Revision Rhinoplasty

Rhinoplasty (nose reshaping surgery) can be an important decision for patients who are counting on achieving the best possible results to resolve their functional or aesthetic concerns. However, some patients do not attain the outcome they had originally hoped for from their initial rhinoplasty procedure. In some cases, individuals experience complications or ineffective solutions to their initial problems. Revision rhinoplasty, also referred to as secondary rhinoplasty, is a procedure in which our skilled facial plastic surgeon addresses issues you may be having from a previous rhinoplasty performed by another surgeon. Dr. Ali Sepehr is double board-certified, fellowship-trained, and can help repair problems that may have arisen after rhinoplasty. He can also help you achieve results more in line with what you had originally envisioned.

Please contact OC Facial Plastic Surgery to schedule a consultation with Dr. Sepehr for revision rhinoplasty.

• Revision Rhinoplasty Benefits
• Revision Rhinoplasty Candidates
• Reasons for Revision Rhinoplasty
• Revision Rhinoplasty Considerations
• Revision Rhinoplasty Timing
• Revision Rhinoplasty Consultation
• Revision Rhinoplasty Procedure
• Revision Rhinoplasty Techniques
• Revision Rhinoplasty Recovery
• Revision Rhinoplasty Results
• Revision Rhinoplasty Scars
• Revision Rhinoplasty Cost
• Choosing a Revision Rhinoplasty Surgeon
• Revision Rhinoplasty FAQs

What Can Be Achieved With Revision Rhinoplasty?

The overarching goal of revision rhinoplasty is to improve the results of your original procedure. Depending on your reasons for surgery, revision rhinoplasty can generally:

• Refine the bridge of the nose
• Adjust the nasal tip
• Correct other cosmetic deficiencies that arise during the healing process
• Repair residual breathing difficulties

It’s important to remember that no plastic surgeon can guarantee the outcome of a revisionary procedure. However, if you’re considering a second nasal surgery to address issues left from your original operation, it’s in your best interest to entrust your care to a professional with significant experience performing such procedures like Dr. Sepehr — a highly trained and double board-certified facial plastic surgeon who specializes in otolaryngological procedures (surgeries of the ear, nose, and throat).

Who is a Good Candidate for Revision Rhinoplasty?

There are a number of reasons patients may want to have a secondary (revision) rhinoplasty — from displeasure with the aesthetic results to functional problems that have been exacerbated or simply left untreated from their previous surgery. You may be a candidate for revision rhinoplasty if:

• You are dissatisfied with the results from the original rhinoplasty
• You experienced complications from the original rhinoplasty
• You had breathing difficulties that have still not been corrected

Dr. Ali Sepehr will discuss your goals with you during an initial revision rhinoplasty consultation. He will explain all aspects of the procedure with you and talk with you about your expectations. Together, you and Dr. Sepehr will come up with a treatment plan designed to address your needs.

Patient Results

Before

After

Before

After

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What are Common Reasons to Undergo Revision Rhinoplasty?

The reasons for considering revision rhinoplasty are many. Some patients are dissatisfied with the results obtained by another plastic surgeon. Others may find that functional issues, like breathing problems, are not fully corrected after the first procedure. In very rare instances, complications could occur initially, and revision rhinoplasty may then be performed to address the effects of this event or to achieve the outcome that was originally intended. Dr. Sepehr is extensively trained in the delicate and complex technique of revision rhinoplasty. With his experience, precision, and artistic eye, he can help you obtain the look and functionality you’re seeking.

Considerations Prior to Revision Rhinoplasty

A revisionary procedure operates on previously treated tissue, presenting unique considerations that may not be applicable during other facial plastic surgeries. Certain factors to contemplate when researching the revision rhinoplasty procedure include:

• Scar tissue buildup: An original rhinoplasty usually leaves scar tissue behind even after the healing process is complete, which can present issues during a revision rhinoplasty procedure. Dr. Sepehr will discuss how scar tissue buildup may affect your surgery during your consultation, but in general, scar tissue may limit the final results.
• Need for tissue grafting: In many cases, over-reduction of the cartilage and bone has left the nose devoid of the necessary structural support it needs, causing deformities and dysfunction. Cartilage from other regions of the body (such as the ribs or ears) is required to help build structural support for the bridge and tip of the nose.
• No guarantee of outcome: Patients who have undergone previous procedures in the area(s) of treatment generally present the most difficult cases in aesthetic surgery. This makes it crucial to select a facial plastic surgeon with substantial experience in revision rhinoplasty to help maximize the likelihood of successful results.

There are many aspects related to revision rhinoplasty that should be discussed with a facial plastic surgeon before you decide to go forward with the procedure. Dr. Sepehr will do his best to help ensure you have a fully informed understanding of revision rhinoplasty prior to making your decision.

How Long Should I Wait Before Undergoing Revision Rhinoplasty?

