Dr. Serhan Derin, born in 1982, is a seasoned ENT specialist who graduated from Ankara University School of Medicine. He completed his residency at Kocaeli University in 2010. Dr. Derin is a highly skilled surgeon specializing in functional and cosmetic nose surgeries, including Primary Rhinoplasty, Revision Rhinoplasty, Ethnic Rhinoplasty, Septoplasty, Septorhinoplasty, Nasal Valve Surgery, and Sinus Surgery.
This is the sixth step of your 8 part journey into the exclusive guide on rhinoplasty types.
Did you know that there is always a possibility in nose surgeries that when you did not like the results or had complications you can get another surgery to get it corrected? It is called revision rhinoplasty.
In every rhinoplasty surgery, surgeons try to give you a perfectly shaped bridge, a well-defined tip, and a better-functioning nose without compromising it. However, even for experienced professionals, surgery carries the potential for complications.
Here, you will find which complications and problems you might encounter after rhinoplasty surgery and the possible solutions for each with revision surgery. We will also mention when revision is needed, what you can expect during the surgery, the recovery process, and of course how much you need to pay for it.
What is revision rhinoplasty?
Revision rhinoplasty is a plastic surgery procedure to correct or improve any previous nose job results. This type of surgery is typically performed when a person is unsatisfied with the results from an earlier rhinoplasty procedure or requires additional changes on the nose.
A common reason to get revision surgery is breathing problems, followed by cosmetic reasons or a combination of these. Like in primary surgery, you should meet some expectations and need to understand that surgery cannot achieve unrealistic goals.
Even though the goal of the revision surgery is to correct any existing problem, the surgery is considered riskier and might cause complications. Generally, surgeons find it harder to operate on a nose that was already manipulated before. So, if you are wondering why is revision rhinoplasty harder, you just got your answer.
When is revision rhinoplasty needed?
People get nose surgeries expecting satisfying results, but it is not the case for every rhinoplasty surgery. You might need revision surgery if your initial or previous surgeries did not meet the expectations or left you with complications.
The most valid reasons to get a revision rhinoplasty are functional problems like difficulty in breathing and obvious unaesthetic results. Other than these, some people might just ask for further improvements.
Generally, revision rhinoplasty is performed when you have or need:
Hanging/ retracted columella
Injury to the nose
Pinched or rotated tip
Reversing a dorsal hump
We will now give you some explicit details about all of them.
Difficulty in breathing is mostly seen as a result of collapsed nostrils. The air passage is blocked and it might also look as if your nasal tip is pinched. In this situation correction of both the form and the function is called septorhinoplasty revision surgery.
Another problem that people take rhinoplasty for is reoccurring deviation problem. After the septorhinoplasty operation, your surgeon would also address any functional problem regarding your septum (the wall between your nostrils). Although rarely, the septum might shift back to its old position naturally, and getting a revision surgery is the solution.
The last one is an injury to your nose. Accidents happen all the time and another possible reason to get a revision procedure is getting an external impact on the nose. Your nose becomes more fragile after surgery, and even little traumatic damage might need to be fixed.
Not functionally but aesthetically your new nose look might be compromised, which calls for revision surgery. The need for an aesthetical improvement might instantly occur right after your surgery, or during your recovery period.
Most of the time you will have swelling after a rhinoplasty operation that will last visibly for a few months and then vanish after a whole year. If you have any other concerns rather than this swelling you might need revision surgery.
These include hanging or retracted columella (your nose looks stretched on the bottom), drooping tip, asymmetry, or visible scarring. Sometimes surgeons make more than they need to and are generally seen with ethnic rhinoplasty patients. A failure to understand ethnic traits might result in overcorrection.
Sometimes you need a revision just because you did not like the new shape of your nose. Surgeons generally make tip and bridge refinements to satisfy their patients with revision surgery. Especially the supra tip break, the transition point between your nasal tip and bridge combines, might be asked to be more smooth or curved.
One other important thing to mention here is the reversal of a dorsal hump. Rarely rhinoplasty patients feel isolated around their relatives, because of their perfectly smoothed nose bridge. It is almost impossible to achieve the same look you had before, but some surgeons are able to rebuild your dorsal hump.
Some surgeons might suggest a nonsurgical revision rhinoplasty method of using dermal filler for those who seek minor improvements. Most of the time this option is only used to correct slightly crooked nostrils or barely visible hump problems.
How long do you have to wait for a revision rhinoplasty?
It is recommended to allow for at minimum 6 months of healing before considering any further rhinoplasty operations. The tissue underneath the nose skin must be fully healed in order to reduce the risks associated with the procedure. Depending on an individual’s healing rate, this healing period can extend up to 18 months. In cases of emergency, exceptions may be made.
Who can get a revision rhinoplasty?
Anyone who is not happy with their previous surgery results can get a revision rhinoplasty. Whether it is cosmetic or functional if you have waited for a certain period of time rhinoplasty surgeons address any existing problem in your nose.
Check out this list to see if you can get a revision rhinoplasty procedure with a successful outcome:
I have a functional/aesthetic concern about my nose.
