What Is A Revision Rhinoplasty?

Technological advances in revision rhinoplasty have significantly enhanced the precision and outcomes of these complex procedures. Dr. Azizzadeh uses innovative 3D morphing software to create highly detailed models of your nose, facilitating better planning and visualization of the expected results. Ultrasonic rhinoplasty, a technique using high-frequency sound waves, enables more precise bone reshaping with minimal trauma to surrounding tissues, reducing recovery time and complications. Additionally, advances in cartilage grafting (now) and tissue engineering (in the future) provide more reliable options for reconstructing and supporting the nasal structure, ensuring long-lasting and natural-looking results. These technological strides are helping to address the challenges of revision rhinoplasty with greater accuracy and patient satisfaction. 

Revision rhinoplasty is a complex procedure aimed at correcting or refining the results of previous nose surgery. One advanced technique that Dr. Azizzadeh employs in revision cases is called “Limited Dissection Revision Rhinoplasty.” This specialized approach focuses on preserving as much of the nasal structure as possible, particularly when only the tip requires refinement. By lifting only the skin of the tip region without disturbing the surrounding nasal bone and bridge cartilage, Dr. Azizzadeh can make precise adjustments while minimizing disruption to the overall nasal framework. 

This method is particularly beneficial in revision cases where preserving the integrity of the remaining nasal structures is crucial to avoid complications such as skin irregularities or cartilage collapse. The technique is less invasive than traditional revision methods, which can involve more extensive dissection and manipulation. By maintaining key nasal structures, this approach not only reduces the risk of complications but also enhances aesthetic outcomes, particularly when viewed from the front. However, it is important to note that this technique requires significant expertise and experience, as well as specialized equipment, to achieve the best results. In some cases, a residual bump or other minor issues may still require further refinement, but this minimally invasive approach offers a promising option for many patients seeking revision rhinoplasty. 

Revision rhinoplasty is often a significantly more complex and challenging procedure than the initial surgery due to the presence of scar tissue, altered anatomy, and the need for structural rebuilding. However, when performed by an expert surgeon, the results can be highly rewarding for the right candidate. It is crucial to choose a surgeon not only for their exceptional surgical skills and aesthetic artistry but also for their strong commitment to ethical practice. A qualified surgeon must thoroughly understand your nasal anatomy and realistically assess whether your expectations and goals are attainable. If they believe the chances of success are not reasonable, they should candidly advise against surgery. Moreover, careful evaluation for factors such as body dysmorphic disorder or an excessive focus on minor flaws is essential, as these may suggest that surgery is not the best course of action. Dr. Azizzadeh’s dedication to these principles, along with his focus on patient safety and realistic outcomes, ensures that those who proceed with surgery are well-suited and have a reasonable chance of satisfaction with their results. However, it is important to understand that while revision rhinoplasty can significantly enhance both function and appearance, the results are not guaranteed. Even with a perfectly executed procedure on an ideal candidate, there is always a possibility of less-than-ideal outcomes due to factors beyond the surgeon’s control, such as individual healing responses and tissue characteristics.

Body dysmorphic disorder (BDD) is a mental health condition where an individual becomes obsessively preoccupied with perceived flaws in their appearance, often minor or nonexistent to others. Individuals with body dysmorphic disorder often see exaggerated or entirely imagined flaws in the mirror, such as perceived deformities, asymmetry, or imperfections. While casual observers, friends, or colleagues may see a normal or even attractive appearance, someone with BDD fixates on these perceived defects, often to the point of significant distress and preoccupation, despite reassurance from others that these flaws are not noticeable. In the context of plastic surgery, particularly revision rhinoplasty, BDD can lead patients to seek repeated surgical interventions in an attempt to correct these perceived imperfections. Unfortunately, surgery is rarely the solution for individuals with BDD, as their dissatisfaction stems from a psychological issue rather than an actual physical defect. Current treatment options for BDD typically involve cognitive-behavioral therapy (CBT) and, in some cases, medication such as selective serotonin reuptake inhibitors (SSRIs), which can help address the underlying anxiety and obsessive thoughts. Surgery is generally not advisable for patients with BDD, as it often exacerbates their condition, leading to further dissatisfaction and the desire for additional procedures. However, even the most astute surgeons, despite their best efforts, may occasionally miss the subtle signs of BDD, as patients may present with what seem to be legitimate concerns.

