Nearly a quarter of a million men and women had cosmetic nose surgery in the last year, but did you know that nearly a quarter of those surgeries were do-over from previous nose surgery? Revision Rhinoplasty is the quiet little secret among those seeking surgical enhancements to their face or figure.

Why Revision Rhinoplasty ?

Well, despite the overall satisfaction rate of those having cosmetic surgery on their nose, working on the nose, which is the middle of the face and easily shows cosmetic blemishes is very tricky. So tricky in fact, that many plastic surgeons don’t even consider trying it in the first place and concentrate on less invasive surgeries such as tummy tucks and breast augmentation.

But hundreds of physicians do attempt cosmetic
nose surgery and the less skilled of them or the in-out next doctors sometimes
leave less than stellar results.

are the risks of a poorly done nose reshaping?

The first and primary risk is poor expectations. Some physicians are just poor with their initial consultations so potential problems such as thin skinning or the overall shape of the nose are bypassed. Many young doctors, in particular, do a poor job of communicating the limits of plastic surgery.

Secondly, some doctors are poorly trained or are simply out of their depth. Their plastic surgery techniques, while workable in the short term, do not do their patients justice over time. These doctors eliminate too much bone or cartilage to the underlying nose while operating and after a few months this defect really shows, particularly in the middle of the nose. The effect of cosmetic surgery should take into account the effects of time, scarring and growth and it should leave a natural, unworked look.

Finally, some doctors simply overlook the
ability of their patients to breathe normally and even weeks after their
initial surgery a substantial amount of patients continue to have problems


Whatever the reason, ultimately about 25 percent of cosmetic nose enhancement patients ultimately decide on a second surgery to correct the defects left by the first surgery. And these defects are not always due to physician error either. Sometimes the body simply reacts in ways to the original surgery that were not foreseen either by the patient nor the doctor.

And now the tricky part. Finding a qualified doctor to make the corrections. If you think doing an initial cosmetic reconstruction on the nose is difficult, wait until you get involved in reconstructive surgery. Here only the bravest and most talented plastic surgeons dare tread.

A reconstructive surgeon needs to have intimate knowledge of how to re-shape a nose using skin grafts so that when he’s finished the nose looks contoured and natural. And he must have intimate knowledge of cosmetic nose surgery, to begin with. Which leads us, the patients, searching the internet or yellow pages for a board-certified plastic surgeon who is an expert at facial reconstruction. We’ll talk more about that later, but first let’s talk about who is, and who is not a good candidate for modifying a previous cosmetic nose surgery operation.

Who is
not a good candidate?

Under this category, the first candidate is
those who have had their initial surgery recently. Men, in particular, seem to
fall victim to this. But whether it is completely obvious or not that the
initial surgery was a failure, the interior of the nose needs time to heal from
the scars. This usually takes a minimum of a year after the previous surgery
and some reconstruction physicians insist on two years.

The second category of patient is those who
had unrealistic expectations in the first place. Here, the failure was not so
much in the procedure but failure to communicate between the physician and the
patient. Here, facial reconstruction physicians sometimes have to be the bad
guy and say, “sorry but what you have is as good as it gets.”

Who is
a good candidate for reconstruction of the nose?

That being said about those who have
unreasonable expectations or have simply had prior surgery that has not healed,
there are some perfectly legitimate reasons for undergoing plastic surgery a
second time.

The first is unexpected healing results from
the initial surgery. In combination with the reduction in underlying bone and
cartilage, as the body heals sometimes new defects appear to replace the old

Another fact is continued poor breathing. If
scarring or incisions in questionable places has led you to struggle with poor
breathing you are certainly a good candidate for reconstructive surgery. Some
people had their initial surgery because they had poor breathing, so by the
time you are done your breathing should be better, not worse.

Another reason for reconstructive surgery on
your nose is asymmetry or alternatively, the collapse of the cartilage supporting
the nose.

Andres Bustillo

If you are considering a revision rhinoplasty in the Miami area, one plastic surgeon you should highly consider consulting with is Dr. Andres Bustillo.

A board certified plastic surgeon with over 15 years of experience, Dr. Bustillo has been at the forefront of revisionist facial construction for many years. You will also find that Dr. Bustillo is tops in frank communication. He believes in a conservative, minimal approach to plastic surgery and if it’s too early to consider a second surgery or it’s doubtful a second surgery won’t likely correct the defects he’ll be straight with you about it. And if you are a great candidate for reconstructive nose surgery he’ll do everything in his power to put you at ease so that your second surgery goes better than the first.

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