Mar 4

How many revisions is too many?

No one likes to think about going through surgery and recovery more than once.

At Profiles Beverly Hills, patients who have not been entirely happy with prior cosmetic results often are referred to us seeking revision surgery. This is not to say that many patients are unhappy after surgery…quite the contrary is true. A great majority of patients are happy with their outcomes and most are not looking for perfection. What is a minor imperfection to some, though, is not so to others.

Still fewer patients are left with a more significant deformity. Conditions that may increase chances for a suboptimal result are poor technique or lack of surgical experience, an uncommon complication such as an infection, or sometimes simply the unpredictability of healing. An honest dialogue between patient and surgeon regarding desires and expectations can go a long way toward avoiding postoperative disappointment.

Revision Rhinoplasty Frontal View

This woman was unhappy with her twisted and bulbous, boxy tip despite a previous Rhinoplasty. Also, her nasal septum was poorly supported and deviated so much that it was jutting into her right nostril and compromising her breathing. She wanted an overall smaller, smoother, and more feminine nose with improvement in her breathing. The 1 year postoperative photo on the right shows that these goals were achieved and she was thrilled that her new nose no longer dominated her face.

If you have a suboptimal result, it can often be improved upon. However, you should be aware that the chances for unbridled success must be downgraded slightly in this situation. This is because we are faced with having to revise surgical alterations against a background of scar tissue and distorted or lost anatomy. Scar tissue also tends to build upon itself with each subsequent surgery while normal structures or layers within and below the skin may thin out or atrophy. Nevertheless, in well-considered cases, we have had numerous successes in third, fourth, or even fifth rhinoplasty revisions. There is no magic number for allowable procedures.

We consider each patient on an individual basis. If we believe that a person’s concerns are clear, motivations are honest, and desired improvements are achievable in our hands with acceptable risk, we may recommend proceeding. Sometimes, though, things are better left alone, and we will be frank with you in that event. If you have questions about revision surgery, feel free to contact us for a more detailed discussion.

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