Frequently Asked Questions about Revision Rhinoplasty | Eugene Alford, MD (2023)

What is revision Rhinoplasty?

Revision rhinoplasty occurs after someone has had a first surgery on their nose and following the surgery the appearance or the function of the nose is not the result the patient desired. Revision rhinoplasty can change the appearance of the nose to make it look more pleasing or revision rhinoplasty can be designed to improve the function of the nose. In all cases of revision rhinoplasty the results should be a nose which functions properly and allows the patient to be able to breathe through the nose without obstruction. Additionally, it is essential that the nose match the face, be in harmony with the rest of the facial features, not draw attention to itself, and not distract from the other features of the face.

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When is a revision Rhinoplasty needed?

If you do not like the appearance or function of your nose following a primary rhinoplasty procedure you should consider a revision rhinoplasty. Revision rhinoplasty allows the surgeon to correct those issues that occurred as a result of the first rhinoplasty. These issues can be related to the appearance of the nose such as an uneven tip, a subtle asymmetry, a scar from the incision or a failure of the tissue to heal properly. Or a revision rhinoplasty can be related to the function of the nose such as an inability to breathe or smell following a primary rhinoplasty. Most commonly however it is a mixture of both appearance and function that brings a patient to see Dr. Eugene Alford for a revision rhinoplasty.

When can revision Rhinoplasty be performed?

Patients frequently ask me how long after a first nasal surgery must one wait until a revision rhinoplasty can be performed. The best answer is: to wait as long as possible after the first surgery to allow all of the swelling, edema, bruising and scar tissue from the first surgery to have resolved as much as possible. If wound healing, scar formation, and edema are still present then the results of the revision rhinoplasty (the second nasal surgery) can still be impacted by the effects of the first surgery. By waiting at least a year all of the negative effects of the first surgical procedure will have gone away and the operating surgeon performing the revision procedure has more control over the tissues and the ultimate outcome.

How is revision Rhinoplasty performed?

Revision rhinoplasty usually involves reshaping the cartilaginous and bony structures of the nose to achieve a more pleasing appearance as well as improved function of the nose following a previous nasal surgical procedure. The shape of the nose is determined by the cartilages that provide the overall structure and shape to the nose. These cartilages are covered by the skin and it is the draping of this skin over the nose that gives its shape. The only way to change the appearance and the function of the nose is to alter the shape and interrelationships of the nasal cartilages and then allowing the skin to re-drape over this cartilaginous framework. Commonly revision rhinoplasty requires taking cartilage from other parts of the body such as the ear or the rib and transferring them to the nose in order to re-create the proper shape, appearance, and function of the nose. In those cases in which too much mucous membrane lining of the nose have been removed, there can be an entity called "empty nose syndrome" which is a devastating malady for which there is currently no cure or way to improve the nasal function.

What is "empty nose syndrome"

Empty nose syndrome occurs when too much mucosal membrane lining of the nose has been removed leading to a dry, crusty, nonfunctioning internal lining of the nasal cavity. Even though the nose is wide open and without obstruction, patients with this disorder feel as if they have no air flow through the nose because the mucous membrane lining has been destroyed and they cannot feel the air passing through their nose. This is most commonly the result of removal of too much of the inferior and/or middle turbinates of the nose. Symptomatic treatment with the use of nasal saline spray and topical treatments with over-the-counter medications, such as Ponaris, and nasal irrigations are the only options available for the improvement of quality of life in patients with this disorder.

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Why is revision Rhinoplasty more difficult to perform?

