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Revision Rhinoplasty

Nose Job Surgeon Sydney

1) What exactly is Revision Rhinoplasty surgery?

Revision Rhinoplasty refers to any second or third ‘nose job’ that is done in order to revise or improve upon a previous Rhinoplasty surgery. It is also sometimes called Secondary Rhinoplasty. These revisional procedures are to correct cosmetic deficiencies and/or unsatisfactory results that arose from (or at least weren’t addressed by) the previous surgery.


2) Am I a good candidate for Revision Rhinoplasty surgery?

Some of the symptoms or indications for an eligible candidate for Revision Rhinoplasty may include any combination of:

  • Breathing difficulty
  • Dissatisfied with the cosmetic appearance of their nose as a result of prior nasal surgery
  • Nasal reshaping
  • Hump or depression on the bridge of the nose
  • An asymmetrical tip
  • A twisted nose
  • Deviated septum
  • A wide middle third of the nose
  • Scar tissue
  • Depressed bridge of nose
  • Wide nostrils
  • Nasal valve collapse

3) Do you qualify for Revision Rhinoplasty surgery?

There are two main reasons why a patient will require revision nasal surgery. First, he or she may be unhappy with the appearance of the nose. This is the most common problem, since most people undergo Rhinoplasty in the first place to change their nasal appearance. Second, the patient may be experiencing nasal obstruction after surgery. Sometimes the obstruction was present before the first surgery and was not improved enough. Other times, obstruction can be caused by surgery.

The ideal candidate for Revision Rhinoplasty surgery is someone who is in good physical and mental health. Smokers are encouraged to quit at least a couple of weeks before the procedure and it is also recommended to not drink alcohol before and after surgery. This promotes proper healing and aids in avoiding complications during the procedure.

Dr. Zacharia will explain what can be done to assist eligible candidates for this procedure. He will discuss the steps of the proposed surgery and the variables that may affect the procedure. Physical characteristics such as the size and shape of nasal bones and cartilage, as well as the thickness of skin may affect the technical considerations.


4) How can Dr Zacharia create the best nose for you?

At the initial consultation, Dr Zacharia will ask patients to express concerns about their appearance and to describe their symptoms.

Some digital photographs of the patient’s face will be taken and Computer Imaging software will be used to analyse their nose, as well as enable the patient to view their current appearance and realistic outcomes following surgery.

Following this, the patient’s medical history will be reviewed and a physical examination will be conducted to determine if nasal surgery is best option.


5) How much does Revision Rhinoplasty cost?

The cost of Revision Rhinoplasty surgery varies to each individual, as well as the complexity of the procedure performed. The cost will be based on specific fees for the physician, anaesthetic, hospital, and if applicable, charges for an overnight stay.

Revision surgery is more complicated than primary surgery, usually because of scar tissue, too much cartilage and bone has been removed, or not enough cartilage or bones have been reduced. It is more time consuming to reverse another physician’s complications; therefore Revision Rhinoplasty surgery is usually more expensive than primary surgery.

Any surgery performed for purely aesthetic reasons will not be covered by health insurance. In cases where the procedure is considered medically necessary, such as corrections of birth defects or damage due to trauma, the procedure may be covered. It is recommended that patients discuss what will be covered by their insurers prior to booking the procedure.

Book a consultation, request a quote online, or contact the staff at Dr. Zacharia’s rooms today on (02) 9192 1600.


6) How do I prepare for Revision Rhinoplasty surgery?

At the consultation, Dr. Zacharia will discuss the procedure, risks and limitations, costs involved, patient expectations and goals, as well as the recovery process. He will also conduct a medical examination and help the patient prepare both physically and mentally for Revision Rhinoplasty.

Dr. Zacharia will then provide a checklist surgery information packet that explains everything a patient should do and know before their Revision Rhinoplasty surgery date.


7) What to Know About Anaesthesia.

