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Comparing the Differences Between Your Primary and Revision Rhinoplasty Procedures

Rhinoplasty is one of the most popular cosmetic surgery procedures

However, it is also one of the most complex cosmetic surgeries to perform. As a result, approximately 10% of rhinoplasty patients seek a second surgery, called a revision surgery, at some point after they have healed. Although there are many similarities between primary and secondary rhinoplasty, there are also many important differences.

Revision rhinoplasty can help you achieve your desired results

Goals for the procedure

While the ultimate purpose of both primary and secondary rhinoplasty is to improve the overall appearance and functionality of the nose, patients often have distinct goals for each procedure. Patients undergoing primary rhinoplasty typically want to alter the size and/or shape of their nose to improve the balance or symmetry of the facial features. Some patients, who opt to combine the procedure with septoplasty, also expect to improve their breathing by straightening a deviated septum.

Conversely, patients seeking secondary rhinoplasty often hope to correct or improve aesthetic changes made during their first surgery. Whether due to miscommunication between the patient and surgeon, unpredictable tissue healing, trauma, or technique, if the results are not what a patient hoped for, they may opt to undergo a second procedure. In some instances, the purpose of revision rhinoplasty is to correct a functional problem caused by the initial surgery.

Secondary rhinoplasty can repair a bent or broken septum to improve your breathing

Surgical approach

Your surgeon can perform either open or closed rhinoplasty for both primary and revision rhinoplasty procedures. Open rhinoplasty is a technique in which the surgeon makes a small incision across the columella to pull back or “open” up the nasal skin, while the incisions made with closed rhinoplasty are within the nostrils. Although either technique can be used, when planning a revision rhinoplasty, there are a number of additional factors that must be considered to ensure the safety and success of the surgery.

As a secondary surgery, revision rhinoplasty is more complicated than primary rhinoplasty because alterations have already been made to the framework of the nose. Some of the nasal cartilage may be depleted from the previous surgery, which means there is less to work with during revision. In some cases, the procedure may require the use of cartilage grafts taken from donor sites on the body. In addition, the presence of scar tissue from the primary surgery requires careful and precise manipulation to ensure that the results are seamless. As a result of the more complex nature of revision rhinoplasty, the open approach is often best because it allows the surgeon greater access and visibility, particularly when making changes to the nasal tip.


In addition to reevaluating the surgical technique used, it is advisable to reconsider your choice of surgeon if you are considering revision rhinoplasty. If you are dissatisfied with the results of your primary rhinoplasty, it is best that you work with a different, specialized surgeon to prevent further disappointment. On the other hand, if you are seeking revision surgery as a result of an injury following a successful primary rhinoplasty, you may be most comfortable returning to your previous surgeon. In either case, as with primary rhinoplasty, it is crucial to select a qualified, experienced surgeon who specializes in facial plastic surgery to ensure that your goals are met and that the second rhinoplasty will be your last.

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