Rhinoplasty, Redux

Your surgeon, your mother, your friends, even your ex... Everyone told you to be patient after your nose job. They all reminded you that it could take up to one year for the swelling to disappear, and warned you not to jump to any conclusions in the short term.

You heeded this advice, but the one year mark year came and went, and you still don't like how your new nose looks. It's not necessarily that you want your old nose back. It's just that your new one doesn't quite meet your expectations, or maybe you are still having some trouble breathing despite the fix. Sometimes with nose jobs (rhinoplasty), the original issue is resolved, but a new problem develops in its place.

You are not alone. As many as 20 percent of people who get nose job surgery end up seeking revision nose surgery at some point. Most surgeons recommend waiting at least a year before considering revision rhinoplasty because it really can take that long for all of the swelling to go down.

You may opt to go back to your original nose surgeon or look for a new one who specializes in revision rhinoplasty. These re-do surgeries often are a lot more complicated than the average primary rhinoplasty procedure. They also tend to be more expensive and involve more time in the operating room (about twice as long as primary rhinoplasty).

Revision Rhinoplasty: Rarely a Quick Fix

Revision rhinoplasty is a highly customized procedure, the exact nature of which depends on your unique concerns. In other words, there is no one-size-fits-all revision rhinoplasty. Some issues may be very simple to fix, while others may involve complex reconstruction. For example, your surgeon may need to add or remove some cartilage. This may be taken from your nasal septum (which separates the left and right airways in your nose), ear or rib. If too little cartilage was removed during your initial nose surgery, some of the excess will need to be shaved off. Other times, only a minor amount of tweaking may be needed. For instance, in some cases injections of soft tissue filler can correct the tip of your nose.

Recovering from your Second Surgery

Your revision rhinoplasty recovery will vary based on the extent of the surgery. It may be more involved, less involved or equal to what followed your first surgery. Healing can be less predictable the second time around because there is already scar tissue in your nose. There are also more risks and complications associated with the second surgery. For instance, you may need general anesthesia the second time around, which can be riskier than other types of anesthetic.

Another issue is cost, especially after you already spent more than $5,000 on your original nose job. As with everything we've discussed, the cost of revision rhinoplasty depends on the scope of the surgery. In some cases, revision may even be free if your original surgeon merely needs to make a small tweak. Insurance won't cover the costs if it is a purely cosmetic procedure, but if the revision is intended to help your breathe better, some of it may be covered. Find out in advance so there are no surprises when the bill comes. The average cost of revision rhinoplasty is close to $9,000 for a complex surgery.

These are all important issues to address during your consult.

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