, you should have no problem proceeding with the revision at 11 months.

Most surgeons like to wait 12 months before performing a revision procedure.  It gives the nose optimal time to heal and assess what needs to be changed. If the surgery is done too soon you may be changing something that would have settled had you waited.