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The Plastic Surgery "Revision Decision"

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plastic surgery problem Photo: Getty Images

If you’re less than pleased with the results of cosmetic surgery, you may be feeling any or all of these things: disappointment, frustration, regret, even anger. You may be considering whether to seek a second procedure. But is it reasonable to expect that a second surgery will yield the outcome you were hoping for originally? Should you go for it?

“Do over” plastic surgery is not uncommon. In medical circles it’s called “revision surgery,” and there are times when the need is obvious. Perhaps the best example is when breast implants have ruptured. If you have an implant that has deflated or may be leaking, you should visit your plastic surgeon right away. In fact, if you notice a potential problem with any other cosmetic implant, schedule a visit with your surgeon.

For patients who simply did not know the outcome they were hoping for, the decision about revision surgery is not as clear. For many people, fortunately, a relatively minor touch up can make all the difference. It’s not unusual at all for a man or woman to return to their liposuction provider for help in smoothing a slight contour irregularity, for instance. And if liposuctioned fat is repositioned to augment the breasts, buttocks or face, repeat injections may be needed due to fat absorption (Kim and Rose, 391).

When it comes to the results of facial plastic surgery, breast augmentation and some body contouring procedures, whether or not to opt for revision surgery is a tricky call to make. If this is the situation you’re in, you have some thinking to do.

A good first step is to try to pinpoint exactly what’s bothering you. If you can see it in the mirror and describe it—say it’s an asymmetrical result of breast augmentation—chances are your plastic surgeon may be able to fine-tune the outcome. If your original procedure resulted in a scar you don’t like, it’s usually possible to achieve a smoother, flatter skin surface through scar revision. While scars can’t be completely removed many can be greatly improved.

But if you have a difficult time saying exactly why you’re not happy with your surgical outcome, think about whether the goals are reasonable. If you had facial plastic surgery addressing the upper and lower face and you think you still look older than you want to, perhaps its time to work on making peace with the aging process. If you feel generally and chronically unhappy with your looks, consider visiting a counselor trained in body image issues.

If the motivation for your cosmetic surgery is related to external factors—such as landing a job or keeping a partner—know that many plastic surgeons usually don't recommend going under the knife for such reasons. If you choose surgery and did not realize one of these external results, call it a lesson learned and go on with your life.

Finally, if you’re considering additional nose surgery—remember the Michael Jackson effect. A talented revision rhinoplasty specialist may be able to improve upon the outcome of a first surgery, and perhaps even on a second one. But the "point of no return" is soon reached with noses, as the underlying structures get impacted to the point where looking natural just isn’t possible.

Above all, exercise your best common sense in making a decision about revision surgery. Read up on it. Visit your original cosmetic surgeon and discuss what’s bothering you and all the possible options. See another surgeon for a second opinion, and make sure to find one who is straightforward and open about what surgery can and cannot achieve. Examine your goals and motivations with brutal honesty.

And apply a strong “reasonableness” filter. Should you elect a second rhinoplasty with an expert? Maybe. Should you go for your fourth eyelid lift, like the New Jersey woman who can no longer completely close her eyes (Conley, 1)? Maybe not.


Kim, Nancy, and Rose, John G. Jr. “Fat Processing Techniques in Autologous Fat Transfer. Shiffman, Melvin A. Autologous Fat Transfer: Art, Science and Clinical Practice. Google books. 391. Springer, 2009. Web. April 12, 2011.

Conley, Mikaela. “New Jersey Woman Sues, Can’t Fully Blink After Eyelid Surgery.” ABC News Health. ABC News. 1, 2, 3, 4. March 31, 2011. Web. April 12, 2011.

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EmpowHER Guest

My wife is thinking about getting plastic surgery. She has been wanting to do it for years. We've been trying to find as much information as we can about it before she makes this big decision.
Gary Puntman | http://www.brunnermd.com

June 23, 2014 - 12:14pm
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.



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