Revision rhinoplasty is a surgery performed to fix the results from a primary rhinoplasty. If you’ve had a nose job in the past and you’re no longer happy with the results, then a second surgery might be the right choice for you.
To ensure that you get the best results possible from secondary nose surgery, it’s important to choose a board-certified facial plastic surgeon who has ample experience in nose procedures. Dr. Benjamin Swartout is a renowned facial plastic surgeon in the Beverly Hills / Los Angeles area. Revision rhinoplasty is one of his specialties and he is known for helping restore the confidence and self-esteem of patients in the Los Angeles area after getting poor results from their first surgery.
What is Revision Rhinoplasty?
Primary rhinoplasty is one of the most challenging plastic surgery procedures to perform, and secondary rhinoplasty is even more difficult. For good results and the patient’s peace of mind, corrective rhinoplasty should only be performed by a facial plastic surgery specialist.
Revision rhinoplasty, sometimes called secondary or corrective rhinoplasty, is a surgery that is performed to fix or change the results of a previous nose job. Patients may decide to have a second nose job for cosmetic and/or functional reasons.
Some people realize very quickly after their first nasal surgery that they are unhappy with their results and would like to have a second procedure performed. In other cases, it might be some time before a person realizes that they aren’t happy with the appearance of their nose. For some patients, a corrective rhinoplasty might be medically necessary if the first surgery changed the function of the nose and made it more difficult to breathe.
Why Undergo a Secondary Nose Job?
Generally speaking, there are three main reasons patients may seek a second rhinoplasty.
One common reason is that the aesthetic or functional concerns the patient wished to address with their first nasal surgery were still unresolved after the final results became apparent. The surgery might not have produced the results the patient was expecting for a variety of reasons, including limited skills on the part of the surgeon who performed the first nose job.
Another reason a person might consider a secondary nose job is if the problems they had hoped to correct with their first surgery were actually made worse during the initial procedure. It might also be the case that the initial rhinoplasty created new issues with the nose, such as airway constriction or crookedness. In some cases, the healing process or the way the patient’s body responded to the first nose surgery might cause them to seek out corrective rhinoplasty in the future.
Some of the issues that revision rhinoplasty can help correct include:
- Breathing problems caused by first nose job
- Collapsed cartilage
- Deviated septum
- Pinched nasal tip
- Excessive scar tissue inside the nose
- Nasal valve collapse
- A nasal bridge that is too high or too low
- An overdone appearance
- Over- or under-projection of the nasal tip
Benefits of the Procedure
For the right candidate, a secondary nose job can offer many benefits. It can be incredibly frustrating to pour your hopes into a surgery that was meant to correct your problems, only to find that it made them worse or created new issues. Revision rhinoplasty gives you the chance to get a clean slate and to start over. With a secondary rhinoplasty, you can finally get a nose that meets your expectations.
Another benefit of a second nose job is that the surgery can correct breathing issues and functional problems that might have been created or exacerbated by your primary rhinoplasty. After a second nasal surgery, you might find that you can finally breathe easy again.
Candidates for Revision Rhinoplasty
To be a candidate for secondary rhinoplasty, you need to have had at least one prior rhinoplasty surgery. Ideally, your nose will have had enough time to heal from the first surgery and your final results should be visible. If your first nose job was only a couple of months ago, it’s usually a good idea to wait a bit longer, as it can take up to a year for the residual swelling to subside.
Candidates for revision rhinoplasty surgery might be unhappy with their noses for a number of different reasons. You might be a candidate for a second surgery if your nose was injured after your first surgery, if your surgeon wasn’t experienced and didn’t perform the surgery well, or if your nose healed poorly, affecting the results of the surgery. Good candidates for a second nose job can have either cosmetic or functional concerns, including breathing issues.
Revision rhinoplasty candidates should be non-smokers in good overall health, with realistic expectations for their results. Candidates can be of any ethnicity. Dr. Swartout is skilled in ethnic rhinoplasty. He can adapt his technique to account for differences in the nasal structure and skin and will perform the procedure with the aim of helping you to achieve your individual goals.
How Much Does Revision Rhinoplasty Cost?