Although Dr. Sepehr understands the desire to undergo revision rhinoplasty as soon as possible after failing to achieve your ideal results, some patience will be required before it’s safe to undergo a secondary procedure. Due to the extensive swelling that typically develops after nose surgery, it’s generally best to wait until the inflammation from your original rhinoplasty resolves before planning a revisional procedure. This waiting period provides time for the final outcome to fully reveal itself before you make a decision about revision rhinoplasty.

After nose surgery, it can take six months to one year for all swelling in the nasal tissues to completely subside. This timeframe often varies depending on the thickness of your skin and which components of the nasal framework were addressed in your original rhinoplasty. The rate of healing for the nasal tip typically differs in comparison with the bridge or septum, therefore the most ideal timing for revision rhinoplasty will vary from patient to patient. That said, a waiting period of 6 to 18 months before pursuing additional surgery can be a good rule of thumb. In fact, during the first year, maintaining close follow up with your original surgeon is the best course of action to ensure the best chances for optimal healing. Dr. Sepehr will ultimately guide you in creating the most beneficial treatment plan based on your needs and overall goals.

Your Revision Rhinoplasty Consultation

When you meet Dr. Sepehr for your consultation, he will listen closely to the concerns you have with your original rhinoplasty results. This extensive doctor-patient communication is essential to achieving the aesthetic and/or functional improvements you seek. He will also perform an in-depth evaluation of your nose to determine the amount of support available, whether cartilage grafts are necessary to make the desired enhancements, and the quality of your nasal airways (if impaired breathing is a concern).

Part of your consultation will also involve a review of your medical history and previous rhinoplasty procedures. Dr. Sepehr will then explain what can realistically be achieved with revision rhinoplasty based on your anatomical indicators, needs, and goals. You will be able to ask any questions you may have about the procedure or Dr. Sepehr’s experience performing rhinoplasty, and he will make sure you understand the risks, potential benefits, and limitations of the procedure. Together, you both will develop an optimal treatment plan to attain the outcome you envision.

How is the Revision Rhinoplasty Procedure Performed?

Revision rhinoplasty procedures typically involve taking cartilage grafts from the ear or rib and reshaping them for the nose. The procedure is very complex and requires the skilled hands of an experienced facial plastic surgeon. Dr. Sepehr is not only a board-certified facial plastic surgeon and can provide very good aesthetic results with revision rhinoplasty, but he is also a board-certified otolaryngologist and can address nasal airway deficits after previous surgeries. Incisions will likely be made in the same area as the original rhinoplasty surgery to avoid excess scarring; however, rhinoplasty usually involves very discreet incisions in any case and scarring is virtually invisible.

What Techniques are Used During Revision Rhinoplasty?

The majority of revision rhinoplasty procedures use an open approach. This technique allows Dr. Sepehr to have better access to the internal nasal structures and provide the optimal outcome. There may be instances where a closed (endonasal) rhinoplasty can be performed. Dr. Sepehr will let you know which method is ideal for your needs and goals during your initial consultation.

What is Recovery From Revision Rhinoplasty Like?

Recovery from revision rhinoplasty is very similar to that of traditional rhinoplasty. You will likely experience swelling, bruising, and discomfort for several days after the procedure; however, pain can be relieved with medication. You will need to diligently shield the nose from harm in the first two months after surgery and avoid blowing your nose for two weeks after revision rhinoplasty. Most patients can return to normal daily routines after one week.

You will also need to take at least a week off from your regular schedule, perhaps more depending on your individual healing rate. We recommend listening to your body to help determine when you’re ready to return to work, school, and other normal activities. Strenuous exertion, such as sports, exercise, and certain other recreational events, should be avoided for at least a month to a month-and-a-half. Dr. Sepehr can provide a more specific estimate based on the activity in which you would like to engage in. Swelling, bruising, and tenderness in the treated area is to be expected, and these effects should gradually fade. Although there is still some residual swelling after a couple of months, you should have a good idea of the direction in which the results are headed. Some residual swelling may continue after this point, but you will likely be unaware of it.

What Can I Expect From My Revision Rhinoplasty Results?

The goal of revision rhinoplasty is to improve the functional and aesthetic outcome of your original nasal surgery, and Dr. Sepehr’s before-and-after photos can provide a good understanding of the enhancements possible with a secondary procedure. It’s important to remember that revision rhinoplasty is even more complex to perform than a primary nose surgery and not all improvements may be possible due to the formation of scar tissue and the limited amount of cartilage available. Therefore, realistic expectations for your revision rhinoplasty are key to achieving satisfaction after surgery. An experienced rhinoplasty surgeon will always give you a comprehensive idea of what to expect from the results of your procedure so you have a good understanding of your anticipated outcome. In general, the majority of swelling after revision rhinoplasty should be resolved after three to four months. The results achieved after 12 – 24 months can usually be considered your final outcome. At this point, the nose contour/shape should remain stable for your lifetime as long as you do not suffer a nasal injury in the future.

Will I Have Scars From Revision Rhinoplasty?

