A lot of people can’t wait to get a nose job and feel good about their new nose. Unfortunately, things don’t always work out the first time. Perhaps you have had a failed nose surgery that has left you unsatisfied with how your new nose looks or you have trouble breathing after your first rhinoplasty.
Revision rhinoplasty is nose surgery that focuses on fixing problems from a previously failed nose job. The first time you get a rhinoplasty, you may notice that your nose looks crooked, too big, too small, asymmetric, or that one nostril is bigger than the other.
After a primary rhinoplasty, a revision nose job can address any remaining cosmetic problems, fix new nasal deformities, undo some of the changes to the nose, and improve breathing.
Dr Stephen Kleid is one of the leading revision rhinoplasty surgeons in Melbourne, Australia. He makes it his personal mission to give his patients the successful nose job they should’ve had in the first place.
A rhinoplasty is a procedure that makes your nose look better, fixes your breathing problems, or both. When the first nose surgery failed whether because it does not meet the patient’s needs and expectations or it negatively affected the appearance or function of the nose, a surgeon can perform a second nose job, or revision rhinoplasty.
Secondary rhinoplasty is a cosmetic procedure for patients who have previously undergone one or more nose surgeries. Patients looking for a revision rhino usually hope to fix:
- Nose problems that weren’t fixed during a previous nose job
- New nose deformities resulting after rhinoplasty
- Other nose deformities that weren’t apparent before the first rhino
- Fix breathing trouble developed after a nose surgery
- Or, Undo some of the structural changes done to the nose during the first rhinoplasty.
A nose job usually involves manipulating the cartilage and bone, reshaping the septum, adding or removing tissue, and altering the nostrils and nose tip. This can make a revision rhinoplasty challenging. Your surgeon will need to keep in mind the changes already made to the nose during the first surgery which can limit the second surgery.
Dr Kleid has an outstanding record in performing successful revision nose jobs that improve both the structure and function of the nose after it has healed from a previous rhinoplasty.
Getting a second nose job is more common than you might think. Patients who have worsened breathing after their septoplasty or are unhappy with the results of their rhinoplasty often consider getting another nose job.
You may be a candidate for a revision rhinoplasty if you’ve experienced the following problems after your first rhinoplasty:
10% of all patients complain that their breathing became worse after rhinoplasty surgery. These breathing problems can be new or residual (already existing problems that persist after surgery).
When a patient has trouble breathing after a nose job it’s usually because of:
- Residual deviation in the septum
- Alar collapse. This occurs when too much cartilage is taken away from the nostrils
- Nasal obstruction from a narrowed nasal valve (the area between the septum and the nostril becomes tight obstructing the nasal airflow)
One study shows that 70% of all revision rhinoplasty was undertaken to alleviate breathing disturbances following reduction rhinoplasty.
In some cases, patients get a blocked nose feeling after a nose job. The scars and loss of mucosal sensation following nose surgery can cause a loss of warm and cold sensations in the nose. This can lead to a blocked nose feeling even when the is nothing obstructing the nasal pathway.
Getting surgery doesn’t always leave you with the aesthetic results you were hoping for. Reasons for patients to seek revision rhino after a failed nose surgery include:
- A crooked appearance
- The nose might stay crooked even after a nose straightening surgery.
- In some cases, a nose can look deviated after surgery even if it was straight beforehand.
- Polly beak
- This is the most frequently reported nose deformity after surgery.
- When the nose has a very thick nasal bridge area right above the nose tip.
- In this case, the nose bridge looks higher than the rest of the nose from the side.
- Visible inner nostrils
- Pinched nostrils
- Another deformity that can happen to the shape of the nostrils.
- When too much cartilage is taken away the nostrils become too narrow and gain a slit-like appearance.
- An obvious sign of a botched nose job surgery.
- If the nose looks asymmetric with the rest of the face then the nose surgery didn’t do its job.
- Dislocated nasal implants
- A surgeon will sometimes use a Nasal implant during rhinoplasty to give the nasal bridge more projection.
- After surgery, the nose implant can shift in position deforming the shape of the nose.
- Distorted cartilage grafts
- Cartilage grafts used to reshape the nose can be reabsorbed or dislocated.
- If the cartilage bends or warps, you can end up with a misshaped nose.
- Mucosal cysts
- During rhinoplasty, some of the nasal mucosae may become displaced and entrapped.
- This buildup of the mucosa can cause cysts.
- Although rare, the displaced mucosal cysts can form a mass and cause nasal defects.
With the right planning and sufficient experience, your surgeon can minimize the possibility of unsatisfactory results.
Problems with Healing
Sometimes the nose rhinoplasty goes smoothly and everything is in place. Nevertheless, the healing process doesn’t go as planned. Things that can go wrong while you’re healing from a nose job:
- Infection from nasal implants and abscess formation
- A perforated septum that dries out very easily causing nose bleeds when you sneeze or blow your nose
- Injury to the nose: Accidents and injuries to the nose can happen after a rhinoplasty while the nose is still vulnerable. Before a nose has fully healed, a hard bump to the nose can cause new deformities that need fixing
It’s true that there is the possibility of undesirable results with any cosmetic surgery including rhinoplasty. However, an experienced plastic surgeon can avoid problems like breathing obstruction, asymmetry in the nose, and disproportional nasal features by choosing a good approach (open or closed rhinoplasty) and the right technique (types of grafts and sutures used).
Revision rhinoplasty is done similarly to how a primary nose job is done.