Several factors make revision rhinoplasty much more difficult to perform than a primary, or first time, rhinoplasty procedure. As a result of the first surgery tissue such as cartilage bone and/or internal nasal lining have been removed; therefore, the second surgery has lost some of the important material necessary to create the appearance and function of the new nose. This material must be replaced with donor material from somewhere else in the body or from donor tissue taken from a cadaver. Commonly when cartilage is needed to rebuild the nose we can take it from the backside of the ear or cartilage from a rib. Newer technology has allowed us to use cartilage harvested from a cadaver which is then rendered acellular such that it does not transmit disease and that tissue can be used to reconstruct the nose without having to make another incision on the patient's body. My personal preference is to use tissue from the patient, either the ear or the rib, as we know that this tissue will have no adverse effects on the patient and the risk of rejection is the lowest risk possible. Cartilage grafts from the ear and the rib can be harvested with no visible scars, without changing the appearance of the ear, very little pain and very low risk. Cadaver cartilage grafts have no extra pain associated with them and a very low risk of rejection but still slightly higher than that of donor tissue taken from the patient themselves.

Will insurance pay for a revision Rhinoplasty?

If revision rhinoplasty is being performed purely for aesthetic appearance concerns then insurance will not pay for the surgery. If however there is a functional concern, i.e. difficulty breathing through the nose, insurance might pay for a portion of a revision rhinoplasty. In all cases of any type of revision surgery, a letter of medical necessity for predetermination of benefits must be sent to the insurance carrier seeking their approval for coverage of the surgery prior to surgery being performed. In general rhinoplasty whether primary, secondary, or revision surgery are very often specifically excluded from the vast majority of insurance policies. Therefore, the general answer is that insurance does not pay for rhinoplasty.

Why is revision Rhinoplasty more expensive than a primary Rhinoplasty.

Revision Rhinoplasty is more expensive than primary Rhinoplasty because the amount of work is much more with a revision Rhinoplasty then it is with a primary Rhinoplasty. Revision Rhinoplasty almost always requires a more difficult preparation of the nose because of dissection through scar tissue. Also a revision Rhinoplasty almost always requires tissue from somewhere else in the body such as the ear or the rib to be harvested, carved, prepared and then sutured into place in such a way as to re-create both a pleasing appearance and a nose which operates properly. A primary Rhinoplasty usually takes only 2-3 hours in the operating room under anesthesia while a revision Rhinoplasty y may take as many as 4-6 hours of surgery time depending on the degree of tissue that is being replaced.

What is the recovery time for Revision Rhinoplasty?

Generally, we encourage you to take at least 2 weeks for your recovery before returning to normal activities. Your first post-operative visit will be 1 week after surgery, during that first week you will have a small cast on the outside of your nose. For some patients, they prefer to wait until that cast is removed before returning to work, school and social activities. During the second week of your recovery you are welcome to ease back into your normal schedule being mindful that you are still in the early recovery phase. Two weeks after surgery you will be able to resume all of your normal activities including full exercise. However, wearing glasses of any kind is prohibited for the first 4 weeks following surgery. In an effort to meet the needs of our patients who wear eyeglasses, we have a special device that is available at Alford Facial Plastic Surgery that will allow you to wear your glasses during your post-operative recovery without affecting your surgical results.

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How can I prepare for my Revision Rhinoplasty procedure?

During your Rhinoplasty Consultation, you will meet with Lindsay, Dr. Alford’s Nurse, who will share in detail how to best prepare for your surgery. She will also share with you the Alford Facial Plastic Surgery Recovery Plan that we have formulated and found to be very successful in expediting healing, resolving bruising, and get you feeling and looking your best after surgery!

Steps you can take to support your best outcome:

1. Discontinue the use of any aspirin, ibuprofen, vitamin E, and certain herbal supplements two weeks before and for the two weeks after your Rhinoplasty surgery. This is for your safety; we will review your current medications and discuss any adjustments that will need to be made in the recovery period.

2. Stop smoking for at least four weeks before surgery. Nicotine slows healing and can compromise the needed blood flow for healing tissues.

3. Stock up on frozen peas and nasal saline spray before surgery as these will be very important components of your recovery!

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4. Enlist the help of a relative or friend to assist for at least the first 48hours after surgery. It's great to have support, someone to fetch your beverages and soft foods, and a person to keep track of when you've taken your meds and when you'll need your next dose. Also, to transport you to and from the hospital for the day of surgery as you will not be able to drive yourself home after your rhinoplasty.