If an open rhinoplasty is performed, there is usually a small, barely noticeable scar created on the underside of the nostrils, an area called the columella. Most patients find that this incision heals very well. If you’re concerned about scarring, we can provide advice on how to minimize the appearance of the mark using topical scar-reduction products and, if needed, laser skin resurfacing and topical scar-reduction products.

How Much Does Revision Rhinoplasty Cost?

Revision rhinoplasty is a more complicated procedure than a first rhinoplasty, and as a result the costs are often higher. The fees associated will depend on your unique treatment plan, and they will also include a hospital or medical facility fee, anesthesiology fee, and other incidentals. We will go over the details of your plan, including the cost, during your initial appointment so you can be well-informed about your options. We also work with CareCredit^® and Prosper, two plastic surgery financing agencies that offer appealing terms to qualified applicants if you’re interested in paying installments rather than a lump sum.

Choosing the Best Revision Rhinoplasty Surgeon For Your Needs

As revision rhinoplasty involves working on components of the nasal framework that have already been operated on, the procedure is typically more complex than a primary rhinoplasty. With this in mind, it is essential to take the time to find a well-qualified facial plastic surgeon who is capable of achieving the results you desire while tailoring the procedure to accommodate your unique needs. While you are in the process of researching your options, the following tips can help ensure you are under the care of the best revision rhinoplasty surgeon for your cosmetic goals:

• Select a board-certified facial plastic surgeon. With a revisionary procedure, it is in your best interest to seek the expertise of a surgeon who has exclusive and focused experience in facial plastic surgery. When you entrust your care to a facial plastic surgeon with accreditation from the American Board of Facial and Reconstructive Surgery, it can give you the confidence of knowing your health and appearance is in the hands of a surgeon with intricate training and familiarity with refining the facial anatomy.
• Read online patient reviews and testimonials. Search through third-party platforms like Facebook, Google, and Yelp to gain an overall idea of a plastic surgeon’s reputation and level of care. Assessments written by previous patients can give you a broad understanding of previous patients’ satisfaction after treatment.
• See revision rhinoplasty before-and-after photos. This is perhaps the best way to introduce yourself to a facial plastic surgeon’s portfolio and past work, as the results achieved in previous revision rhinoplasty surgeries can be an excellent indication of the quality of your final outcome.
• Meet your prospective surgeon in person. All in all, the most important factor in selecting the right facial plastic surgeon is your ability to feel comfortable and confident under their care. A consultation is a great opportunity to ask a prospective surgeon any questions you may have about their experience or the revision rhinoplasty process. Make sure he or she evaluates your concerns thoroughly and fully explains what you can expect during your procedure without pressure or haste.

Additional Revision Rhinoplasty FAQ

Is revision rhinoplasty safe?

Revision rhinoplasty is considered a safe procedure, but the complexity of a second rhinoplasty surgery should not be understated. It requires a great deal of knowledge and skill in facial plastic surgery to enhance parts of the nose that have already been operated on; therefore, selecting a well-qualified revision rhinoplasty surgery is crucial. When compared to a general plastic surgeon, a facial plastic surgeon certified by the American Board of Facial Plastic and Reconstructive Surgery (ABFPRS) is generally the most experienced practitioner to perform primary and secondary rhinoplasty. With a board-certified facial plastic surgeon, you can feel confident that he or she has had an exclusive, career-long focus on facial reconstruction and is well-equipped to provide you with the safety and care you deserve.

Will revision rhinoplasty change my breathing?

If you have trouble breathing after your first rhinoplasty, revision rhinoplasty may be useful in identifying and correcting the issue(s) obstructing airflow. An in-person examination is necessary to determine how a second nose surgery may affect your breathing, and whether the procedure is the best option to resolve your concerns. In general, revision rhinoplasty should not negatively affect breathing for patients who are good candidates for the procedure; however, one must be sure to choose a surgeon who respects the support structures of the nose and doesn’t weaken them even further.

What is the success rate of revision rhinoplasty?

The vast majority of patients who undergo revision rhinoplasty are happy with their results, but a mutual understanding of goals is key to your satisfaction after surgery. During your consultation, Dr. Sepehr will help ensure you understand what the potential results of revision rhinoplasty may look like, so you maintain realistic expectations for the outcome.

Will I need a rib graft for revision rhinoplasty surgery?

Whether you need a tissue graft during revision rhinoplasty depends on your concerns and the issues you seek to improve or correct. To properly repair/reconstruct the nose, cartilage is commonly borrowed from the ear and/or rib; however, the need for grafting depends on the nature of the desired improvements and the current state of the nasal septum. Dr. Sepehr will closely go over the details of your unique procedure, so you understand what to expect during revision rhinoplasty.

How do I know if I need revision rhinoplasty?

If you have trouble breathing, dislike the shape of your nose, or if you’re experiencing complications after your initial rhinoplasty, these are all potential reasons to consider revision surgery. An evaluation with a facial plastic surgeon is the only way to confirm whether revision rhinoplasty can fix the issues you seek to correct.

If you would like more information on revision rhinoplasty and secondary rhinoplasty procedures, please contact our practice.