Many board-certified plastic surgeons agree that rhinoplasty is one of the most difficult cosmetic procedures to do well. The nose is complex, obviously in the middle of the face, and highly visible.
Doing an excellent job with rhinoplasty means improving the nose’s appearance while also maintaining or improving nasal function.
Sometimes a patient has rhinoplasty that, for many reasons, didn’t work out or didn’t means their expectations. If that happens, the patient may seek revision rhinoplasty.
Some of the reasons that patients have revision rhinoplasty are:
- Nose shape: The patient may be unhappy with the shape of the nose from the previous rhinoplasty.
- Nose size: The surgeon can make additional adjustments to the soft tissues to change the shape and enhance symmetry.
- Breathing issues: The previous surgery may not have fixed problems that affect nasal breathing.
Revision rhinoplasty is a challenging procedure that will test the skills of even the best surgeon. Patients should understand that additional rhinoplasty may or may not improve the situation. In addition, scar tissue from the previous surgery can cause complications.
But if you select a board-certified surgeon with a track record of successful revision rhinoplasties, you can have impressive results.
Dr. Smita R. Ramanadham is a double board-certified plastic surgeon specializing in rhinoplasty, facelifts, and related procedures. She will perform your revision rhinoplasty with the skill and artistic sense necessary for the best, natural-looking result. Dr. Smita also performs other facial and body cosmetic procedures in the New Jersey, New York City, and Tri-state areas.
Revision Rhinoplasty Procedure
Revision rhinoplasty may require a cartilage transplant to support the tip or nose bridge. However, the cartilage in the nose may be insufficient for additional surgery, so the surgeon may add cartilage from the rib or ear.
Irregularities in the soft tissue on the nose bridge or nose tip may require additional tissue to cover the work done. Some surgeons remove tissue inside the hairline that provides excellent support for further nose surgery.
Some patients may need skin grafts to reopen the nasal airway. But even with the best skill and technique, revision rhinoplasty has a higher complication rate than those who have their first rhinoplasty.
It’s important to remember that no plastic surgeon can assure satisfactory results with revision rhinoplasty. Many procedures go well, but there are no guarantees with revision rhinoplasty.
Also, revision rhinoplasty is always performed with an open approach, which means three incisions are used, so the surgeon has full access to the internal nasal structure.
Open rhinoplasty has higher complications because of scar tissue or issues with previous changes. The open procedure also has a longer recovery time, but it allows the surgeon to see as much of the internal structures as possible, leading to a better result.
Revision Rhinoplasty Benefits
The benefits of revision rhinoplasty are similar to those of the initial procedure. The primary goal is to make you feel better about how you look and provide a better nose appearance. The biggest benefit of revision rhinoplasty is improving the results that you weren’t satisfied with before.
After revision rhinoplasty, you may be more pleased with the shape and size of your nose. In addition, adding cartilage from another part of your body may give the nose the structure it needs for better appearance and breathing function.
Other benefits of revision rhinoplasty are:
- Correct nasal deformities: The revision procedure may fix nose deformities caused by medical issues, accidents, or inadequate nasal structure.
- Improve nasal function: A beautiful nose isn’t helpful if it doesn’t allow you to breathe freely. Therefore, improving nasal function is often the most crucial benefit of this procedure.
- Enhanced appearance: It can be distressing to spend thousands of dollars on a nose job and have the nose not look the way you want. This procedure can make you feel good about your nose.
- Having a second procedure can also help quiet that inner voice that says something is ‘wrong’ with your nose.
Ideal Candidates For Revision Rhinoplasty
As with all plastic surgeries, it’s important that you are in good health before undergoing another procedure. You shouldn’t have a major health problems or take medications that can slow the healing process
Also, ideal candidates for revision rhinoplasty usually fall into one or more of these categories:
- You don’t like how your nose looks: If you often fret about how your nose looks after the first procedure, you may want to have a second rhinoplasty. But it’s important to have realistic expectations, and remember revision rhinoplasty has a higher complication rate.
- You have trouble breathing: There are times when the first rhinoplasty may make it harder for the patient to breathe. But fortunately, revision rhinoplasty often can successfully address airflow through the nose.
- You had an accident: Some patients have a successful initial rhinoplasty but have an accident that damages the nose. But a plastic surgeon can usually fix your nose and make it like it was before.
- It’s been at least a year: People who don’t like how their nose turned out may want to have another procedure ASAP. But it’s important to wait at least a year after the first procedure before having another one.
Surgery Preparation For Revision Rhinoplasty
As you consider revision rhinoplasty, the most important thing is to make sure the nose is fully healed from the previous operation. It takes about a year for the nose to heal, so let that happen before you seek another procedure.
As with your previous surgery, you shouldn’t smoke or take blood thinners for at least two weeks before the procedure. The same is true for after surgery, as well.
Revision rhinoplasty can take two to five hours, and you will need someone to take you home. Recovery will take about six weeks.
For the first week, make sure you have all pain medication prescriptions filled and ready to go for the first week. Also, have prepared meals on hand and ice packs to cut down the swelling.