Determining whether you need a revision rhinoplasty involves carefully assessing your current nasal function and appearance, particularly if the initial surgery did not deliver the desired results. Common reasons for pursuing revision rhinoplasty include issues such as an unsatisfactory cosmetic outcome, over-resection of cartilage, or internal problems leading to breathing difficulties. Patients often seek revision rhinoplasty to correct both cosmetic and functional issues, aiming to achieve facial harmony or restore proper nasal function.

However, the decision to undergo revision rhinoplasty is complex and requires more than just identifying these problems; it involves a thorough evaluation by an expert surgeon to make sure your goals can be achieved. There is art, science, and emotional components to revision rhinoplasty.  Dr. Azizzadeh takes into account not only the physical aspects of your case, such as nasal anatomy and healing process but also your psychological readiness. Some individuals may be deeply impacted and traumatized by their initial surgery, making them particularly vulnerable to the emotional toll that revision surgery can bring, especially if the results do not meet their expectations. For these patients, Dr. Azizzadeh may recommend extensive mental wellness counseling before considering surgery, to ensure they are in the right state of mind to handle the process and its potential outcomes. His commitment to patient safety and realistic expectations means that if he believes surgery might not achieve your goals or could potentially worsen your emotional state, he will candidly advise against it. This careful, personalized approach helps ensure that those who do proceed with revision rhinoplasty are well-suited for the procedure and have a reasonable chance of achieving a satisfying result, both physically and emotionally.

Determining whether you need a revision rhinoplasty involves carefully assessing your current nasal function and appearance, particularly if the initial surgery did not deliver the desired results. Common reasons for pursuing revision rhinoplasty include issues such as an unsatisfactory cosmetic outcome, over-resection of cartilage, or internal problems leading to breathing difficulties. Patients often seek revision rhinoplasty to correct both cosmetic and functional issues, aiming to achieve facial harmony or restore proper nasal function.

Revision ethnic rhinoplasty presents unique challenges due to the distinct anatomical features and healing tendencies of non-Caucasian patients. Dr. Azizzadeh is particularly attentive to the specific considerations for patients with thicker skin, weaker cartilage, and a higher risk of scarring, which are often present in Asian, Hispanic, and African-American individuals. Middle Eastern patients may have a more prominent dorsal hump or thicker skin, requiring delicate reshaping to maintain facial balance. African-American patients often have softer cartilage and wider nasal bases, which demand careful refinement to preserve structure without compromising natural features. Asian patients may present with flatter nasal bridges, where subtle augmentation or tip projection is often needed, while Hispanic patients frequently seek adjustments to the dorsal hump or nasal tip, which can vary significantly depending on regional background. However, Dr. Azizzadeh recognizes that no single feature defines any ethnic group, as there are significant variations within all populations, making a personalized approach essential to achieving a harmonious and authentic outcome for each individual.

Dr. Azizzadeh also recognizes that revision ethnic rhinoplasty goes beyond just physical correction; it involves respecting the cultural aesthetic ideals of the patient. This is why he rejects a standardized approach based solely on ethnicity and instead focuses on creating a harmonious, natural outcome that reflects the individual’s unique facial features. Understanding that nasal characteristics vary significantly within every ethnic group, he prioritizes a personalized approach to ensure the results honor the patient’s ethnic identity while meeting their aesthetic goals. As with Caucasian patients, ethnic rhinoplasty revision often requires utilization of rib cartilage to support the nasal structures and obtain ideal outcomes.  In short, revision ethnic rhinoplasty is a complex procedure, but with Dr. Azizzadeh’s specialized expertise, it’s possible to correct prior surgeries while celebrating and maintaining the patient’s distinctive ethnic traits.

When considering revision rhinoplasty, age is an important factor. For younger patients, it’s crucial that their nasal structures are fully developed before undergoing any rhinoplasty, including revisions. This typically means waiting until after puberty—around 15-17 years old for girls and 16-18 years old for boys—when the nose has mostly finished growing. In addition to physical maturity, young patients must demonstrate emotional maturity and have realistic goals. The disappointment from an unsatisfactory first surgery can be emotionally taxing, especially as they navigate critical stages in their social, academic, or workplace environments. The pressures of social media, with its constant promotion of idealized appearances, can further complicate their feelings and drive the desire for change. Dr. Babak Azizzadeh takes these factors into account, guiding teenagers and young adults to carefully consider their motivations and ensuring they are truly ready before moving forward with another surgery that may take many months to heal.

