Revision Rhinoplasty: What Every Patient Should Know
Originally published on November 8, 2019. Updated June 6, 2025
Revision rhinoplasty is a secondary procedure done to correct undesired results from an original rhinoplasty surgery. Many patients seeking revision rhinoplasty feel the results they received are too unnatural, not in harmony with their other facial features, or the results are not as pronounced as they desired. Many also suffer from new or under-corrected nasal obstruction after primary rhinoplasty.
What Is Revision Rhinoplasty?
Revision rhinoplasty (or secondary rhinoplasty) is a surgical procedure to correct an undesired outcome that persists or develops from the original nose surgery. It’s a procedure done to correct either the appearance or functionality of the nose following an initial rhinoplasty surgery.
Revision rates are dramatically higher for less experienced surgeons. However, it’s important to understand that all rhinoplasty surgeons, regardless of experience and expertise, will have some rate of revision. This is due to the complexity of the procedure; often unanticipated obstacles become apparent after the surgery has begun. Additionally, complications can arise during the healing process.
Before and After Revision Rhinoplasty
Before 
After 
Before 
After View Revision Rhinoplasty Photo Gallery
How Common Is Revision Rhinoplasty
While numbers vary by study, one study published by the Aesthetic Surgery Journal found the average rate of rhinoplasty revision to be 9.8%. In another study which used a questionnaire to ask surgeons about their revision rates the majority of self-reported revision rates fell between 0% to 5%, although roughly 30% of respondents have revision rates between 6% and 10%.
Understanding revision statistics is important for any rhinoplasty patient. However, it’s also important to understand what revision rhinoplasty is and why it may be necessary. Here’s an overview of revision rhinoplasty, including some tips on how to avoid the need for a revision.
Why Patients Seek Revision Rhinoplasty?
Many patients seeking revision rhinoplasty do so for strictly cosmetic reasons. Some of these patients may feel the results they received are too unnatural or not in harmony with their other facial features. Some wanted more done than what their surgeon did. Still others have new deviations, bumps on their tip or other irregularities that occurred during the healing process. They seek additional treatment to achieve a better cosmetic result.
Some patients seek revision surgery for a functional reason. Post procedure, they may suffer from new or under-corrected nasal obstruction after primary rhinoplasty. These patients may need functional nasal surgery, which may include septoplasty, nasal valve repair or inferior turbinate reductions.
The Challenges Of Revision Rhinoplasty
Revision rhinoplasty can be a difficult procedure, so much so that many surgeons prefer not to offer revisions. Here are some factors that make revision rhinoplasty challenging:
Scar Tissue
One of the biggest factors revision rhinoplasty surgeons must contend with is the amount of scarring stemming from the initial procedure. The more scar tissue there is, the longer and more difficult the procedure becomes. The surgeon will have to make carefully calculated incisions to have proper access to correct the nose while being careful to not create additional scarring. Scarring can alter the way the nose settles and heals after revision surgery in unpredictable ways if the revision rhinoplasty surgeon fails to create enough structural strength.
Nose Strength
Oftentimes the structure of the nose needs to be reinforced to maintain its shape after undergoing the initial rhinoplasty surgery. Using septal cartilage grafts is normally the best way to add strength to the structure of the nose. In revision cases, it is often depleted by the primary surgery. As such, revision rhinoplasty surgeons may have to use cartilage from the rib or ear.
Since septal cartilage is the best first choice, it is preferred over ear or rib cartilage grafting. Ear cartilage is chosen if there is moderate weakness or if camouflage grafting is to be used. Ear is sometimes employed combined with skin when there is scarring or loss of internal lining, causing airway constriction or nostril retraction. These combined grafts, called “composite grafts”, restore structure and lining simultaneously. Cartilage from the rib is necessary in severe cases where the nose is drastically deviated, scarred or otherwise weakened. Although some surgeons avoid rib grafting, fearing a result that is too large or stiff, most expert revision rhinoplasty surgeons have learned to sculpt the rib to take advantage of it’s strengths while also creating a natural look.
The Unknown
Even with access to medical records that document the initial rhinoplasty surgery, revision rhinoplasty providers are sometimes met with unknown variables during the revision procedure. The surgeon must do everything they can to plan for these unknowns, while also making quick decisions during the procedure itself as problems are uncovered.
This is the reason why patients should choose a surgeon that is experienced in revision rhinoplasty. Surgeons who regularly perform revision procedures are better able to both predict potential problems before the procedure and have vastly more options in terms of dealing with the unknown during the surgery. Since complication rates after revision rhinoplasty are higher than after primary rhinoplasty, the expert revision rhinoplasty surgeon has learned how to minimize these through his intraoperative selection of the right graft, put in the right place, using the right technique.
Tips: Ways To Avoid Needing Revision Rhinoplasty
Obviously, the goal of any patient and their surgeon is to avoid the need for any revision procedure. Here are a few ways to reduce your chances of needing a revision:
- Select a surgeon certified by the American Board of Facial Plastic & Reconstructive Surgery (ABFPRS) or the American Board of Plastic Surgery (ABPS).
- Make sure your surgeon has an abundance of experience performing rhinoplasty.
- Make sure your surgeon takes their time evaluating your nose and you understand what the plan is. Evaluations of the nasal airway are mandatory to insure no land mines exist that may compromise function postoperatively.
- Ask what issues may arise during surgery and what their contingency plan is
- Ask what the surgeon’s revision rate is. Ask if there are additional charges if a revision is needed.
- Make sure to provide your entire medical history, along with any nose related issues you’ve experienced. Today Quality of Life evaluation surveys exist to help quantitate the degree your nasal obstruction affects your life.
- Work with your chosen surgeon to fully understand what results are and are not possible through Rhinoplasty. Many experienced rhinoplasty surgeons use photo imaging software to help predict what result is possible and desirable.
- Follow all post-operative instructions during the recovery process. Remember final results in rhinoplasty do not occur until after at least one year of healing.
Dr. Minas Constantinides is a board-certified Facial Plastic Surgeon at Westlake Dermatology & Cosmetic Surgery in Austin, Texas. He is on the Executive Committee of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) and is a Senior Advisor of the American Board of Facial Plastic and Reconstructive Surgery (ABFPRS).
Disclaimer: The contents of the Westlake Dermatology website, including text, graphics, and images, are for informational purposes only and are not intended to substitute for direct medical advice from your physician or other qualified professional.
I had a nose job about 10 years ago to lessen my bulbous nose. There was no bump. I’m not happy with the results as it is still quite bulbous and pug like. I’d like it thinner, more refined and a bit longer. My mother has had several procedures done at WD and has been thrilled with the results. I currently live in Spain, but would like to come back to have the procedure done at your facility. I know a consultation will be necessary, but could you give me an estimate of the cost? There are no functional problems with my nose. This is purely aesthetic.
Hi Ellen,
Thanks for reading our post and for your comment. We are sorry to hear about your unhappiness with the result. I have forwarded your email to our consultants who will be in touch. We should be able to provide a basic cost estimate with more information.
Thanks
WD Staff
In general, the most cosmetic surgery includes removing old skin, new layers can grow in its place resulting in a brighter, clearer, more youthful looking complexion.