Revision Rhinoplasty Risks And Complications
Revision rhinoplasty has one of the highest complication rates of all plastic surgeries. The reason is that the tissues in the nose have already been operated on, and there is scar tissue there.
Because of the scar tissue, many actions taken during rhinoplasty may not have the intended effect. While a board-certified plastic surgeon can usually produce a good result, it’s possible that revision rhinoplasty can produce unsatisfactory results that are difficult to fix.
Experienced surgeons say it’s difficult to know what will be needed during revision rhinoplasty until the surgery is being done. Much depends on what the previous surgeon did and left in place.
Further, blood flow to the nasal tissues may have been reduced from the last procedure. This can extend healing and recovery time.
Other potential complications with rhinoplasty are difficulty breathing, alternations in skin sensation, poor wound healing, and scarring.
Revision Rhinoplasty Recovery
Recovery from revision rhinoplasty takes about two weeks before the most significant swelling and bruising recedes. It’s recommended that you take a week to 10 days off work. The surgeon may put a splint on your nose and it can be taken off about one week later.
You should expect significant swelling, bruising, and discomfort for the first three or four days. The surgeon will give you prescription pain medication to manage the pain during this time. If you have significant swelling, you can apply ice packs every 20 minutes or so.
Breathing through your nose may be difficult for the first few days, but you should be able to breathe freely after two weeks.
You should be able to go back to light activities after two days, such as going for a walk. But you should avoid anything that puts stress on the nose or makes it bleed. Some things to avoid include bending over, doing heavy lifting, or blowing your nose.
Many patients go back to work or school about one week after the procedure.
If you are getting revision rhinoplasty, why not consider other procedures, too?
After all, if you are having anesthesia and a month or more of recovery, why not get it all done at one time?
Plus, having several facial procedures at once will make an even more dramatic difference to your appearance. Some of the other procedures people choose with revision rhinoplasty are:
Revision Rhinoplasty FAQ
If you are considering revision rhinoplasty, here are some of the most common questions:
Will My Revision Rhinoplasty Work?
How successful the surgery is depends on many factors, but one of the biggest is the skill of the surgeon. If you have the best surgeon, they may be your best chance to have a fantastic result.
What Is Empty Nose Syndrome?
This problem happens if the first surgeon removed too much membrane from the nose lining. This can make the inside of the nose constantly crusty and dry.
Even if the nose is unobstructed, you may feel like they can’t breathe through it because the membrane is gone, and they can’t feel air passing through it.
Unfortunately, the membrane is no longer there and can’t be replaced. But your surgeon may prescribe nasal spray or topical treatments to help this problem.
Will Insurance Pay For Revision Rhinoplasty?
If the surgery is intended to fix a breathing issue, insurance may pay for part of the procedure. But if you only want to address a matter of appearance, you will need to pay out of pocket for your surgery.
How Old Do I Need To Be?
Cosmetic rhinoplasty can be done any time after your nasal growth is finished, which is usually by age 15 or 16. In rare situations, the procedure may be performed in younger patients where there is a several functional problem with the nose.
Am I Too Old For Revision Rhinoplasty?
Cosmetic rhinoplasty is more difficult as you get older. Many surgeons prefer to perform rhinoplasty on patients in their 20s at the latest. While you can have a successful rhinoplasty later, healing is more difficult after age 60 and should be avoided.
When Should I Consider Revision Rhinoplasty?
If you had rhinoplasty and don’t like the result, you may be tempted to schedule another procedure as soon as you can. This is understandable.
However, surgeons recommend waiting at least a year before another procedure. This allows your nose to fully heal and for swelling to dissipate. If you still don’t like the result, then you should talk to your surgeon about another nosejob.
Does Revision Rhinoplasty Take Longer To Heal?
It will probably take at least a year for your nose to heal from revision rhinoplasty. But some patients may need to wait more than a year for all swelling to disappear.
But every patient is different and how long your nose takes to heal depends on your anatomy. Most importantly, follow your surgeon’s instructions carefully after surgery and attend all follow-up appointments.
Does Revision Rhinoplasty Hurt More Than Primary Rhinoplasty?
Good news – many patients report that revision rhinoplasty is less painful than the first time. Also, some patients have a shorter recovery with the second procedure and have less swelling and bruising, too.
Will Revision Rhinoplasty Work?
How successful the revision procedure is depends on the skill of your surgeon and other factors. If you have a board-certified surgeon with ample experience with rhinoplasty, you have the best chances for a successful procedure.
Is Revision Rhinoplasty Worth It?
Whether you need revision rhinoplasty or not is a complex question. Many revision procedures have excellent results, but there are risks to consider before moving forward.
If you want revision rhinoplasty, talk to your plastic surgeon about it. They will examine your nose and face and tell you what is possible or not. As long as you have realistic expectations, revision rhinoplasty can be a good choice.
Our practice is committed to ensuring that you receive the look you want, even more so if you had a less-than-desirable experience with your initial rhinoplasty. During your consultation, we will work with you to gain an understanding of your needs and goals before talking about your options to provide you with the best possible outcome. If you are considering secondary rhinoplasty surgery and are ready to schedule your consultation with Dr. Ramanadham, contact our New Jersey office today.