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Rhinoplasty Revision Surgery

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, under correction or over reduction, 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.

Nose reshaping. What would you like to improve about your nose?

The goals of NYC revision rhinoplasty are achieving a result that is natural and harmonious with the rest of the face while matching patient expectations. Revision rhinoplasty can be an extremely demanding procedure. Many patients requesting revision rhinoplasty are also interested in restoring breathing function which may have been disturbed by the initial rhinoplasty procedure.

Dr. Khosh is a surgeon who has anchored his cosmetic practice in excellence in revision and primary rhinoplasty. He is skilled in the analysis and treatment of all the forms of deformities associated with failed rhinoplasty. He is an expert in the harvest and use of rib cartilage, fascia, and dermal grafts. He understands and treats breathing disturbances associated with failed rhinoplasty. Whereas some cosmetic practices rarely perform revision rhinoplasty, revisional surgery comprises a large portion of our rhinoplasty practice.

Rhinoplasty Revision Specialist

Dr. Khosh acknowledges the discontent and frustration of revision rhinoplasty patients and works to help the patient overcome them. This process begins with the consultation that includes a thorough discussion of the past experiences, a careful evaluation of the external and internal nasal anatomy, and computer imaging to help demonstrate the likely outcome of your revision rhinoplasty.

It may take years before a patient seeks consultation for revision rhinoplasty. This can be the result of the significant psychological and financial impact of the initial rhinoplasty operation, leaving patients unwilling to consider a revision procedure. Dr. Khosh is acutely aware of these important, sensitive considerations. He will work diligently to ease your concerns and gain your confidence before recommending surgery. Contact our practice today to schedule a consultation for yourself, a friend or a member of your family.

Revision rhinoplasty New York, NY

Case Study

This 40-year-old man had undergone rhinoplasty at age 18. He complained of over-reduction of the dorsum, over-rotation of the nasal tip, and inability to breathe. Revision rhinoplasty with the use of cartilage grafts and a Gortex graft allowed the recreation of a natural looking nose with excellent breathing function.

  • Patient: 40-year-old man seeking revision rhinoplasty in Manhattan
  • Problem: Prior rhinoplasty causing scooped-out nose, over-rotated tip, nasal obstruction
  • Procedure: Revision rhinoplasty performed through the open approach

Disclaimer: These are actual results for patients of Dr. Maurice Khosh. Plastic and cosmetic surgery results can vary between patients.

Revision rhinoplasty New York, NY

Case Study

This ​38 year old gentleman had previously undergone rhinoplasty with another surgeon. This resulted in loss of nasal tip support, collapse of the tip, breathing obstruction, and significant asymmetry of the lower nose. Revision rhinoplasty was performed through an open approach. Cartilage grafting from his own rib allowed elevation of the nasal tip and restoration of tip symmetry and improved breathing function.

  • Patient: 38 year old with history of unsuccessful rhinoplasty in the past.
  • Problem: Droopy nasal tip, asymmetry of the tip, breathing obstruction
  • Procedure: Revision rhinoplasty with rib cartilage graft.

Disclaimer: These are actual results for patients of Dr. Maurice Khosh. Plastic and cosmetic surgery results can vary between patients.

Frequently Asked Questions

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Female face before and after revision rhinoplasty.

Click Here to See Revision Rhinoplasty Photo Gallery

What Dr. Khosh's Patients Say

5.0

Based on 174 reviews

Meredith G.
Saw Dr. Khosh for a fractured nose. He reset my nose beautifully (and with little discomfort to me) and then discussed some of my sinus issues with me upon my follow up visit. Never felt like he was rushing me out and felt very confident in his abilities. I would highly recommend to anyone needing plastic or reconstructive options!
Jackie C.
Great front office, really good experience after what was a terrible accident. I was made to feel comfortable. Dr. Khosh is very good at what he does. I'm still healing but I'm confident of the results
Kaitlin M.
Dr. Khosh takes exceptional care of his patients. He has operated on me twice, each time making me feel extremely comfortable and satisfied with the results. His staff is also very kind and knowledgeable.
Diana G.
Dr. Khosh & his staff Susan & Christine are absolutely amazing! They were so supportive & helpful from beginning to end & they are just wonderful people. Thank you guys I truly appreciate everything you guys have done for me. I would recommend them to anyone & everyone!
Joann M.
After visiting and being evaluated by several doctors, I kept going back to Dr. Khosh. His tranquil spirit and professionalism were captivating. Thank you for a job well done and keeping me calm throughout the entire process. A special thanks to your staff Susan and Christine for all of their support as well. Hi highly recommend Dr. Khosh.
Leah G.
Upon hearing of the overwhelmingly positive experience a friend of mine had in choosing Dr. Khosh as her surgeon, I decided to make an appointment for my own septoplasty/rhinoplasty/turbinate reduction. Although I was slightly skeptical as the praise I had heard seemed a bit hyperbolic, all uncertainty dissipated after meeting the Doctor and his staff. My pre- and post-operative experience was excellent in terms of concerns adequately addressed prior to the surgery and mitigation of any bruising in the convalescent period. Despite my apparent predisposition to rather slower healing, a year after the surgery, my nose looks really pretty and my breathing entirely unobstructed! I highly recommend Dr. Khosh!
Courtney G.
AMAZING!!!!!! I had Dr Khosh perform lipo on my chin/neck and my result is unbelievable! Better than I could have expected! I met with a couple of surgeons and the second I met with Dr Khosh I knew he was the one I was going with. He was compassionate and explained every detail of what would take place during the surgery and what to expect during recovery. I even emailed a few times during recovery with various questions and he got right back to me asap which was really comforting! I honestly fully recommend Dr Khosh, he did an amazing job and is an amazing person.
Frieda S.
i can finally breathe!! Dr. Khosh made the entire experience a breeze, it was truly a pleasure to be under his care. I am forever thankful and highly recommend him. Not only does his work speak for himself, but he has excellent bedside manner. His kindness and patience is above and beyond. He takes the time to answer to every question you have to help you understand the process while at the same time making you feel so comfortable. From the first consultation i knew i was in good hands. I am so pleased with the result and forever thankful.
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