For older patients, additional considerations come into play. As we age, changes in cartilage, bone, and skin can impact the approach to revision rhinoplasty. Thinner skin, weaker cartilage, and altered bone structure may require specific techniques to achieve the desired outcomes. Regardless of age, overall health is the most crucial factor. Dr. Azizzadeh collaborates with your primary doctor to ensure you are physically prepared for surgery, addressing any underlying health issues that could affect your recovery. Having a certified anesthesiologist on hand during the procedure is also essential for your safety. Dr. Azizzadeh’s thorough and personalized approach ensures that both younger and older patients are well-prepared and have the best chance of achieving a successful outcome with revision rhinoplasty.

Nose jobs (rhinoplasty) can fall short of expectations for various reasons, often due to issues during the planning and execution of the procedure. Common causes include insufficient planning before surgery and excessive removal of cartilage and bone from the nasal bridge, which can compromise the structure of your nose. Damage to the nasal tip cartilage and over-removal of cartilage can also contribute to an unsatisfactory outcome. Sometimes, unrealistic expectations or a lack of clear communication from your surgeon about potential risks and realistic outcomes can also lead to disappointment. Some individuals have extremely difficult noses to fix and it is critical for your surgeon to communicate this with you.  Even if you are the perfect candidate with realistic expectations, results can still be less than ideal due to factors beyond anyone’s control, such as your body’s healing process or unforeseen complications. Rhinoplasty is widely regarded as one of the most challenging cosmetic procedures, requiring exceptional skill and precision. This is why it’s crucial to choose an expert surgeon to give yourself the best chance of a successful outcome, though it’s important to remember that even the most skilled surgeons cannot guarantee a 100% success rate. Dr. Babak Azizzadeh understands how complex these situations can be and works closely with you to assess your unique circumstances. He carefully evaluates whether you are a good candidate for revision rhinoplasty, including tip revision, or if other facial rejuvenation treatments might be more suitable to help you achieve your desired results.

Revision rhinoplasty carries several risks that are generally higher than those associated with primary rhinoplasty, primarily due to the complexity of the procedure, the unpredictable healing process, and the presence of scar tissue from your previous surgery. Common risks include persistent nasal asymmetry, difficulty in breathing due to compromised nasal structures, and the potential for unsatisfactory aesthetic outcomes. There is also an increased risk of skin and soft tissue complications, such as thinning or thickening of the skin, and reduced blood supply to the nasal tissues, which can affect healing. The procedure may involve the need for cartilage grafts, often harvested from your rib or ear, which carries additional risks, including pain at the donor site and the possibility of graft resorption or warping. Psychological risks are also notable, as you may have heightened anxiety and expectations.  Dr. Babak Azizzadeh strives to help you make an informed treatment decision by educating you about revision rhinoplasty, its benefits, and its potential complications prior to treatment. He also crafts a custom treatment plan tailored specifically for you, designed to minimize the risk of complications. With this plan in place, Dr. Azizzadeh will work closely with you to achieve the optimal revision nose surgery results, balancing your desire for improvement with a realistic understanding of the possible outcomes.

When choosing a surgeon for rhinoplasty revision, it is crucial to ensure they have specialized qualifications and extensive experience in this complex procedure. Your surgeon should be board-certified in facial plastic and reconstructive surgery or plastic surgery, demonstrating a high level of training and expertise in the field. Additionally, they should have a proven track record of performing successful rhinoplasty revisions, as this procedure requires advanced skills beyond those needed for primary rhinoplasty. A deep understanding of nasal anatomy, experience with cartilage grafting, and proficiency in addressing complications from previous surgeries are essential. Your surgeon should also have the utmost ethical standards and be able to tell you if you are not a great candidate.  Dr. Babak Azizzadeh is exceptionally qualified in this regard, holding double board certification in both facial plastic and reconstructive surgery and otolaryngology-head and neck surgery (ENT surgery). His extensive experience, particularly in revision rhinoplasty, combined with his reputation for delivering natural and satisfying results, makes him a leading expert in the field. Dr. Azizzadeh’s qualifications ensure that you are in skilled hands, increasing the likelihood of a successful and aesthetically pleasing outcome.