I have waited enough after my first surgery and my nose is healed.
I explained my concerns with realistic expectations.
I can manage without smoking and drinking for a while.
I am aware of further risks with revision surgery.
If you checked every one of the boxes then congratulations because you are a possible candidate for a revision rhinoplasty procedure.
Revision rhinoplasty procedure
You might expect nothing but the same rhinoplasty procedures in revision surgery. The challenging and the different part is the fact that your surgeon needs to operate on a nose that has been already operated on before.
Mostly general anesthesia is preferred and just like your first surgery, you will not remember anything about the surgery. After anesthesia kicks in by using either open or closed approach incisions they start operating in your nose with the techniques we mentioned below:
- Cartilage grafting: Surgeons add some extra parts from your ear or rib cartilage for revision rhinoplasty. You can think of it like building a tent in your nose, and the cartilage grafts are poles.
- Osteotome: Osteotome cuts and reshapes the bone and cartilage structure. With osteotome techniques, your surgeon corrects any remaining wide or overcorrected bridge problems.
- Suturing: Sutures are almost inevitable options in any nose surgery. In cartilage grafting, soft tissue repair and sometimes solely suturing offers lots of options.
- Implants: With implants, your nose gets projected. Often surgeons correct any remaining implant complications like shifting implants. This technique is mostly preferred in Asian regions.
- Tissue grafting: A little amount of skin or fat tissue might be added to your nose to gain volume and to make your nose appear more smooth on the bridge.
By using these techniques surgeons address any deviated septum, scarring, ill-defined tip, misaligned bridge, collapsed nostrils, and many other issues that bother you.
To achieve successful surgery, this time your surgeon would pay more attention and the surgery might take longer.
How long does revision rhinoplasty take
The duration of a revision rhinoplasty surgery typically ranges from 2-4 hours, depending on the complexity of the procedure. While a minor correction can take as short as 2 hours, a delicate surgery where you need lots of manipulations can even prolong the surgery up to 5 hours.
One of the things lengthening your surgery time is the delicacy of your nose. If you had multiple revisions or had a serious complication before, surgeons have to deal with different problems at a time. This includes; increased bleeding, a fragile nose structure that needs more build-up, and complications like scarring.
Benefits of undergoing revision rhinoplasty
We know how you feel about your first rhinoplasty procedure right now and you might be wondering how it will affect you, going over the same procedures again.
Although it has higher risks of complications, a revision rhinoplasty can bring your beauty back on track in a way that almost perfectly suits you. So, the number one benefit of revision rhinoplasty is that it will make your nose look better.
While the beauty standards matter if the surgery was breathtaking in real terms then it should be corrected. Another important benefit of the surgery is that it will make your breath better.
Even though physically it has some concrete effects on your life, it is not just about that. With your comprised look and breathing issues you might have lost your confidence or it could affect your life quality. The revision rhinoplasty will make you take control and live better.
What are the risks and complications of revision rhinoplasty?
As you might be familiar with the primary rhinoplasty risks and complications, you should expect the same for the revision rhinoplasty. Although, some risk factors differ and increase with further nose surgeries. That is because your nose gets more and more fragile with every surgery.
General risks for any revision rhinoplasty surgery are:
- Difficulty in breathing
- Nostril wall weakening
- Enduring swelling
Surgeons always do their best to avoid any risks and try to give you complication free in every surgery.
How long does revision rhinoplasty take to heal
You will be able to get back to your daily life within 1 or 2 weeks after revision rhinoplasty. The healing period might take longer for some people who had big changes or undergone several procedures before. During this time you should care for your nose as it can be more fragile than your first time.
Avoid any strenuous exercises for a certain period as your doctor instructed. Generally, it is recommended to avoid any lifting or physical contact sports for like 6 weeks (1).
You might have scar tissues behind your ear or on your chest and these will heal nicely without no one even noticing. After it completely healed you might apply moisturizer on the areas if it is itching.
Revision rhinoplasty recovery timeline
After a revision rhinoplasty procedure here’s the standard recovery timeline:
- Day 1: You will stay at the hospital for a day
- Day 2: When you get home you will have cast and taping
- Day 3: The cast is removed after a day
- After a week: Taping is also removed after 1 or 2 weeks (depending on your surgeon’s preferences)
- After two weeks: You will be able to get back to your daily life
- After a month: Most of the swellings will be gone
- After two months: You might continue your exercises
- After a year or two: Even the residual swelling will be gone
Cost of revision rhinoplasty
Revision rhinoplasty price can go between 3,500 and 30,000 dollars. The more zeros you might see when the surgery gets more complicated. The cost is generally higher than primary surgery because of the complexity and the need for an experienced doctor.
This is not the case for every revision surgery though. Some revisions might require minor corrections that a fair and skilled surgeon would operate for a more moderate price. Some surgeons even offer free-of-charge revision rhinoplasty to their own patients.
Other factors affecting the price are the geographical location, the experience of the surgery staff, and the need for different surgical techniques. Most often surgeons need to get extra parts from your ear and rib to support your nose structure which adds up to the price.