Revision Rhinoplasty in New York City

Dr. Khosh is the former President of the New York Facial Plastic Surgery Society, and he is known as one of the top Revision Rhinoplasty surgeons in the U.S. He is a founding member of the New York Head and Neck Institute, and a long-time Castle Connolly Top Doctor and New York Magazine “Best Doctor” in facial plastic surgery. He is widely known for his expertise in both primary and revision rhinoplasty, including cases referred by other surgeons when problems are especially challenging.

Rhinoplasty is one of the most intricate and nuanced cosmetic procedures performed today. The cosmetic outcome of rhinoplasty can sometimes fall short of your expectations, and revision rhinoplasty may be necessary. Inadequate patient selection, incorrect or poorly executed surgical maneuvers, and poor healing in the postoperative period may lead to asymmetry, undercorrection or overcorrection, and nasal obstruction. New York Facial Plastic Surgeon, Dr. Maurice Khosh, is known as one of the Best NYC Rhinoplasty Surgeons, and he is uniquely equipped to handle your Rhinoplasty Revision.

A first rhinoplasty is a big decision, so realizing that you need a second surgery can feel discouraging, emotional, and sometimes embarrassing. Revision rhinoplasty, sometimes called secondary rhinoplasty or a second nose job, is a highly specialized procedure that corrects problems from a previous surgery, improves nasal function, and restores confidence in your appearance.

For many patients, revisional surgery by an experienced specialist like Dr. Khosh can dramatically improve nasal symmetry, correct over-resection or under-correction, and restore comfortable breathing while preserving a natural, non-operated look that fits the rest of the face.

What Is Revision Rhinoplasty

Revision rhinoplasty is performed on a nose that has already had at least one prior rhinoplasty. Patients typically seek a second nose job to improve appearance, function, or both. Common reasons include:
• A persistent dorsal hump or a scooped bridge from over-reduction
• An over-rotated or droopy nasal tip
• Pinched, asymmetric, or collapsed nostrils
• A crooked or twisted appearance
• Breathing difficulty after prior rhinoplasty
• Bridge collapse or saddle nose deformity

Because the nose has been operated on before, tissues may be scarred, weakened, or missing, making revision rhinoplasty far more complex. Advanced surgical skill, precision, and structural grafting are often required.

Why Patients Choose Dr. Khosh for Revision Rhinoplasty

Choosing the right surgeon is the most important decision in revision rhinoplasty. Many surgeons perform primary rhinoplasty, but far fewer consistently perform complex revision cases. Dr. Khosh stands out because of:

• Dual board certification in facial plastic surgery and otolaryngology, ensuring a deep understanding of both nasal aesthetics and breathing function
• Leadership roles, such as past president of the New York Facial Plastic Surgery Society
• Years of recognition as a Castle Connolly Top Doctor, New York Magazine Best Doctor, and Best Doctors in America
• High-level experience with advanced grafting, including rib cartilage, fascia, and structural reconstruction
• A surgical philosophy that prioritizes natural, balanced changes, long-term structural support, and improved airflow
• An artistic background in drawing and painting, which enhances his aesthetic judgment
• A reputation for helping patients who have already undergone one or more unsuccessful surgeries

Common Concerns Improved With Revision Rhinoplasty

Revision rhinoplasty can correct a wide range of functional and cosmetic problems, including:

• Scooped or over-reduced bridge
• Saddle nose deformity
• Droopy, bulbous, or over-rotated tip
• Pinched or collapsed nasal valves
• Crooked nasal bridge
• Persistent asymmetry
• Internal nasal valve collapse
• Difficulty breathing through one or both sides of the nose

Patients often notice significant improvements not only in appearance but also in nasal airflow, exercise tolerance, comfort during sleep, and overall quality of life.

The Consultation Experience

Revision rhinoplasty begins with an in-depth consultation. Dr. Khosh understands that many patients feel discouraged after one or more unsatisfactory surgeries, so he spends time listening closely to their concerns.

Your consultation typically includes:
• A detailed review of prior surgical history
• Examination of external anatomy and internal nasal structures
• Endoscopic evaluation when needed
• Discussion of specific goals, concerns, and expectations
• Computer imaging to visualize realistic outcomes
• Explanation of whether cartilage grafts or structural reconstruction will be needed
• Honest guidance on what is and is not achievable in a single revision

The goal is to create a tailored, realistic plan that addresses both form and function.

Surgical Approach and Techniques

Revision rhinoplasty is usually performed using an open approach to provide maximum visibility and precision. Depending on your needs, Dr. Khosh may use:

• Septal cartilage grafts (if available)
• Ear cartilage grafts for nostril and tip support
• Rib cartilage grafts for major reconstruction or collapsed bridges
• Spreader grafts to open the internal nasal valve
• Onlay and dorsal grafts to rebuild the profile
• Tip support grafts for definition and stability
• Osteotomies to straighten a crooked nose

The overall aim is to restore strong structural support, improve airflow, and achieve a refined but natural appearance.

Recovery and Healing Timeline

Recovery from revision rhinoplasty is similar to primary rhinoplasty, though swelling may take longer to resolve due to scar tissue from previous surgeries.

Typical recovery milestones include:
• Return to work or school in about one to two weeks
• Significant reduction in bruising within ten to fourteen days
• Improvement in swelling over several months
• Final refinement of the nose over twelve to eighteen months

Noses that have undergone prior surgery often need more time to reach their final shape, especially at the tip.