5. Wear comfortable clothes the day of surgery. Front-buttoning tops are better than shirts that pull over your head.

6. For your comfort you may use a humidifier at night and use throat lozenges throughout the first few days. This is to soothe dry mouth/throat as breathing through your mouth is common in your initial recovery period when your nose is initially congested.

7. Rest! Allow ample time for your body to heal. While we encourage you to walk and stay vertical as much as possible, knowing your own limits and not over-doing-it too soon is best!

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Ask Questions! If you are feeling anxious, we understand! The decision to have any surgery is one made with thoughtful consideration, so feel free to ask any and all questions!


How do I prepare for a revision rhinoplasty? ›

5 Steps to Take Before Revision Rhinoplasty
  1. Make Sure Your Nose Is Fully Healed. ...
  2. Choose Your Plastic Surgeon Wisely. ...
  3. Schedule More than One Consultation. ...
  4. Get as Much Information as Possible from Your Previous Surgeon. ...
  5. Plan for a Longer Recovery. ...
  6. Contact our Newport Beach Plastic Surgeon.

What is the success rate of revision rhinoplasty? ›

Revision Rhinoplasty Success Rate

Although studies and statistics show that the success rate of revision rhinoplasty ranges from 5% to 10%, most patients who have undergone it are satisfied with its results. Experienced rhinoplasty surgeons will give you enough information about the possible results of your surgery.

How long does it take to recover from revision rhinoplasty? ›

What happens after a revision rhinoplasty? The recovery period typically lasts one to two weeks, and a patient will need to stay home from work for seven to 10 days following surgery. A splint can be placed on a patient's nose after the procedure, and this splint will be removed approximately one week later.

Should I go to the same surgeon for a revision rhinoplasty? ›

If the original surgeon has extensive experience in rhinoplasty and revision rhinoplasty and you and your surgeon's expectations are the same, then stay with your original surgeon. If the patient and the surgeon and not the same page, then it is time to seek out a revision rhinoplasty specialist.

How risky is a revision rhinoplasty? ›

An initial rhinoplasty has its own risk factors, and so does a revision rhinoplasty procedure. Possible complications of a second (or third or fourth) procedure can include a temporary loss of smell, skin discoloration or bruising, swelling or scarring, breathing problems, or risk of infection or further problems.

Should you go to same surgeon for revision? ›

In some cases, it might make sense to go to the same surgeon that performed your initial procedure, as most doctors will offer some revision procedures with reduced charges. Other times, you may feel more comfortable finding a different surgeon for your revision surgery.

How long should I tape my nose after revision rhinoplasty? ›

Most patients who are instructed to tape their nose do so for 1-3 months after the procedure.

How many times can you do revision rhinoplasty? ›

While there is no limit to how many revision surgeries can be safely performed, each procedure does come with a new set of risks and challenges. Learn more by scheduling a revision rhinoplasty consultation at DeRosa Center Facial Plastic Surgery & Med Spa.

How long will my nose be swollen after revision rhinoplasty? ›

In most cases, swelling will continue for at least six months to over a year and may last as long as two years. Individual experience will vary based on the technique used, degree of difficulty, and the individual's unique rate of healing.

How do you sleep after a revision rhinoplasty? ›

Sleeping in an elevated position is best. This reduces swelling and cuts down on post-rhinoplasty congestion. If you sleep on your side, the lower nostril will likely become plugged while you sleep, and since you can't blow your nose, this congestion can be uncomfortable.

Why do so many people get revision rhinoplasty? ›

Many patients seeking revision rhinoplasty do so for strictly cosmetic reasons. Some of these patients may feel the results they received are too unnatural or not in harmony with their other facial features. Some wanted more done than what their surgeon did.