You will go under general anaesthesia. Then, Dr Kleid will gain access to your nose tissue using one of the two techniques:
- Open incision: The surgeon will make a small cut at the base of the columella (the column between the two nostrils)
- Closed approach: The surgeon will access the nasal tissue through incisions made on the inside of the nose.
After accessing your nose, Dr Kleid will be able to use surgical manipulation, cartilage grafts, and/or synthetic implants to:
- Structurally support the excessively reduced tip or bridge of the nose (that can make the nose look too small or too flat)
- Compensate for deficient septal cartilage and/or straighten the septum (septoplasty)
- Reopen the narrowed nasal airway (using spreader grafts between the lateral nasal cartilage and septum)
Dr Kleid can also reconstruct your nose after an unsatisfactory rhinoplasty by:
- Reducing the size of your nostrils (alarplasty) if the nose looks too wide
- Removing extra parts of the bone and cartilage if the nose still looks too big
After the nose is sculpted into a new satisfying shape, your wounds will be closed and your nose will be splinted.
You can never be 100% sure how your nose job surgery will turn out to be. Nonetheless, you can be sure you have the best odds when you choose an extremely skilled and meticulous surgeon to perform your revision surgery.
A second rhinoplasty can be even more challenging than the first one because:
- Patients are unhappy with how their noses look after the first surgery and expect the revision rhino to make everything right.
- The nose will already have an “operated on” look from the first botched nose surgery.
- Scar tissue from the previous surgery can get in the way during the second nose job.
- Cartilage may be needed to make up for the lost tissue from the first surgery.
- Primary rhinoplasty/failed nose surgery changes how the bone, cartilage, and tissue in the nose are laid out. Thus, reshaping the nose will be more challenging during the second rhinoplasty.
Dr Kleid takes the time to understand the procedures used in your previous nose job and the complications that resulted afterwards. That way, he is able to give you a more successful rhinoplasty surgery that satisfies your original and new needs.
If you’re unhappy with the results of your nose reshaping surgery, you might feel like you can’t wait until you get another surgery to fix it. But you keep in mind that the nose is vulnerable after rhinoplasty and you should wait for it to completely heal before getting another nose job, otherwise you may end up with another failed nose surgery.
Surgeons recommend you should wait for at least 1 year before getting a second rhino. This will give your nose enough time to recover and be ready for a second surgery.
Also, in the first 12 months after your rhinoplasty, the nose will continue to gradually heal and change until you can see the final results of your nose job. By that time, some of the problems that were bothering you about your nose might not be there anymore.
Moreover, at first, you may not accept the shape of your new nose, you may consider it another failed surgery, but if you give it some time, you might become familiar and comfortable with how your nose looks and begin to love it.
It’s not easy to determine how much fixing a failed nose job will cost before a consultation.
During your visit, Dr Kleid will give your nose a thorough examination and determine the extent of work you require. Based on that, he will be able to give you an estimation of how much you’ll need to pay for your second rhinoplasty.
Normally, the fees will be a lot less if your nose needs only slight adjustments in comparison to more extensive revision surgery.
You may feel scared or worried about getting a revision Rhinoplasty after a failed nose surgery. Sometimes you can’t help thinking what if the second nose job fails as well?
Every cosmetic surgery has a risk of failing; it’s rare, but unfortunately, it can still happen. You shouldn’t give up on getting the nose you’ve always wanted and you should definitely not give up on fixing your breathing problems.
Control the things you can. A second rhinoplasty is more complicated and requires more skill to make up for the problems from your primary nose surgery. Make sure you choose a highly skilled surgeon with extensive experience in revision rhinoplasty to perform your surgery. A surgeon who has done many second nose jobs will be able to properly reshape your nose for the last time.
When can I breathe normally out of my nose after rhinoplasty?
It usually takes 1-3 weeks before you can feel more comfortable breathing after your nose job. Though, nasal congestion can persist for several months. Follow your surgeon’s instructions on how to use a nasal spray to clear out your blocked nose during recovery. Read more tips for recovery after Rhinoplasty, here.
When can I see the final results of my nose job?
Your nose will continue to improve as the swelling goes down during the first couple of months of recovery. 3 months after your surgery, most of the swelling should be gone and your nose will look dramatically better. However, it can take up to a year to see the final results of your rhinoplasty; by then any residual swelling will have subsided.
How many nose jobs can I get?
There isn’t a set limit to how many revision rhinoplasty procedures can be performed. Nevertheless, with every new surgery, there are new risks and new complications that can arise. Also, the nose becomes more and more vulnerable with every nose job.
How soon can I get a revision rhinoplasty?
Typically, you should wait 12 months before getting a second nose job. Nonetheless, the waiting period can be cut down to around 6 months if there is a severe nose deformity (e.g. dislocated implant, collapsed nostrils).
- Risks and complications in rhinoplasty – PMC
- Functional and Aesthetic Factors Associated with Revision of Rhinoplasty – PMC
- Differences between Primary and Revision Rhinoplasty: Indications, Techniques, Grafts, and Outcomes
- Introduction of a Less Invasive Revision Rhinoplasty Using Closed Nasal Chondrotome – PMC
- Revision rhinoplasty: measurement of patient-reported outcomes and analysis of predictive factors – PMC
Why Choose Dr Kleid ?
Dr Stephen Kleid,
Dr Stephen Kleid is an experienced ENT Surgeon (Otolaryngologist) based in Melbourne with a passion for Septo-rhinoplasty, Septoplasty and a strong interest in Rhinoplasty Revision.
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