Who Is a Good Candidate

You may be a candidate for revision rhinoplasty if:
• You are unhappy with your appearance after prior rhinoplasty
• You are experiencing breathing problems following surgery
• You are in good general health
• You have realistic expectations and patience for the healing process
• At least twelve months have passed since your last rhinoplasty (in most cases)

In some situations, a touch-up may be possible earlier, but a comprehensive revision is safest after full healing.

Frequently Asked Questions About Revision Rhinoplasty

How long should I wait before having revision rhinoplasty?

Most patients should wait at least twelve months after a primary rhinoplasty before undergoing revision. This allows swelling to resolve and tissues to stabilize.

Is revision rhinoplasty more difficult than a first rhinoplasty?

Yes. Scar tissue, weakened structures, and missing cartilage make revision surgery more complex, which is why choosing an experienced revision surgeon is essential.

Can revision rhinoplasty fix breathing problems?

Yes. Many patients pursue revision rhinoplasty primarily to improve airflow. Dr. Khosh’s background in nasal and sinus surgery enables him to address both cosmetic and functional issues.

Will revision rhinoplasty make my nose smaller or more refined?

In many cases, yes. However, skin thickness, structural limits, and prior surgical changes determine what is realistically achievable. Computer imaging helps set clear expectations.

How many nose surgeries can someone safely have?

While there is no strict limit, each surgery creates scar tissue and reduces available cartilage. It is ideal to correct as much as possible in one well-planned revision.

Is recovery more painful than the first surgery?

Most patients find that revision rhinoplasty is not significantly more painful than their first procedure. Discomfort is typically well managed with oral medication.

Schedule a Consultation

If your previous rhinoplasty left you with cosmetic or breathing concerns, you do not need to live with those results. A carefully planned revision rhinoplasty with a highly experienced specialist can dramatically improve both appearance and function.

To learn more or schedule a personal consultation with Dr. Maurice Khosh,  contact our practice.

Frequently Asked Questions

How soon can I have revision surgery after a rhinoplasty?

The general answer is six months. There are two main reasons for this timing. First, the effects of rhinoplasty take that long to settle. Second, scar tissue from the first operation needs time to mature and soften. Sometimes that timing may need to be moved up or slowed down depending on the patient and the anatomic findings.

How many times can revision rhinoplasty be repeated?

It is best to have as few procedures as possible. Each revision rhinoplasty can induce further skin damage or scar formation. When revision surgery is delayed, the skin has a chance to heal, and scar tissue softens and thins out. Most patients can tolerate three operations on the nose without significantly increased risk.

My nose is still too big after rhinoplasty; can revision rhinoplasty make my nose smaller?

Probably yes, but a physical examination will be necessary. In some patients, skin thickness in the nasal tip limits reduction in size. I use computer imaging to demonstrate likely outcome from revision surgery to the tip.

I had rhinoplasty, and now the tip of my nose looks round and unrefined; can this be fixed?

There are two main causes for such development: scar formation and/or poor nasal tip cartilage support. In revision rhinoplasty, both problems can be addressed. Frequently, cartilage grafts will be placed to add definition and support to the nasal tip region.

My nostrils look too big after rhinoplasty; can you fix this problem?

Excess nostril show is often due to over rotation of the nasal tip. In revision rhinoplasty, the nasal tip can be rotated down to eliminate an unappealing look. Sometimes, reducing the size of nostrils can alleviate such problems.

Rhinoplasty made my nose too small; can my nose be made larger?

Revision rhinoplasty is often sought to restore an overly reduced, “operated looking” nose. In these cases we employ cartilage grafts or implants to replace missing structure.

Where do you get cartilage to repair my nose during revision rhinoplasty?

The best source of cartilage for revision rhinoplasty is septum cartilage from inside the nose. Unfortunately, due to prior surgery, there may not be adequate cartilage available from inside the nose. Other sources of cartilage include: the ear, cartilage from your ribs or cadaver rib cartilage.

If ear cartilage is used for my revision rhinoplasty, will my ear look different? Will my hearing be affected?

We harvest ear cartilage from a totally hidden incision behind the ear. By removing cartilage only from designated areas, the shape of the ear will be undisturbed. Your hearing will not be affected after cartilage removal from the ear.

How do you take cartilage from my rib?

We make a small incision over one of the lower ribs, near the midline of the chest. In women, this incision can be hidden under the breast. Once an adequate length of the rib is removed, the incision is closed. Most patients stay in the hospital for one night after this procedure.

What is the difference between the open approach versus the closed approach in rhinoplasty?

Rhinoplasty and revision rhinoplasty can be preformed via the closed (endonasal) or the open (trans-columellar) approach. Both approaches entail incisions inside the nostrils. The open approach adds an incision across the columella (the skin between the two nostrils). Open approach is commonly used in rhinoplasty because it affords better visualization of the nasal tip cartilages and allows for precise manipulation of the cartilages. The open approach to rhinoplasty is bit more times consuming. Patients who undergo open rhinoplasty may experience slight numbness in the nasal tip for up to 3 months. Dr Khosh is proficient in both approaches.

Related Procedures

Revision rhinoplasty often entails associated procedures to enhance breathing, procedures such as septoplasty and nasal valve reconstruction. If there is a need for cartilage grafting, and the nasal septum is not adequate, harvest of cartilage from the ear or a rib may be necessary. In select patients, chin augmentation can enhance the rhinoplasty results by creating better balance between the lower face and the nose.

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