Revision rhinoplasty is typically performed under general anesthesia.

Revision rhinoplasty and septoplasty procedures are both nose surgeries, but there are many differences between the two. A revision rhinoplasty corrects the results of a prior nose job, which may include the septum, cartilages that shape the nose, and breathing valves. On the other hand, a septoplasty treats only a deviated septum, a problem that occurs when the bone and cartilage between the nostrils are displaced. During a septoplasty, the nasal septum is repositioned and straightened.

A revision nose job tends to be more expensive than a primary rhinoplasty. This is due to the fact that a revision nose job can require additional expertise, time and resources to complete in comparison to a primary nose surgery.

If you break your nose after a primary rhinoplasty, a revision rhinoplasty may be necessary, but it’s not always required. Each person’s nose is unique, and the impact of trauma can vary significantly. In some cases, a broken nose might heal without needing further surgery, while in others, especially if the trauma is severe, a revision rhinoplasty may be necessary to restore both the appearance and function of your nose. It’s essential to consult with a qualified surgeon, like Dr. Babak Azizzadeh, who can assess the extent of the damage and determine whether revision surgery is the best course of action for your specific situation.

Telltale signs of a bad nose job can vary, but some common indicators include noticeable asymmetry, where the nose appears uneven or lopsided, and breathing difficulties that persist or arise due to internal nasal structure issues. A bad nose job may also result in a pollybeak deformity, characterized by a bulge or fullness above the tip, giving the nose a beak-like appearance. Additionally, a pinched nasal tip, often caused by excessive cartilage removal, can create an overly narrow look, while a scooped or saddle nose—a concave or collapsed nasal bridge—can give the profile a scooped-out appearance. Visible scarring, especially if it hasn’t healed well or is prominent externally, is another sign. Issues with the nostrils, such as them appearing too large, too small, or irregularly shaped, can also contribute to an unnatural look. An over-rotated tip, where the nose tip is excessively upturned, sometimes referred to as a “piggy nose,” makes the nostrils overly visible from the front. Overall, if the nose looks overly altered, out of harmony with the rest of the face, or simply unnatural, it may be a sign of a poorly performed rhinoplasty. If you notice any of these issues, it’s important to consult with an experienced revision rhinoplasty specialist, like Dr. Babak Azizzadeh, who can evaluate the situation and discuss potential options for correction.

After a rhinoplasty, it is generally recommended to wait at least 12 to 18 months before considering a revision rhinoplasty, but Dr. Babak Azizzadeh may advise you to wait even longer, sometimes up to three years, depending on your individual healing process. This waiting period is crucial because it allows time for the nose to fully heal, with swelling subsiding and tissues stabilizing, which is essential for evaluating the final results of the initial surgery. The emotional impact of the first surgery may also necessitate a longer delay, as undergoing revision rhinoplasty is a significant decision that requires you to be physically and emotionally ready. Dr. Azizzadeh emphasizes the importance of being fully prepared for the procedure, and he is honest and forthright in his evaluations. If the concern is a minor flaw, he may advise against proceeding, as revision rhinoplasty carries inherent risks. Your surgeon should share this level of transparency and commitment to your well-being, ensuring that revision surgery is only pursued when it is truly necessary and likely to result in a meaningful improvement.

Revision rhinoplasty is a complex procedure that is tailored to address specific issues from a previous rhinoplasty, and it often requires more advanced techniques than the initial surgery. The procedure usually begins with a thorough assessment of the nose’s structure, taking into account any scar tissue, altered anatomy, or functional issues. Depending on the extent of the correction needed, the surgeon may use an open or closed approach, with the open approach being more common in complex cases. If there is a need to rebuild or reinforce the nasal structure, the surgeon may need to harvest cartilage from the rib or fascia from another part of the body, such as the temple or behind the ear. This harvested tissue is then carefully shaped and grafted to provide the necessary support and achieve the desired aesthetic result. Dr. Babak Azizzadeh uses his extensive expertise to meticulously plan and execute each step of the surgery, ensuring that both the functional and cosmetic aspects of the nose are addressed. The goal is to create a natural, balanced appearance while resolving any breathing difficulties or structural weaknesses that may have resulted from the previous surgery.

