Since the nose is one of the defining features of anyone’s face, many people are dissatisfied with the shape or size of their nose and opt to get rhinoplasty, commonly known as a nose job.

Is your nose asymmetrical, lopsided or otherwise just unnatural-looking? The objective of the rhinoplasty surgery should be to improve the appearance of your nose so that it complements and balances out your other facial features.

Life doesn’t give us very many opportunities to do things over or fix something that didn’t go quite right the first time. If you were hoping cosmetic surgery would help you feel more confident about the way you look, but the results of your previous nose surgery procedure left you less than satisfied with your appearance, you may be wondering if there’s anything you can do about it.

Fortunately, there is an option to get a skilled cosmetic surgeon to redo your nose job in a procedure known as revision rhinoplasty.

What Is Revision Rhinoplasty?

Rhinoplasty is an intricate and delicate surgery, with both aesthetic and functional aspects that take many years of surgical experience to master. The complexity of a cosmetic nose job is one reason patients are not happy with their outcome and are looking for a revision. What went wrong?

Rhinoplasty is widely regarded as one of the most difficult plastic surgery procedures, and a revision rhinoplasty is generally an even more challenging operation that requires a truly expert touch.

As a leading specialist in cosmetic plastic surgery, San Francisco surgeon Dr. Michael Kulick encounters a variety of problems that can result when a rhinoplasty was performed by less skilled surgeons, there was a postoperative complication or there was an issue with patient cooperation after the initial surgery. Each patient’s problem is unique and requires various expert techniques to improve upon the result of the original procedure. Communication and trust are both critical for this next step.

Symmetry Is Key

It is important to remember that a rhinoplasty involves two separate procedures: one on the right side of the nose and one on the left. In every stage of the surgery, the surgeon must pay exacting attention to focus on symmetry while making changes. When the original doctor doesn’t remove or alter the cartilage or bone on both sides to the same degree, or there is some other complication, an asymmetric nose can be the undesirable result.

Asymmetries may also occur due to unequal scarring during the healing process, and not reveal themselves until months or even years after the surgery. For any successful revision rhinoplasty, the surgeon must concentrate on symmetry at every stage of the procedure and use his or her extensive knowledge and experience to anticipate how the scar tissue is likely to form to achieve a final, aesthetically satisfying result. Analyzing the cause of the patient’s nasal appearance after their initial rhinoplasty is critical to improving it. True nasal symmetry is often not possible, but a plastic surgeon performing such a procedure needs to communicate the structural problems and the goal of a revision nose job.

The Rhinoplasty Procedure and Recovery

In most rhinoplasty procedures, the surgeon will cut the skin of the nose and lift it up and away from the bone and cartilage framework beneath, which will allow these supporting structures to be reshaped as desired. The doctor then re-drapes the skin over the re-sculpted framework, and applies a splint to help your nose maintain its reshaped form. Cartilage, preformed silastic or dermal grafts may be inserted to attain the desired treatment goals.

Occasionally, the aims of a revision rhinoplasty are to restore both nasal structure and function.The original procedure may have made it harder to breathe. In these situations, a patient’s insurance may pay for the corrective procedure. In some cases, a surgeon may try to correct the asymmetry by altering the existing or removing cartilage. If needed, sources of extra cartilage can be your nasal septum, ear or one of your ribs.

After surgery, your surgeon may use soft splints placed inside your nose to provide additional stability, which can be removed about a week after the surgery. Any bruising usually resolves at that time, as well. External splints and sutures are removed within about a week, and you can usually return to work or non-strenuous activities at that time. Most of the swelling resolves within two to four weeks, and the major healing period progresses for up to four to six months; however, it usually takes a year or two before all swelling is gone, scar tissue softens and you can fully see the true shape of your new nose. A revision rhinoplasty may take longer to show its final result, due to the altered blood supply and previous scarring from the initial procedure.

Can a patient who had an initial procedure that went bad have a successful outcome with a second procedure? As one happy revision rhinoplasty patient reported, “I had rhinoplasty about five years ago from a different doctor. When I spoke with Dr. Kulick, I couldn’t articulate what I didn’t like about my nose, because it wasn’t bad, I just wanted it to be a little better. Now, I wouldn’t change a thing about it.” A revision rhinoplasty is a reality! 

Revealing a Better Nose

Cosmetic surgery is equal parts art and science. Not only does a surgeon need to take into account the proper proportions and distinctive characteristics of a patient’s face during the surgery itself, he or she must also consider the patient’s overall healing process and how his or her face could change over time to achieve the ideal final result.

Sometimes a rhinoplasty procedure is successful in medical terms, but unsuccessful in terms of the aesthetic outcome. The key to a revision rhinoplasty is having it be performed by a trained expert like Dr. Michael Kulick that can manage the complications introduced by the previous surgery and strike both the balance and the beauty the patient was originally seeking.