According to many surgeons, revision rhinoplasty is one of the most difficult plastic surgery procedures for both doctor and patient. Why is this? If you’ve had one or more nose jobs and are still unhappy with your look, what should you do?
Part of the answer to these questions is simple: any revision surgery is more challenging than the original procedure. During a second surgery, your doctor faces scar tissue, altered circulation patterns and so on. One Beverly Hills plastic surgeon also points to the loss of “normal anatomical landmarks” that happens with the primary surgery.
With revision rhinoplasty, the effects of the first operation can pose extra problems for a plastic surgeon. Doctors explain that rhinoplasty tends to weaken the support structure of the nose, made up of both bone and cartilage. Revision rhinoplasty surgeons must take care not to negatively impact even more of the foundation that supports soft tissues and thin skin. (Remember Michael Jackson’s nose?) In fact, many operations will necessitate rebuilding some of the nose’s original support system to allow it to hold up under the healing process and passage of time.
For many patients, a second nose job involves improving breathing difficulties as well as appearance. These dual goals can be difficult to achieve.
For the patient, there’s no denying that a poor outcome from a primary rhinoplasty can be a crushing blow. After making the tough decision to have surgery, experiencing the procedure and recovery and waiting months for your nose to settle into a more pleasing new shape, it can be very difficult to come to grips with the fact that it just didn’t work out as you had hoped. Some people feel they look worse after their nose job than they did before surgery.
Finally, fixing a failed rhinoplasty normally takes longer than the procedure time of the initial surgery and poses a longer recovery period as well. Major revisions can cost more too.
So, what should you do if a year or more has passed since your nose surgery and you’re wondering whether you should try again?
First, return to your original plastic surgeon to discuss your dissatisfaction. If a small “refinement” is all that’s needed and you feel you’re in good hands, you may opt for minor fine-tuning with the same doctor. At least talk through your options.
You should also find out whether an injectable might be a good choice for you. Small dents, lumps or other asymmetries can sometimes be improved a great deal with a filler. While this is not a permanent solution, it would allow you to avoid the risks of a second surgery.
If you believe a major revision is in order, consider seeking a surgeon who specializes in revision rhinoplasty. Careful review of a surgeon’s website will indicate if you may have found one. Choosing a board certified plastic surgeon is a start, but you will also want to hear that your candidate has vast experience with nose job revisions. You may want to consult a specially trained facial plastic surgeon, and/or one who has a reputation for being the best and has trained with the best. You may need to fly across the country, and it could be that you’ll need more than one correctional procedure.
Generally speaking, the more problematic the revision, and the further from the original surgery (third, fourth, or fifth revision), the more research you’ll need to do and the more careful you will need to be with your decisions. And the more you and the plastic surgeons you consult will need to wrestle with the ultimate question of whether to operate at all. If an extremely well qualified specialist suggests you may have reached the point of diminishing returns, listen and process that input. It may be time to try some injectables, accept your nose as it is and get on with your life.