Revision Rhinoplasty

Revision Rhinoplasty

What if your rhinoplasty didn't turn out the way you hoped it would? What if your nose looks great initially but subsequently changes in ways you don't expect or don't like? Or what if you aren't able to breathe as easily following the surgery? Perhaps your surgeon will tell you he or she can refine your initial result with an additional procedure, called a revision rhinoplasty. With any cosmetic surgery, a touch-up or revision procedure is sometimes necessary. Even in the hands of the best surgeon, the need for revision sometimes occurs. And because rhinoplasty is a complex operation, it has a higher revision rate than other cosmetic procedures.

Common Reasons for Revision Rhinoplasty

The reasons why you may choose to have revision rhinoplasty fall into one of two categories: dissatisfaction with the way your nose looks or dissatisfaction with the way your nose functions, and breathing is affected.

If you are displeased with the way your nose looks, you may feel that the changes to your nose are too dramatic or perhaps too subtle. Or you may be happy with your initial results but may experience subsequent changes that alter the shape of your nose in a way you don't like.

There are other common reasons why one might seek revision rhinoplasty.

Asymmetry: This may occur due to no fault of your surgeon. Post-operative scarring within the nose can cause it to appear uneven from one side to the other. The nose is a three-dimensional object that can heal in unpredictable ways.
Callous or bump: A small callous or bump may appear on the dorsum up to one year following your procedure. The cause of this is unknown, but if it occurs, it can usually be removed in a minor procedure.
Polly beak: Sometimes called a "parrot beak," this can occur when a hump on the bridge of the nose isn't sufficiently reduced in the area just behind the tip or when there's a build-up of scar tissue. Correction requires revision rhinoplasty.
Pinched tip: When the tip of the nose appears pinched, it's often because too much tip cartilage was removed or the cartilage didn't heal well and collapsed. To correct this, cartilage is usually added to the nasal tip in a revision rhinoplasty procedure.
Inverted V: When a hump is reduced, sometimes the middle vault of the nose collapses inward, causing an "inverted V" appearance. This may be corrected with the placement of grafts in a revision rhinoplasty procedure.
Post-operative changes: In general, following primary rhinoplasty, the nose changes every year. These changes can be unpredictable, and you may not like the way these changes look.
Disappointment with results: Despite your surgeon's best efforts, it's possible that you may be disappointed with your results. Disappointment may be due to unrealistic expectations on your part, unclear communication of your goals, surgical aesthetic misjudgment, or complications during the healing process.

Even if you're completely satisfied with the way your nose looks following surgery, it is possible to experience a nasal obstruction that make it more difficult to breathe through your nose. Most nasal obstructions can be corrected with revision rhinoplasty. If your breathing is hindered in any way, you may want to consult with your surgeon about a
follow-up procedure to alleviate the problem.

Paying for Revision Rhinoplasty

Who pays for revision rhinoplasty? It depends. Revisional procedures performed to correct functional problems may be covered by insurance. Follow-up procedures performed solely for cosmetic purposes typically aren't covered by insurance. However, that doesn't necessarily mean that you'll be responsible for the entire bill. In some cases, if you return to your original surgeon for a minor touch-up, you may pay for only a portion of the procedure. For instance, if you have a healing complication, your surgeon's fee may be waived, but you may still be responsible for paying fees for the operating room and anesthesia. However, if you're dissatisfied with your nose, and didn't communicate your wishes clearly, you may be responsible for all revision surgery fees. If you decide to go to a different surgeon for revision rhinoplasty, you will be responsible for all charges. It's a good idea to ask in advance about your surgeon's revision policies.

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