In most nasal surgeries, general anaesthesia is used. However in some cases, local anaesthesia with intravenous sedation may be used. Dr. Zacharia and his anaesthetist will assist patients in making the decision regarding which type of anaesthesia is best for their individual procedure.


8) About the Procedure:

As with Primary Rhinoplasty, the Revision Rhinoplasty procedure duration can last up to two-to-three hours, depending on complexity. There are two main techniques and approaches used in Revision Rhinoplasty – the closed and open techniques; however Dr. Zacharia uses the closed techniques in over 90% of cases.

As with a Primary Rhinoplasty, the surgical time for revision Rhinoplasty can last 2 to 3 hours. There are two main techniques and approaches used in Revision Rhinoplasty but most Revision Rhinoplasty is performed by an open approach. Cartilage may need to be taken from the ear or the rib to reshape the nose, depending on the complexity of the procedure.

Closed technique:

Small incisions are made inside the nose and specialised instruments are used to separate the skin from the underlying supporting framework of bone and cartilage. The bone and cartilage are then sculptured to the desired shape. The nature and extent of the sculpturing depends on the patient’s nasal anatomy and desired contour. The skin is then re-draped over the new framework, while dissolvable sutures are used to close the incisions.

Open technique:

Small skin incisions are made across the columella (the skin that separates the nostrils.) This provides more exposure, particularly in complex cases, and is often used in Revision Rhinoplasty. This incision heals very well and is usually inconspicuous within weeks after surgery.

Revision Rhinoplasty procedures tend to involve the same discomfort as Primary Rhinoplasty. Any discomfort that patients do experience can be controlled with pain medication.


9) What to expect after surgery?

Right after surgery, patients may feel some discomfort, which generally can be controlled with medication. Recovery duration varies on individual-to-individual basis. Most of the bruising that patients experience will have faded by about the tenth day. Swelling is also common and this can take months to fully fade. The splint and stitches will be removed within about six to seven days. Patients should also avoid bumping or jarring the nose, as well as sunburn for eight weeks after.

Quite often patients comment that the revision procedure performed by Dr. Michael Zacharia was less painful, with less swelling than their original procedure performed by the other physicians.


10) What are the risks and complications involved in Revision Rhinoplasty surgery?

No surgery is risk free. As with all procedures, there are number of risks and complications. Understanding the risks is imperative and Dr. Zacharia discusses these openly with prospective patients in the initial consultation.

The chance that any of these complications may occur during the surgery or during recovery is usually very small.

The following is a list the most common risks that may occur, such as bleeding, infection, scarring, small burst blood vessels, etc.

There is a 25% chance of requiring further touch-up surgery performed after Revision Rhinoplasty.

During the initial consultation, Dr. Zacharia will answer any questions and make sure the patient fully understands all possible complications involved with the surgery


11) How long is the recovery time after surgery?

Recovery after Revision Rhinoplasty can take longer than the first surgery. Generally, the nose will be more swollen for two to three weeks. It is not uncommon for patients to have slight discoloration of their skin after a secondary (revision) surgery because the skin has been traumatised by the multiple surgeries.


12) How long will I be off work/school?

At least one week is recommended to all patients. The plastic splint on the patient’s nose will be removed after seven days or more, leaving the patient free of this obvious stigma of surgery. In some cases, patients may want to take two weeks off to feel comfortable to return to work or school.


13) Will I have visible scars after Revision Rhinoplasty surgery?

Anytime that the skin is cut, a scar is formed. Incision healing is dependent on several factors, including surgical technique, prevention of infection, reduction of tension, patient nutrition, as well as smoking (before or after surgery), etc.

Like general Rhinoplasty, if a procedure is done with the “closed” technique, then all incisions are inside the nose, meaning no scars are created in the skin. The “open” technique will likely lead to a very small, unnoticeable scar in the skin between the patient’s nostrils.

If the nostrils are narrowed, there will be fine scar on the skin.


14) When will I see the final results?

Like General Rhinoplasty, It can take between two years for the final shape to become apparent.


Other Surgeries Performed by Dr Zacharia

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