The cost of revision rhinoplasty can vary based on the complexity of the procedure and other considerations. It’s important to understand that because secondary rhinoplasty is more complicated than a primary nose job and because it requires a greater amount of expertise and skill, the surgery usually comes at a higher price than primary rhinoplasty.
If you are concerned about the cost of your surgery, Dr. Swartout can sit down with you to review the price of the procedure. You might qualify for financing to make the cost of surgery more manageable. If you need the surgery to correct breathing problems or an issue with your nose’s function, your health insurance might consider it a reconstructive surgery and offer some coverage.
How to Prepare for Revision Rhinoplasty
If you decide to move forward with revision rhinoplasty after your initial consultation, Dr. Swartout will give you specific instructions to help you prepare for the surgery.
What you will need to do to get ready for the procedure depends on your current lifestyle and health. If you are a current smoker, you’ll need to quit using any type of tobacco or nicotine products starting a few weeks before your surgery. You’ll need to abstain from tobacco use for several weeks after the surgery, too.
Some medications can interfere with the healing process after surgery or increase your risk of developing complications. Let Dr. Swartout know about any medicines you take regularly, even vitamins, minerals, and herbal supplements. He’ll let you know if you need to take a break from your supplements or if you should avoid taking certain medicines immediately before your surgery.
The night before surgery, start fasting around midnight, or as instructed by your revision rhinoplasty surgeon. You’ll most likely be receiving general anesthesia during the surgery, so you’ll need to avoid solid foods and caloric beverages. Plain water is fine to drink.
You’ll most likely need to prepare your home, family, and work to accommodate your recovery period. Either find someone to cover for you at work or put in a request for time off. Arrange to have a friend or relative drive you to and from our practice in Los Angeles. Stock up on ready-to-eat meals, movies and books, and pillows for your bed or couch.
The Day of Surgery
On the day of the surgery, you’ll be given general anesthesia, which will put you completely to sleep during the plastic surgery procedure. General anesthesia makes the surgery more comfortable for you.
After you’re asleep, Dr. Swartout will begin the surgery. Depending on the changes you request and the extent of the scar tissue from your first surgery, he might perform an open or closed rhinoplasty.
During a closed rhinoplasty, all of the incisions are made inside of your nose. During an open rhinoplasty, Dr. Swartout makes an incision externally, at the base of the nose and between the nostrils. The incision is usually very small and leaves a barely-there scar.
The techniques Dr. Swartout will use during the surgery will depend on your goals. He might adjust the nasal bone, use cartilage grafts, or straighten a deviated septum. The goal of the surgery is usually to improve the appearance of your nose and enhance nasal function.
A secondary rhinoplasty might take between two and three hours to perform, depending on its complexity. Soon after the surgery is over and you’ve woken up from the anesthesia, you’ll be able to go home. A friend or relative should drive you home and stay with you overnight.
The initial recovery after corrective rhinoplasty usually takes between one and two weeks. You might be ready to go back to work, school, and other light activities after a week or so, but you’ll want to avoid strenuous activities for a few more weeks. You may have to make changes to what you eat, wear, and do during the recovery period. Here’s what you can expect:
|Day of surgery|
|First week after surgery|
|7 to 14 days after surgery|
|30 days after surgery|
|3 months after surgery|
|1 year after surgery|
I went to 4 of the top facial plastics rhinoplasty docs in southern california. All were great but Dr. Swartout was the best. I had my primary (open) rhinoplasty 3 years ago and was very unhappy with the results. Dr. Swartout spent an hour with me and we both agreed upon a digital image of what I wanted my nose to look like. He told me it's important that we're on the same page and that's why the digital image is so important...it's his goal to achieve that result while doing the surgery. It's been 2 months and my nose looks fabulous. I went to a family party 8 days after surgery and no one noticed I had surgery. All they said was "wow you look great", etc. I met with another, well-known, doc in town who is known for closed primary rhino and he referred me to Dr. Swartout. He told me he has sent patients to various facial plastics docs and Dr. Swartout's patients have consistently been the happiest. That's all I needed to hear. I few of my close friends and relatives are MDs and they told me to make sure to have a board-certified, ENT-trained, facial plastics doc do my surgery and not have a general plastics doc do it. ENT docs focus ONLY on the face/neck during their entire training. General plastics focus on the entire body (breast, lipo, etc). I was dreading have a revision, especially because I had such a bad experience with my first surgery. Dr. Swartout gained my trust and delivered realistic, beautiful results. When having plastic surgery, it's wise to get several consultations/opinions. It would be unwise not to have one of those be with Dr. Swartout.
