Revision Rhinoplasty: More Common Than Before

According to the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), the number of revision surgeries performed by their board-certified members has nearly doubled since 2017. Why is that?

Sadly, the rise of revision rhinoplasty can be attributed to the increasing number of nose jobs and botched nose jobs being performed by unqualified and uncertified non-medical staff. The migration of non-core physicians (such as ER doctors and general physicians) into the field who have not been trained to provide aesthetic surgical services has resulted in much poorer outcomes for patients.

Rhinoplasty, or any other type of facial plastic surgery for that matter, should only be performed by a specially trained and highly experienced facial plastic surgeon. The purpose of this article is not to scare you - the vast majority of nose jobs are done correctly by qualified surgeons. Our goal is to give you the information you need to make informed decisions about cosmetic procedures.

What is Revision Rhinoplasty?

Revision rhinoplasty, simply put, is the correction of a previous nose job. The surgeon who performed the initial surgery may have been underqualified or inexperienced, resulting in a nose that appears asymmetrical, misshapen, or no longer functions properly.

Revision surgeries are far more complex than the initial nose job, which is why they should only be trusted to a top rhinoplasty surgeon. Due to scar tissue and changes in the bone and cartilage from the first procedure, revision surgery takes longer to perform and the nose remains swollen for a longer period of time.

It's important to remember that every face and every nose job is different. The healing process will vary from person to person, but you typically won't see the final result until at least one-year post-op.

Reasons for Revision Rhinoplasty

Several problems can arise from a botched rhinoplasty. They can be:

• Functional: The nose appears normal, but is not functioning as it should. Functional problems include internal or external nasal valve collapse and obstruction of the airways due to excessive scar tissue.
• Cosmetic: The nose is functioning correctly, but the patient is not satisfied with its appearance. The botched rhinoplasty may have caused the nose to become asymmetrical, oddly shaped, or too narrow at the tip ("pinched tip").
• Functional and Cosmetic: A combination of both resulting in a nose that neither looks good or functions well.

Often, botched nose jobs create both functional and cosmetic problems. Fixing all of these problems is a challenge, and your facial plastic surgeon will work with you to set realistic goals for revision.

Choosing a Revision Rhinoplasty Surgeon

Not every revision rhinoplasty procedure is as dramatic as an episode of "Botched". Sometimes, the problem may be very minor and only require a small adjustment.

If you're on good terms with your primary plastic surgeon and the only issue you have is some slight asymmetry, it's actually best to have them do the revision instead of seeking out a different doctor. They know your nose best.

Of course, if you feel that your primary surgeon has failed you, it's time to move on. Before you schedule an appointment with a new surgeon, make sure that you have all of your medical records, photographs of your nose before surgery, and the operative notes from your first procedure. This will make the consultation process go more smoothly and give your new surgeon a better understanding of your situation.

How Long Should You Wait to Get Revision Surgery?

Regardless of the surgeon you choose, you won't be able to have a revision rhinoplasty done right away. For starters, your nose needs time to heal before it can be safely operated on again. And because it takes a year or more to see the final result of a nose job, you might find that you don't need revision surgery after all once the swelling has subsided and the tissue has softened.

With that in mind, this is a question best answered by your plastic surgeon. While 12 months after your initial surgery is standard, your surgeon may recommend revision rhinoplasty sooner or later depending on how your nose has healed.

Potential Complications

While most facial plastic surgeons are qualified to perform initial rhinoplasty procedures, revision rhinoplasty requires a much greater depth of knowledge and experience due to the surgery's more complex nature.

The risk of complications is higher for revision rhinoplasty patients for a variety of reasons. If the structural cartilage in the nasal septum was removed completely during the initial surgery, the revision surgeon will have to take cartilage from the patient's ear or rib to reconstruct the nose.

Because the procedure is more complex, it also takes longer than a first-time nose job. A typical rhinoplasty takes about 2 hours - a typical revision rhinoplasty can take 3 ½ to 4 hours. It may take even longer depending on how badly the first nose job was botched.

Revision Rhinoplasty: Is It Worth the Risk?

After a bad experience with a plastic surgeon, it's normal to have some anxiety about seeing another one for revision rhinoplasty. What if they make your nose even worse? How can you trust them?

Here are some steps you can take to ensure the best outcome from your revision rhinoplasty:

• Do your homework. It all starts with research, which you'll probably do online. But the internet is something of a double-edged sword - while it can help you get to the truth, it can also provide you with misleading information. Unfortunately, search engines like Google tend to favor style over substance, putting plastic surgeons with the most social media followers above surgeons with more experience and greater academic pedigree. Take search engine rankings with a grain of salt and pay attention to what matters - board certification, years of experience, curriculum vitae, and patient testimonials.
• Know that if it sounds too good to be true, it probably is. If cost is your #1 concern when choosing a plastic surgeon, you might be enticed by special deals and discounts. But price cuts almost always mean that a surgeon is cutting corners, and your face is NOT something that you want to take a gamble on. Do not make cost your priority.
• Ask tough questions. It's easy to assume that a person wearing a white coat knows what's best for you, but that isn't always the case. Don't be afraid to ask tough questions during your consultation. This is your best chance to learn as much as you can about the surgeon's credentials, experience, and the procedure itself. What type of anesthesia do they use? Where will the procedure be done? Ask for proof of board certification, too - a reputable surgeon will not hesitate to show you.

Speak with a Dual Board Certified Facial Plastic Surgeon

Revision rhinoplasty is one of the most difficult plastic surgery procedures out there, but it is possible to restore the function and attractiveness of your nose.

If you'd like to learn more about this procedure, speak with Dr. Edward Farrior, a dual board certified facial plastic surgeon in Tampa, FL, with more than 30 years of experience. Of the thousands of rhinoplasties he's performed over the decades, 37% have been corrections of other surgeons' work.

Dr. Farrior fully embraces the unique challenge that each revision rhinoplasty patient brings and is dedicated to making them feel confident in their appearance again. To schedule your consultation, call our office at 813-291-3992 or fill out our online contact form.