Is revision rhinoplasty easier recovery? ›

Increase Your Recovery Time

If the original rhinoplasty recovery was difficult, your revision rhinoplasty recovery will be even more so. The swelling and bruising will likely be greater and take longer to go away. You might be in more pain. In total, your recovery time will also be a lot longer.

How do I know if my rhinoplasty surgeon is good? ›

Now, let's look at five factors to consider when selecting a surgeon to perform your rhinoplasty.
  • Board Certification. Ask prospective surgeons if they are board-certified. ...
  • Before and After Photos. ...
  • Clear Communication. ...
  • The Office. ...
  • Personalized Care.

Who is a good candidate for revision rhinoplasty? ›

Who is a Candidate for a Revision Rhinoplasty? Any patient who wants to fix the form and function of a previous nose surgery is a candidate. Ideally, our patients have waited at least a year after their initial surgery before they undergo a second nose surgery.

Can revision rhinoplasty be closed? ›

Closed Rhinoplasty

A closed revision rhinoplasty surgery only involves incisions on the inside of the nose; therefore, Dr. Porter's patients who choose this technique will not have any visible scarring. However, this approach has limitations and is not appropriate for all revision rhinoplasty candidates.

Can revision rhinoplasty look natural? ›

A poorly performed rhinoplasty procedure can result in a nose that appears uneven, disproportionate, or even off-center. Revision rhinoplasty can create a more natural, even look to compliment your entire facial structure.

How long does a revision surgery take? ›

The procedure may take two to four hours and a variety of techniques may be used in the revision surgery. These include: Removal of the old prosthesis (cup, liner, stem and/or femoral head) Preparation of the bone (socket and femur) for the new implant.

Is revision surgery successful? ›

Most patients who undergo revision procedures can expect to have good to excellent results. Although expected outcomes include pain relief with increased stability and function, complete pain relief and restoration of function is not always possible.

How do you talk to a plastic surgeon about revision? ›

You should discuss how your surgeon plans to perform the revision surgery, whether you will have more scarring, and what to expect from the wound-healing process. Depending on what caused the issues after your initial procedure, there may be extra precautions for you to take both pre- and post-op.

What happens if I bend over after rhinoplasty? ›

Avoid bending over or lifting for about two weeks. Besides aggravating swelling, these activities may raise the blood pressure and cause bleeding.

How long should you sleep with your head elevated after rhinoplasty? ›

While you may be anxious to return to your preferred sleeping position, it is critical that you continue sleeping on your back with your head elevated for about 7 – 10 days after rhinoplasty, or until cleared by Dr. Khorsandi.

How long do I have to elevate my head after rhinoplasty? ›

Keep Your Head Elevated

Sleeping on your side after rhinoplasty isn't just uncomfortable – it can prolong your recovery time by causing additional bruising and swelling. More frighteningly, it can displace your nose. To avoid this, you'll need to keep your head elevated at night for 6 weeks following surgery.

Which country is best for revision rhinoplasty? ›

Turkey is home to some of the best rhinoplasty surgeons in the world, with specialists like Dr. Gamze Bektas being an excellent choice. Dr. Bektas is based at the renowned Gaziosmanpasa (GOP) Hospital and has over 17 years of experience, performing around 2,600 treatments.

Can revision rhinoplasty Make nose smaller? ›

Benefits of Revision Rhinoplasty

In some cases, the surgical outcome from a poor rhinoplasty procedure may appear less attractive than even the original nose. During a revision rhinoplasty, the doctor can change the size and shape of the nose and refine the look of the nasal tip.

How do you reduce swelling after rhinoplasty revision? ›

Tips for reducing swelling include keeping your head elevated as much as possible and using ice packs around your eyes. Do not apply pressure to the nose with the ice packs, however. Just gently lay the ice over the area with your head elevated.

How much will tip drop after rhinoplasty? ›

Your tip should drop between five and ten degrees after rhinoplasty. This drop is due to gravitational pull and your incisions tightening. Any drop that is greater than that means there may have been a surgical complication.

