There is a reason that rhinoplasty (a.k.a. nose job) is perennially one of the most popular cosmetic surgeries. Whether it’s performed for aesthetic or functional reasons, the procedure can be transformative. Rhinoplasty is generally considered safe and effective, especially when carried out by a board certified facial plastic or plastic surgeon. Even so, there is always a risk of complications and/or unsatisfactory outcomes. Furthermore, the results of rhinoplasty, while long lasting, are still at the mercy of age and gravity, which means they can change over time.
For some patients, one or more of these factors can be reason to undergo a revision rhinoplasty. Generally speaking, secondary surgeries are more costly and involved than primary procedures, and rhinoplasty is no exception. In fact, the revision is considered one of the most complex in plastic surgery. With that in mind, making an informed decision with the help of a highly skilled surgeon is key. Here, we hear from two patients who had a revision rhinoplasty to learn more about their experience and any advice they have for people considering the surgery.
When Is Revision Rhinoplasty Appropriate?
Although revision rates are not published, it is generally accepted that it is around 20 to 25 percent for rhinoplasty. That means one in every four or five patients pursues a corrective surgery down the line. There are two main reasons a revision rhinoplasty may be necessary. One is chiefly cosmetic in nature and the other has a medical component.
- You’re unhappy with how your nose looks and would like to further refine the results
- Your primary surgery was meant to address a deviated septum or other anatomical issue, but did not resolve the problem(s)
Rhinoplasty has one of the longest recovery periods of any cosmetic surgery. While you may be cleared to resume most normal activities after a few months, it can take a year (or more) for the body to fully heal – that includes clearing up any residual swelling, however mild, that can influence how the nose looks. But what if your patience is not rewarded with your desired result? Or what if you have a rhinoplasty as a teenager and, as an adult, aren’t thrilled with how the surgery has aged? Revision is an option.
Functional rhinoplasty, meanwhile, is medically necessary surgery often prescribed for people who have a deviated septum, cleft palate, polyps, or even trauma from an accident or injury. In these cases, the surgery will be considered ‘failed’ if the functional concern the surgeon sought to address with the procedure is not resolved after healing is complete (think: your breathing issue is still, well, an issue). Again, revision is an option.
In either instance, the first step is usually to meet with your surgeon to discuss the differences between what you were looking for and what you ended up with. You are under no obligation to pursue revision with the same surgical team, and it is best to consult with multiple surgeons. Ultimately, choose someone who specializes in revision rhinoplasty specifically, as the secondary surgery is more nuanced.
Whether it’s the first revision or the fifth (yes, seriously), there is often a great deal of scar tissue to contend with, which may also impact the skin and its ability to be stretched and re-draped. If there is not enough cartilage available to reshape the nose while maintaining its function, grafting may be required. For all of these reasons, seeking out a highly skilled revision expert is key for both the safety and efficacy of the corrective procedure.
Needless to say, there is a lot to consider before opting for a revision rhinoplasty. To help you understand what it’s really like to get and recover from the procedure, we’ve spoken to two patients about their experiences.
Sam, 28, Providence, RI
Sam had a nose job to address concerns about the bridge of her nose and a bulbous tip. Unfortunately, the results from her first procedure weren’t satisfactory, so she decided to have a revision with another surgeon.
The AEDITION: What led to your revision rhinoplasty?
Sam: I had a first nose job in my late teens and went to a random local surgeon purely out of convenience. We never got on very well, and, looking back, I don’t think he took enough notice of what I was hoping for from the procedure and just stuck to a standard nose shape — at least that’s what it felt like. Once I was more established in my career and had some cash available to give it another go, I asked a few friends who’d had nose jobs about their surgeons and consulted based on recommendations this time.
The AEDITION: How did the second surgery compare to the first?
Sam: It was honestly a completely different experience. I think, in part, that came from the fact that by the time I tried again, I’d learned to advocate for myself more than I could as a teenager. I had honest discussions with a few surgeons, discussed if what I was hoping for was realistic, and looked at some projected results that were produced from scans and photos. The actual process of the surgery was similar, though. I feel that having already done it once meant the recovery seemed less daunting than before.
The AEDITION: Have the results from your revision surgery met your expectations?
Sam: My new nose is as close to perfect as possible. Honestly, it wasn’t entirely what I had in mind, but my surgeon took the time to explain why this would be the best approach, and it suits me so much better than before. It’s been a couple of years now, but I still catch it in the mirror sometimes and just kind of take it in and thank myself for bearing with the process and giving it another go.
The AEDITION: Do you have any advice for patients considering revision rhinoplasty?
Sam: Don’t be afraid of being picky. It’s your face, after all! You’re spending a lot of money on it and you’re getting a revision for a reason, so don’t feel like you’re wasting people’s time by asking questions.
Paola, 33, Austin, TX
Paola needed surgery to fix a deviated septum that was affecting her breathing. The first surgery was unsuccessful due to excessive scarring that left her nose looking asymmetrical, so she underwent a second procedure.
The AEDITION: What led your surgeon to suggest a revision rhinoplasty?
Paola: I had some complications after my original procedure that meant my nose had some scar tissue that made it look asymmetrical and overall a bit weird. There’s no other way of describing it. My surgeon and I decided to leave it a couple of years while carefully monitoring how I recovered with regular checkups. Eventually, we decided there was no further improvement, so revision was the best option.
The AEDITION: Did you experience any difficulties in the period between the two procedures?
Paola: It was more of a mental struggle than anything else. It’s tough when you think you’re resolving an issue and going through the unpleasant period of post-surgical healing, only being told they need to do it again. The healing time in between both procedures gave me a chance to get my head around the idea of needing further surgery. The fact that it was a medical procedure instead of an elective procedure in the first place was probably a contributing factor.
The AEDITION: How was your recovery from the revision surgery?
Paola: It was pretty similar to the first time. I had some bruising, and the swelling was similar, too. I think there are some tricks you pick up during recovery that are helpful to go back to a second time around. For example, after my first surgery, I found a pillow that was particularly comfortable to sleep on, so I made sure I had that all set up for when I got home. Knowing what to expect made my recovery feel smoother this time than the first time around.
The AEDITION: Do you have any advice for patients considering revision rhinoplasty?
Paola: My advice to others would be what I told myself at the time: It’s not something you can control. Your surgeon knows what they are doing, and you have to trust them. It can be difficult going through the whole process again, but, in the long run, it’s worth it.
In an ideal world, every procedure would end in a successful outcome. Unfortunately, for a myriad of reasons, that’s not always the case. If you are unhappy with your rhinoplasty for aesthetic or medical reasons, a revision surgery may be able to improve your results. Be sure to choose a board certified plastic surgeon who specializes in the corrective procedure and be realistic about what can be achieved.
*Patient names have been changed
More Related Articles
‘Try on’ aesthetic procedures and instantly visualize possible results with AEDIT and our patented 3D aesthetic simulator.