Rhinoplasty, commonly known as a “nose job”, is one of the most popular cosmetic surgery procedures. In 2021 alone, over 253,000 rhinoplasties were performed in the United States according to the American Society of Plastic Surgeons. With nose surgery being so common, many patients wonder – how often do these procedures fail or require revision surgery?
What is the success rate of rhinoplasty?
Most patients are happy with the results of their primary rhinoplasty. According to a 2015 study published in JAMA Facial Plastic Surgery, the success rate of rhinoplasty is around 91-94%. This means only 6-9% of patients require revision surgery. The success rates are even higher for procedures performed by surgeons who specialize in rhinoplasty. One study found that revision rates were only 3.4% for surgeons who perform a high volume of rhinoplasties.
The success of a nose job depends on many factors including the skill and experience of the surgeon, the complexity of the desired changes, and characteristics of the patient’s anatomy. Simple procedures like removing a dorsal hump tend to have higher success rates than complex reconstructive rhinoplasties. Revisions may be needed in 10-15% of more difficult cases according to the American Academy of Facial Plastic and Reconstructive Surgery.
What causes rhinoplasty to fail?
There are several potential reasons a nose job may require a second surgery:
- The surgeon was unable to achieve the patient’s desired results, such as not removing enough of a dorsal hump.
- New cosmetic concerns have developed like pollybeak deformity or pinched tip.
- Functional issues persist or arise after surgery like nasal airway obstruction.
- Scarring at incision sites or other healing complications.
One of the most common reasons for revision is the patient being unsatisfied with some aspect of the appearance of their new nose. However, sometimes the surgeon did their best to meet expectations and the desired changes simply were not possible due to limitations of the patient’s anatomy. In these cases, it is important for the surgeon to have an honest discussion with the patient before surgery to manage expectations.
How long after a nose job can revisions be done?
Most surgeons recommend waiting 9-12 months after the initial rhinoplasty before considering revision surgery. This allows maximum healing and swelling to subside so the final result can be properly assessed. Some patients experience persistent swelling for a year or longer after rhinoplasty which can impact the perceived results. Waiting at least 9 months ensures the nose has stabilized.
In some cases, minor revision surgery can be done sooner than 9 months if medically necessary. For example, if scar tissue is obstructing the airway, this may need to be addressed earlier. But the majority of aesthetic-focused revisions should wait until the one year mark.
Can you fix a bad nose job?
Yes, poorly done rhinoplasties can be improved through revision surgery in most cases. Some of the common problems from a “bad nose job” that can be corrected include:
- Excessive narrowing of the nasal passages – Widening narrowed airways by grafting or spreader grafts.
- Over-resected nasal tip – Reconstructing the tip using cartilage grafts.
- Pinched nasal tip – Correcting tip deformities with suturing techniques or grafts.
- Pollybeak deformity – Reducing excess tissue and refining the nasal profile.
- External nasal valve collapse – Stenting or grafting the valve area.
The extent a poor rhinoplasty outcome can be improved depends on the severity of the deformity, quality of remaining nasal tissues, and skill of the revision surgeon. Some patients may require multiple stages of revision surgery over several months or years to achieve desired results after a bad primary rhinoplasty.
Risks and limitations of revision rhinoplasty
While revision nose surgery can often deliver significant improvements, there are some risks and limitations to be aware of:
- Higher risk of postoperative complications like infection, breathing issues, and poor wound healing compared to primary rhinoplasty.
- Scarring and loss of cartilage from the original surgery can limit options for reshaping the nose.
- Grafts taken from elsewhere on the body may be needed if nasal cartilage is deficient.
- Revisions typically take longer to perform and recover from than first-time procedures.
- Results may still not meet the patient’s desired outcome.
The complexity and limitations of revision rhinoplasty underscore the importance of selecting an experienced, board-certified facial plastic surgeon to perform your original nose job. As the saying goes, “Do it right the first time” when it comes to rhinoplasty.
How much does revision rhinoplasty cost?
On average, revision nose jobs cost $10,000-$15,000 in the United States according to the American Society of Plastic Surgeons. This is considerably more expensive than primary rhinoplasty, which averages around $5,000. Here are some of the factors that influence the cost of revision rhinoplasty:
| Factor | Impact on Revision Rhinoplasty Cost |
|---|---|
| Surgical time and complexity | More difficult, lengthy revisions cost more |
| Use of grafting | Harvesting and placing grafts adds to cost |
| Surgeon experience and training | Board-certified facial plastic surgeons charge more |
| Geographic location | Higher costs in metro areas like LA or NYC |
Since the costs are out-of-pocket, many surgeons offer financing plans to make revision rhinoplasty more affordable. Patients should be prepared for the higher costs associated with corrective nose surgery compared to initial procedures.
Finding a surgeon for revision rhinoplasty
Choosing the right surgeon is critical when undergoing revision nose surgery. Ideal traits to look for include:
- Board certification in facial plastic surgery.
- Extensive experience performing rhinoplasty revisions.
- Operates at an accredited surgical facility.
- Advanced training in grafting techniques.
- Artistic skill for sculpting noses.
- Caring bedside manner.
Patients should thoroughly research surgeons’ backgrounds, training, revision rhinoplasty before and after photos, and reviews from past patients. It may be advisable to pick a different surgeon than performed the original nose job if it had poor results.
Preparing for revision rhinoplasty
To optimize outcomes from corrective nose surgery, patients should:
- Stop smoking at least 6 weeks before surgery to prevent healing issues.
- Avoid certain blood-thinning medications that can increase bleeding risks.
- Arrange a ride home after surgery and help during the recovery period.
- Stock up on soft, easy-to-chew foods to eat while jaws are sore.
- Schedule time off work for 1-2 weeks to rest and heal.
It is also extremely important to discuss goals, concerns, and anticipated results in depth with your surgeon. Clear communication and trust between patient and surgeon lead to the best revision rhinoplasty outcomes.
Recovering from revision nose surgery
Revision rhinoplasty recovery typically involves:
- First 24 hours – Rest at home with head elevated. Use cold compresses to reduce swelling.
- First week – Bruising and swelling peak around day 3-5. Stitches removed 5-7 days after surgery.
- 2 weeks – Return to non-strenuous work. Swelling diminishes but may persist for months.
- 6 weeks – OK for light cardio exercise. Swelling continues to improve.
- 3-12 months – Healing completed but subtle changes can occur up to a year.
Pain, congestion, fatigue, and other symptoms are common during the first 1-2 weeks. Patients require extra rest and recovery time compared to initial rhinoplasty procedures. Most can resume normal activities after 2 weeks, but strenuous activity should be avoided for 6 weeks.
Conclusion
While complications from nose surgery are not common, around 6-15% of rhinoplasty patients elect to have a revision procedure. Reasons for corrective surgery include cosmetic or functional issues from the primary nose job. Revisions can improve outcomes but do have higher risks than first-time procedures. Meticulously researching surgeons, setting realistic expectations, and following preparation and recovery instructions helps maximize success from revision rhinoplasty.
