A Rhinoplasty do-over

Thousands of people decide to get a nose job (rhinoplasty) every year. Due to the rising costs of safe plastic surgery procedures, some people seek out less costly options with dreadful results. unfortunately, some patients are dissatisfied with their appearance after a correctly performed surgery. All plastic surgeries pose a risk for complications that can result in an asymmetrical, painful or difficult breathing, and a disfigured or unnatural appearance. When a person experiences bad results with a nose job, a revision rhinoplasty can be performed to correct errors in the first surgery – and restore your self-confidence.

Dr. Paul S. Nassif, a pioneering Los Angeles Revision Rhinoplasty surgeon, offers hope to patients suffering from an unsuccessful rhinoplasty. Dr. Nassif travels the world performing nearly impossible facial reconstructions. Working within a variety of ethnic groups, as a Revision Rhinoplasty surgeon, he has gained a great breadth of knowledge of facial structure, harmony and balance. As a leader in the field, Dr. Nassif has been featured in the most prestigious publications in the country including People Magazine, USA Today, The Los Angeles Times, and the Wall Street Journal.

Revision Rhinoplasty Consultation

You may recall the consultation from your first surgery. This is the initial meeting between you and your physician. During this time the physician will assess your current health and candidacy for the procedure. When this occurs for Rhinoplasty revision, the consultation will be split into two major sections, the previous procedure and the revision planning.

Past Procedure

Dr. Nassif will need information about the first rhinoplasty. He needs to have an understanding of what went wrong in order to form a plan of correction. If you experienced any problems or complications, tell him about the nature of the problem and how it was, or wasn’t, resolved. If you don’t have any information about the first procedure, such as paperwork, don’t worry, a full evaluation of your nose will reveal where the surgeon went wrong.

Proposed Procedure

Dr. Nassif will need to know more about how many previous procedures you have had. You will need to bring a complete list of medications and supplements you are taking. This is an open discussion between you and Dr. Nassif. During your consultation, Dr. Nassif will make suggestions about ways to improve your appearance; he may suggest additional procedures to gain the best effect, and help you achieve the appearance you envision.

Procedure

The procedure varies depending upon the specifics of the revision. In cases involving botched surgeries, Dr. Nassif will need to correct the affected areas. Some people will need to have the sunken effects of an unstable nose corrected.

The incisions will be made to the interior of the nose so you are not left with visible scars. If your previous surgery left scars, he will work to remove them or contour the nose with the scars hidden in the nose’s natural creases.

If you’re receiving a revision to further enhance your appearance, the procedure type greatly depends upon the agreed upon goals in the consultation. A small incision on the dorsal, or back, aspect of the nostrils (nares) can increase the amount of flare. Dr. Nassif uses tiny sutures to place the nose in the proper position.

Recovery

The recovery process for a rhinoplasty revision will be similar to your recovery after your first rhinoplasty. In addition to these steps, Dr. Nassif may use more extensive bandaging or splints to keep the nose in the correct shape, and for a longer period of time than the initial nose job. Please visit our rhinoplasty procedure page for more information about your recovery.

Will this procedure cost the same as my first procedure?

This depends upon who completed the primary surgery and where it was conducted. In most cases, a revision costs more than the initial rhinoplasty due to the increased amount of surgical work involved. Dr. Nassif may need to remove difficult scar tissue, hide visible scarring, or change the entire structure of the nose. Furthermore, any permanent sutures placed during the primary rhinoplasty may need to be removed or replaced.

Will insurance cover my cost of the revision?

The tricky world of insurance premiums, co-payments, and deductibles can confuse anyone. However, most insurance policies follow a standard payment for medically necessary procedures. This means a revision rhinoplasty for obstructed airways, or initial rhinoplasty to resolve upper respiratory problems is often covered by insurance. In revisions for cosmetic reasons, health insurance typically does not provide coverage. Insurance policies vary greatly from company to company, so please check with your insurance provider, or get help from our office staff.

Why did my first procedure fail?

There are a number of reasons someone decides to go in for a second surgery. Some surgeries result in an unsatisfactory appearance. Others experience medical complications that lead to problems. Some of the common problems with a rhinoplasty include the following:

Deviated Septum: The dividing wall between the nostrils becomes positioned in a manner that obstructs airflow.

Perforated Septum: A hole, or an opening, within the septum which makes a whistling or wheezing sound when a person breathes.

Asymmetrical: The nose didn’t heal properly and isn’t proportioned equally on both sides of the face. It may appear crocked or pinched. This condition is usually caused by scar tissue within the nose from the initial rhinoplasty.

The new nose has a change that’s either too subtle or too extreme when measured against what the patient had expected.

I’ve had several nose jobs, but it just doesn’t fit me. My other plastic surgeon wants me to see a psychologist. Why?

The demand for a perfect body in society leads to some people developing an addiction, an unhealthy obsession, with surgical procedures to achieve a specific image. Some people spend upwards of one-third of their day obsessing about the current body image. This condition is known as Body Dysmorphic Disorder (BDD); it affects approximately one to two percent of the general population. The prevalence increases in patients seeking plastic surgery. This seems like a minor problem, but people living with this disorder have a tendency to engage in risky or violent behaviors. Often times, they experience repeated dissatisfaction with their plastic surgery outcomes.

When a physician decides to ask a patient to be screened for BDD, he wants to place the patient’s health and mental status above the immediate needs of the plastic surgery. This does not reflect any judgment about who you are – it is merely a measure to protect you and your health. The doctor is here to help you, and will proceed with your procedure once you have been determined to be a candidate for surgery. We want your experience with Dr. Nassif to exceed your expectations, but we need to take care of the whole person, body and mind.

It’s been six months since my first nose job. It’s terrible! Can I schedule a consultation and surgery now?

You need to wait a minimum of one year after your first rhinoplasty before attempting a revision. The swelling and healing process from the initial procedure can last up six months, and the nose needs time to adjust to its new position. It would be pointless to get a revision if waiting a few extra months corrects the problem areas.

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