How do you wash your face after rhinoplasty? ›

Answer: Washing face after rhinoplasty

You will need to ask your surgeon for their specific preference; however, once the splint is removed you should be able to wash your face and nose with soap and water. I recommend to my patients using a gentle, facial soap cleanser once the cast is removed.

Can I sleep on my side 3 weeks after rhinoplasty? ›

Sleeping on your side or stomach is not recommended for several weeks after the procedure because it places unnecessary pressure on your nose. Resting on your back in an elevated position cuts down on congestion and minimizes swelling after rhinoplasty surgery.

Can I tilt my head after rhinoplasty? ›

Answer: Face position after surgery

Keeping your head tilted down after surgery can lead to more swelling to the nose and slower resolution of swelling. It is better to keep the head tilted neutral or even upwards to minimize swelling.

What is considered a difficult nose job? ›

Tips presenting a major problem are those that are very wide, very asymmetric, very prominent, very recessed, or overturned down or up, etc. Such deformities are challenging to correct, even in experienced hands, and the results they generate are usually more gratifying to the surgeon than to the patient.

What questions should I ask my rhinoplasty surgeon? ›

10 Questions to Ask Before A Rhinoplasty
  • Is my surgeon board-certified? ...
  • Can I see photos of previous patients' work? ...
  • Am I a good candidate for a rhinoplasty? ...
  • Do you use a closed or open approach? ...
  • What is the revision rate for your rhinoplasty patients? ...
  • What are my options if I want a revision?
8 Oct 2020

Who is the world's best rhinoplasty surgeon? ›

Dubbed “the KING of the Hollywood nosejob” by ELLE Magazine, Raj Kanodia is widely acknowledged as the best rhinoplasty surgeon in the world having performed over 9,000 rhinoplasty surgeries with over 3 decades of experience.

What can you not do before a nose job? ›

What to Avoid Before Rhinoplasty
  • Don't smoke. You know smoking is bad for you, but it's an especially bad idea leading up to and after surgery. ...
  • Don't drink. Don't drink in the days leading up to surgery. ...
  • Don't use topical creams. ...
  • Stick to the shade. ...
  • Avoid certain medications.
22 Jul 2021

What happens if you bend over after nose job? ›

Avoid bending over or lifting for about two weeks. Besides aggravating swelling, these activities may raise the blood pressure and cause bleeding.

Will the tip of my nose shrink after rhinoplasty? ›

To put it simply: yes, the tip of your nose will certainly be smaller after rhinoplasty san antonio surgery, particularly if your goal is to reduce the size of that portion of your nose.

How long do you have to sleep elevated after nose surgery? ›

You'll need to sleep in an elevated position for at least one week, however, it's generally recommended that you wait around 10-14 days before returning to your regular sleeping positions.

Can I brush my teeth before nose surgery? ›

Can I brush my teeth the morning of surgery? Yes. You may brush your teeth and swish with a small amount of water to rinse.

What vitamins should I take before rhinoplasty? ›

Two weeks before surgery, start taking 500 mg of Vitamin C once or twice a day. Vitamin C promotes healing and is a free-radical scavenger. Look for Vitamin C that is time-release and pure (that is, not mixed with any bioflavonoid or anything else).

How can I calm my nerves before rhinoplasty? ›

How to Calm Those Pre-Rhinoplasty Nerves
  1. Got questions? Get answers. ...
  2. Focus on the positive. A positive mindset can work wonders in easing rhinoplasty nerves. ...
  3. Learn stress reduction techniques. ...
  4. Build a support network. ...
  5. Plan ahead for post-surgical care.

Does taping nose change shape? ›

Taping can be effective to subside the swelling and shrink the skin down. It doesn't, however, affect the shape and form of the nose.

Should I be tapping my nose after rhinoplasty? ›

Nose taping is often recommended for 1-3 months after a rhinoplasty procedure. Dr. Miller provides patients with clear instructions for recovery care and taping.


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