Frequently Asked Questions
Since the nose can continue to heal for up to a year after a rhinoplasty procedure, it’s a good idea to wait at least 12 months before you have a secondary procedure. You can schedule a consultation with Dr. Swartout before the 12-month mark to discuss a preliminary plan for revision surgery, however.
Cosmetic surgery has its risks, but there are steps you can take to minimize these potential complications. Working with a rhinoplasty expert who has years of experience will help improve your results and reduce risks. Following your surgeon’s instructions carefully and avoiding smoking can also help to lower your risks.
Post-operative swelling affects nasal function and the appearance of the nose. There are several things you can do to reduce swelling in the nasal area. Keeping your head elevated will encourage fluid to drain away from the nose, bringing down the swelling. Applying a cold compress or a bag of frozen vegetables to the area around the nose also helps to minimize swelling after surgery.
Some rhinoplasty techniques used in the past were successful in creating a narrow nose during the initial postoperative period. Unfortunately, these techniques often cause the nose to gradually become too narrow and the inside to become pinched and obstructed. Typically, this pinching and nasal obstruction gets worse over time.
The goals of any revision rhinoplasty procedure are to strengthen the supportive structure of the nose and restore normal function. Of course, the ability to reach these goals will depend on the exact nature of your nasal obstruction and will require a complete physical exam.
Sometimes, because of a cartilage graft from a prior surgery, there is not enough cartilage left inside of the nose to build an adequate nasal structure and create a normal-looking and functional nose. When this is the case, additional cartilage will need to be taken from another part of the body. In some cases, a small piece of cartilage can be taken from the ear. When more material is needed, the rib can be used.
The ribs are made of bone on the back and on the sides, but in the front, they are made of cartilage. Dr. Swartout makes a small (1.25 inch) incision in the bottom of the right breast or the chest area and removes a small section of cartilage. He takes this cartilage and carves thin, delicate sheets to replace the cartilage removed during a prior surgery and to reinforce the structure of the nose.
After the surgery, the area can be a little sore for the first week. It typically heals quickly with a thin scar (about 1.25 inches long) hidden in the crease under the right breast in women.
Sometimes, the skin is injured during rhinoplasty and this area heals with increased blood vessels. This thin, vascular area is prone to redness or sometimes even pain in the cold. When the skin has been thinned it can also reveal some irregularities in the bone or cartilage underneath, yielding an artificial appearance. Frequently, this can be improved at the time of the revision rhinoplasty by smoothing the underlying cartilage and bone, and by placing some soft tissue directly underneath this thin region.
Why choose Dr. Swartout
- Fellowship trained sub-specialist in Facial Plastic surgery who attended college at Harvard University.
- Attended medical school at Albert Einstein College of Medicine in New York.
- Interned in general surgery at New York University, followed by a specialty residency in Otolaryngology – Head & Neck surgery at New York University.
- Completed a fellowship in Facial Plastic & Reconstructive Surgery at the University of Illinois at Chicago where he worked with Dr. Dean Toriumi.
- A member of the American Academy of Facial Plastic & Reconstructive Surgery, the American Academy of Otolaryngology – Head & Neck Surgery and the American Rhinologic Society.
- Teaches nasal surgery to residents at Harbor UCLA both to contribute to the education of future doctors and to give back to an underserved community.
- Special interests include the development of rhinoplasty techniques to create long lasting, favorable nasal shape and good nasal breathing.
Schedule your Revision Rhinoplasty Consultation in Beverly Hills Today
Dr. Benjamin Swartout specializes in surgical procedures of the face, including rhinoplasty and rhinoplasty revisions. In addition to performing countless nasal surgeries, he has published extensively on the subject and has taught nasal surgery techniques to medical residents at UCLA. View the photo gallery to see examples of Dr. Swartout’s work.
If you have had a prior nose job and aren’t happy with the results, learn more about revision rhinoplasty in Beverly Hills and the greater Los Angeles area. Call (310) 274-6005 to schedule a consultation today.