Revision Rhinoplasty

The important factors guiding revision rhinoplasty are:

1. How the nose looks now
2. What is the problem/irregularity that needs to be addresses/repaired
3. How much scarring is present from previous surgeries
4. The mental state of the patient requesting the revisions, i.e., is he/she an unsatisfiable perfectionist, a surgery junkie, or psychologically unbalanced in any way that is causing an unjustifiable surgical request
5. Is the problem correctable

If all of these factors are in order, then a patient who is not satisfied with her previous rhinoplasty is now requesting a second rhinoplasty from either the same surgeon who performed the primary rhinoplasty or a surgeon who specializes in revision rhinoplasty. A surgeon who specializes in revision rhinoplasty is specially trained in the field and it is important to ask pertinent questions of any surgeon who is offering to do this work for you. While it is rare for a nose to be completely beyond repair, it is important to analyze the patient’s motivation behind requesting multiple surgeries.

According to statistical analysis, revision rhinoplasty procedures need to be performed in 17% of the total number of primary rhinoplasty surgeries in the United States. However, it is important to note that a large percentage of the cases, a very small irregularity, or bump is the specific cause of the revision rhinoplasty and for the most part, these are predominately office procedures done on an outpatient basis and for a very small fee. It is the rare case that requires extensive revision rhinoplasty work unless something, for some reason, has gone awry. Furthermore, the majority of the remaining “clean up” cases are the result of those rare instances when the patient himself has caused some damage to the nose after surgery by falling, bumping the nose or some other physical trauma requiring surgical attention.

As rare as it may be, some patients have decided after rhinoplasty that their nose is now too small for their face and that it was not the fault of the primary physician but in their own request for changes. In these instances, revisionary surgeons can add tissue, spread the nostrils a bit, stretch the cartilage and expand the nose to more properly fit the face. There is almost no condition of the nose that cannot be fixed, repaired or improved. Other instances of requests for revision rhinoplasty have to do when patients request a certain “look” for a new nose. They bring in a photo of a celebrity or a historical figure and request a nose identical to the one in the photo. And even when the computer imaging does not justify the look they demand to look just like their favorite celebrity. Oftentimes the final result simply does not look good on them and they seek out a trained revision rhinoplastic surgeon to make their nose look “normal” again, that is, to restore it to it’s original state. As bizarre as this sounds, it is quite common for patients to receive exactly what they wanted and then to change their minds afterwards.