Have you had a rhinoplasty before but were not satisfied? Revision rhinoplasty now provides safer and more successful results with experienced surgeons. The difficulties, processes and modern approaches are in this article by Dr. Gediz Murat Serin!

Revision Rhinoplasty: Why It’s Hard, What to Expect, and Is Better Now Possible?

Dr. Gediz Murat Serin – Ear Nose and Throat Specialist

Rhinoplasty surgery is one of the most delicate and personalized surgeries in medicine. The aim is not only to provide an aesthetic appearance, but also to protect or correct nasal functions. However, not every rhinoplasty surgery may produce the expected results. Sometimes it is not found to be aesthetically sufficient, and sometimes functional problems occur. In such cases, the surgery that comes into play  is called revision rhinoplasty  .

Revision rhinoplasty is a technically much more complex intervention that aims to correct the results of a previous nose surgery. I have been working as an ENT specialist for 20 years, and I have spent the last 12 years developing special techniques, especially for nose surgeries and nostrils. During this time, I have had the chance to reshape many failed or inadequate nose surgeries. What I see is this:  Revision rhinoplasty requires more knowledge, experience and strategic approach than the first surgery.

What is Revision Rhinoplasty?

Revision rhinoplasty is the second (sometimes even third or fourth) surgery performed on patients who have had a previous rhinoplasty but were not satisfied with the results. The purpose of this surgery is to:

• Correcting aesthetic errors that occurred in the first surgery
• Regaining nasal functions (e.g.  problems such as breathing difficulties ,  nasal congestion  )
• It is to prevent the nose structure from collapsing , becoming crooked or deformed.

This intervention is not a “re-operation”; it is often a reconstruction process.

Why Is Revision Rhinoplasty More Difficult?

Some of the main reasons that make revision surgeries difficult are:

1 – Disruption of Natural Anatomical Plans

During the first rhinoplasty, the natural tissue plans in the nose are usually changed. Cartilages are cut, bone structures are shaped, and the integrity of the subcutaneous tissues is disrupted. Therefore, the surgeon cannot predict which structure is where in the second surgery. This makes surgical dissection more difficult and risky.

2 – Cartilage Deficiency and New Tissue Requirement

In noses that have undergone revision rhinoplasty,  the internal cartilage reserves are usually depleted . In this case, it may be necessary to take cartilage from the outside (from the ear or rib). Especially in cases where the nasal dorsum has collapsed and the tip of the nose has fallen, a strong and controlled reconstruction should be performed.

In my own practice, I achieve both durable and natural-looking results by using the cartilage part of the rib and the rib membrane (fascia) in a controlled manner.

3 – Tissue Hardness and Skin Problems

After the first surgery, fibrosis (hardening and adhesion) may develop in the subcutaneous tissues   . This makes shaping difficult and may lead to unpredictable results during the healing process. In addition, since the skin loses its elasticity, the desired nose shape may not always be clearly reflected from the outside.

4 – Psychological Status and Expectations of the Patient

Revision surgeries often come after a period of disappointment. This leads to very high expectations in patients, both aesthetically and psychologically. The nose may be physically improved, but the patient may not be satisfied psychologically. This makes communication and expectation management vital for the surgeon.

Who is Suitable for Revision Rhinoplasty?

Revision rhinoplasty is not recommended for everyone. The patient profile suitable for surgery is the following cases:

• Those with collapsed noses , flattened or curved nasal bridges
• Those whose nose tip is too low or asymmetrical
• Those who cannot breathe after a previous surgery  and have constant nasal congestion
•  Those with narrowing  or  constriction in the nostrils
• Patients who have realistic expectations and can be patient with the post-operative recovery process

What is done before surgery?

Planning is the most important step in determining success in revision rhinoplasty. During the preoperative process:

• The inside and outside of the nose are examined in detail.
• If necessary, endoscopic evaluation is performed.
• Skin quality, tissue condition, and previous surgical scars are evaluated.
• Photographs are taken and analyzed.
• Psychological support is recommended if necessary.

The aim is to understand not “why the patient is not satisfied” but “what kind of nose he/she wants”.

What is the Revision Rhinoplasty Process?

• The surgery is usually  performed under general anesthesia  .
• It takes an average of 4-6 hours. If ribs or ear cartilage are to be removed, the time may be longer.
• Advanced techniques apply minimal trauma to the tissue.
• The nose is both aesthetically reshaped and functionally opened.

The recovery process may be longer than the first surgery. It may take 6 to 12 months for the swelling to completely disappear and the results to become apparent.

Is Revision Rhinoplasty More Successful Today?

Yes.  The success rate of revision rhinoplasty surgeries has increased significantly compared to the past . The main reasons for this are:

• Using more refined and micro-level surgical techniques
• Rib cartilage can be removed with less scarring and deformation.
• Functional nose surgery is now considered together with aesthetic surgery.
• Experienced surgeons specialize in this field

With the techniques I have used in my own practice in recent years, it is possible to achieve more natural, solid and long-lasting results, especially in the reconstruction of the nasal dorsum and the reshaping of the nostrils.

Conclusion: Revision Rhinoplasty Is Not a Misfortune, But a New Beginning

Revision nose surgeries may seem complicated and scary at first glance. However, with the right patient selection, realistic expectations and an experienced surgeon, this process can once again become a source of satisfaction.

In every revision surgery, 1+1 does not always equal 2. But in the right hands, this result can sometimes be 3. When you have open communication with your surgeon, make a detailed plan, and work with a team with strong surgical knowledge  , revision rhinoplasty can offer the opportunity to open a new and satisfying page.

Dr. Gediz Murat Serin
Ear Nose Throat Specialist – Nose Functions and Revision Rhinoplasty