Revision Rhinoplasty

Surgical reshaping of a nose which had a previous rhinoplasty is known as revision rhinoplasty. If a rhinoplasty procedure is not performed with careful balance of nasal proportions, or careful respect of nasal structures, or if a post-operative course becomes complicated by an unfortunate event, revision rhinoplasty can become a good surgical option.

Revision rhinoplasty is a surgical art form distinct from that of rhinoplasty in an un-operated nose. The associated scarring and potential damage or loss of structures from a prior surgery, impose significant challenges. Thus, revision rhinoplasty is a complex surgical procedure which should be performed only by surgeons with a vast experience with this operation. Any surgeon performing revision rhinoplasty should be adept with the techniques to rebuild the nose in a structurally balanced and beautiful way. Given Dr. Sparano’s previous Otolaryngology – Head and Neck Surgery training, along with his fellowship training in Facial Plastic and Reconstructive Surgery, he is extremely well-trained to handle the most difficult cases in form and function. Dr. Sparano is often consulted even by other plastic surgeons to handle complex aesthetic and functional difficulties that result from overly aggressive previous reduction rhinoplasty.

Dr. Sparano is asked to perform revision rhinoplasty quite frequently. He has a wealth of experience with all aspects of rhinoplasty. At every initial consultation, Dr. Sparano performs free graphic morphing, to allow a patient to visualize planned surgical results. This facilitates the discussion between a patient, a family, and Dr. Sparano, as to what the distinct goals of the revision surgery are to be. Dr. Sparano will stress the importance of careful pre-operative communication at all of his pre-procedure consultations.

Dr. Sparano believes every patient considering a revision rhinoplasty should carefully consider the surgeon they are choosing. Patients should consider a surgeon’s understanding of the nose; experience with revision cases; understanding of nasal function and breathing-related disorders; and prior training with regard to aesthetic and functional nasal surgery.

A revision rhinoplasty procedure can be extremely rewarding for a patient who has become dissatisfied with an initial surgical outcome. Dr. Sparano enjoys working with patients through any troubling or challenging circumstances. Careful pre-operative planning and surgical execution can optimize surgical results, even in the most challenging of cases.


When can a revision rhinoplasty be performed?
A revision procedure can be performed after sufficient time for post-operative swelling and scar maturation has taken its course (usually after 9-12 months). Most revision cases are scheduled for at least 1 year following the initial procedure, to minimize the evolving variables which can influence the secondary surgical result.

Where is a revision rhinoplasty performed, and is general anesthesia necessary?
Revision rhinoplasty is generally performed in an outpatient surgical center and most patients return home hours after the procedure is performed. To maximize safety, Dr. Sparano performs all revision rhinoplasty procedures using general anesthesia.

Is a revision rhinoplasty more painful than an initial rhinoplasty procedure?
Revision cases are usually not more painful. Patients will often describe moderate discomfort over the first 1-2 days. This discomfort is easily controlled with an appropriate medication regimen. Patients can usually transition to Tylenol/acetaminophen therapy after 2 days.

Is the recovery after revision rhinoplasty worse than initial surgery?
The swelling and bruising after a revision rhinoplasty procedure are usually about the same as with an initial rhinoplasty. They are common during the first week after surgery. Patients usually feel most comfortable in bed for the first day after surgery. Patients feel progressively better each day afterward. The associated bruising is usually diminished by the 1-week follow-up.

Is nasal packing necessary after revision rhinoplasty?
Dr. Sparano rarely uses nasal packing for any of his nasal surgeries. It is rarely necessary.

How much time off from work or school should I plan for?
Patients typically are able to return to work or school one week after surgery.

How soon can I exercise after rhinoplasty?
After the first week of recovery, light exercise can be resumed. Strenuous exercise and weightlifting must be avoided for three weeks. Contact sports should be avoided for six weeks

When are stitches removed after revision rhinoplasty?
When non-absorbable sutures are used, they are removed within the first week after surgery.

Does insurance ever cover the cost of a revision rhinoplasty?
Insurance companies are infrequently involved in cases of revision rhinoplasty.