The duration of a revision rhinoplasty can vary depending on the complexity of the procedure and the extent of the corrections needed, but it typically takes between 3 to 5 hours to complete. Revision rhinoplasty is generally more intricate than primary rhinoplasty, as it often involves addressing issues such as scar tissue, altered nasal anatomy, or the need for cartilage grafting from other parts of the body, such as the rib or ear. The additional time allows the surgeon to carefully navigate these challenges and ensure precise adjustments to both the form and function of the nose. Dr. Babak Azizzadeh, known for his meticulous approach, dedicates the necessary time to achieve the best possible outcome, balancing aesthetic goals with the structural integrity of the nose.

No, you will not be able to drive after anesthesia, you must have a friend or family member pick you up and take you to your destination. Additionally, you can not take an Uber, Lyft or similar service.

Recovery from revision rhinoplasty depends on several factors, including the surgical approach and how your surgeon handles the tissues. While revision surgery typically requires more time for recovery due to the need to restructure your nose and address previously operated tissue, which generally leads to more swelling, certain techniques can influence the healing process. If Dr. Azizzadeh utilizes endonasal, preservation rhinoplasty or a limited dissection external rhinoplasty approach, it can potentially reduce initial swelling and lead to a quicker recovery. However, it’s important to note that some people may still experience a more protracted healing process despite these minimally invasive techniques. To support your recovery, closely follow your surgeon’s post-operative care instructions, keep your head elevated to reduce swelling, and use cold compresses as recommended. Avoid strenuous activities, maintain a balanced diet, and stay hydrated to facilitate healing. Additionally, steering clear of smoking and alcohol is essential, as they can impair circulation and slow down the recovery process. Always consult your surgeon before trying any new remedies or supplements.

When Dr. Azizzadeh performs a closed revision rhinoplasty, the incisions are made entirely inside the nose, resulting in no visible scarring. In contrast, an open revision rhinoplasty involves a small discreet incision under the tip of the nose in between the nostrils, which may leave a minimal scar that is nearly invisible. Dr. Azizzadeh carefully evaluates each patient before recommending whether an open or closed approach is best, considering the patient’s unique anatomy, goals, and other factors. He meticulously plans and executes each procedure to minimize the risk of complications, including scarring, by making precise incisions and ensuring the highest standard of care.

The revision rhinoplasty procedure itself isn’t painful because you’ll be under anesthesia during the surgery, ensuring you’re comfortable and unaware of what’s happening. The level of post-operative discomfort can vary based on the techniques used during your revision rhinoplasty. For example, if rib grafting is involved—where cartilage from your rib is used to reconstruct your nose—you might experience additional discomfort at the rib site. However, this is typically well-managed with over-the-counter pain relievers like acetaminophen and, if necessary, prescription medications.

Stitches are typically removed about 5 to 7 days after a revision rhinoplasty procedure. However, the exact timing can vary depending on the surgical approach and how your body is healing. If dissolvable stitches are used, they will gradually dissolve on their own within a few weeks, eliminating the need for removal. Your surgeon will provide specific instructions based on your individual case, and they’ll monitor your healing progress to determine the best time for stitch removal.

There are no guarantees with any plastic surgery, especially revision rhinoplasty. However, choosing an expert and experienced rhinoplasty surgeon can significantly increase your chances of a successful outcome. During your consultation, Dr. Azizzadeh will thoroughly explain the benefits and risks associated with revision rhinoplasty. He will also help you carefully weigh the pros and cons, ensuring that you make an informed decision that aligns with your goals and expectations. By providing personalized guidance, Dr. Azizzadeh supports you in making the best choice for your unique situation.

Immediate post-op complications, such as excessive bleeding, severe pain, or signs of infection, should prompt you to contact our office right away. These issues may require prompt medical attention to prevent further complications. Long-term concerns, such as persistent swelling, difficulty breathing, or dissatisfaction with the results, should also be addressed with your surgeon to evaluate the best course of action. You have on-demand access to our office, and a doctor is always on call to assist you with any concerns, ensuring that you receive the support you need throughout your recovery process.