When is the Right Time for a Revision Rhinoplasty?

north-carolina-rhinoplasty-revision-surgeryAnytime a patient undergoes a rhinoplasty, there is always a chance they may require a revision rhinoplasty in the future. In looking at the national data, approximately 10% of all patients undergoing a rhinoplasty will undergo a revision. This rate will vary widely between individual surgeons. The very best rhinoplasty surgeons will have a low revision  rate while less talented surgeons may have a much higher rate of revision surgeries. If you are considering treatment for either aesthetic reasons or nasal obstruction, the timing of the surgery is important. In order to understand the right time to undergo a revision, let’s first discuss a primary rhinoplasty.

What is a Rhinoplasty?

A rhinoplasty is a surgical procedure to either improve the aesthetic appearance and/or open the nasal airway. During a rhinoplasty, the underlying bone and cartilage framework of the nose is manipulated to change the shape of the nose. There are infinite surgical technical combinations to create the goal result for the patient. This is one of the reasons why a rhinoplasty is one of the most technically demanding plastic surgery procedures.

What is a Revision Nose Job?

A revision rhinoplasty is a surgical procedure to repair the function and features of the nose if a patient is unhappy with the initial rhinoplasty. This procedure is technically more challenging than a primary rhinoplasty. After a rhinoplasty, the nose develops scar tissue and the normal anatomy has been changed. During the procedure, the surgeon must be prepared to tackle a variety of surgical decisions and have mastered a variety of surgical maneuvers to ensure the best result.

Why Would You Undergo a Revision?

The two main reasons to have a revision are:

  1. If the patient is unsatisfied with the appearance of his or her nose.
  2. If the patient is having trouble breathing.

Why does this occur?

Most commonly, a revision rhinoplasty is more reconstructive in nature. Many times during the primary rhinoplasty, bone and cartilage are overly aggressively removed. This may create a good result initially but this is not the best surgical technique for the long term. Aggressive removal of bone and cartilage can compromise the support of the nose. This can lead to pinching and collapse of the nose. In this situation, the procedure is termed a reverse rhinoplasty. During a reverse rhinoplasty, the nose is supported and rebuilt to restore the loss structure of the nose during the initial aggressive rhinoplasty.

How Long Do You Have to Wait to Have a Revision?

Unfortunately, rhinoplasty takes a long time to fully heal, and it is imperative that the nose is fully healed before undergoing a revision. During the healing process, the shape and function of the nose will continue to change. We would not advise a patient to undergo a revision until the final result of the primary rhinoplasty has been realized. It takes most noses one year to heal. For this reason, we prefer and advise patients to wait for one year after their initial rhinoplasty before undergoing a revision.

Is a Revision Technically Easier for the Surgeon Than the First Rhinoplasty?

A revision rhinoplasty surgery is actually more difficult to perform than the initial rhinoplasty. Usually, there is scar tissue, which can be tricky. Additionally, parts of the nose may have been shaved away or changed, which can make restoring or making further changes difficult.

Who is the Best Choice to Perform My Revision?

If a patient still has trust and confidence in your surgeon that did the initial rhinoplasty, they are the best choice for the revision. We believe this is the case because this surgeon has the best idea on how to fix the nose since they know exactly what was done in the previous surgery.

Unfortunately, patients may have lost confidence in their surgeon or the surgeon is not comfortable in performing revision rhinoplasty surgery. In this situation, it is important for patients to research a revision rhinoplasty specialist. We would suggest choosing a surgeon that has a special interest, passion, and experience in revision and primary rhinoplasty. Commonly, these doctors are facial plastic surgeons, but this is not always the case. We would advise undergoing a consult with imaging morphing to ensure clear communication.

Why Choose Carolina Facial Plastics for You Procedure?

Carolina Facial Plastics was founded and directed by double board-certified facial plastic surgeon Dr. Jonathan Kulbersh. Dr. Kulbersh has extensive experience training and surgical experience. He is a well-known student of one of the leading revision rhinoplasty surgeons, Dr. Paul Nassif of the TV show “Botched.” Dr. Kulbersh has a passion for rhinoplasty surgery and it shows in the care and results he provides for his patients in Charlotte, NC.

Learn more about rhinoplasty at WebMD.com.

Schedule a Consultation with a Double Board-Certified Facial Plastic Surgeon

Dr. Jonathan Kulbersh is a Beverly Hills trained double board-certified facial plastic surgeon with an expertise in rhinoplasty procedures. To schedule a treatment consultation at Carolina Facial Plastics in Charlotte, NC, and learn more about having a revision rhinoplasty performed, please call (704) 842-3644 or fill out the online appointment request form.


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