Revision Rhinoplasty in the UK: Costs, Recovery, Rib Cartilage and What to Expect
Updated: Oct 4
Last reviewed: 4 October 2026 — Mr Tim Biggs, PhD, FRCS (ORL-HNS)Consultant Rhinologist & Facial Plastic SurgeonRoyal College of Surgeons Board Certified in Cosmetic Nasal Surgery
Revision rhinoplasty is surgery performed on a nose that has previously undergone rhinoplasty or septorhinoplasty.
It is usually more complex than first-time, or primary, rhinoplasty.
The reason is straightforward: after previous surgery, the normal anatomy may have been altered, cartilage may have been removed, scar tissue has developed and the structural support of the nose may no longer be intact.
Some patients seek revision because they remain unhappy with the appearance of their nose. Others develop breathing problems, nasal valve collapse or structural weakness. Frequently, there is a combination of aesthetic and functional concerns.
Common questions I hear from patients include:
Why is revision rhinoplasty more difficult?
How long should I wait before considering another operation?
Can an over-reduced or pinched nose be rebuilt?
Will I need rib cartilage?
Is donor rib cartilage safe?
Can revision rhinoplasty improve my breathing?
How much does revision rhinoplasty cost in the UK?
Will the result ever be as predictable as primary rhinoplasty?
This guide explains the issues in detail.
What is revision rhinoplasty?
Revision rhinoplasty, sometimes called secondary rhinoplasty, is an operation performed after one or more previous rhinoplasty procedures.
The objective is not necessarily to create an entirely different nose.
Depending upon the problem, revision surgery might involve a relatively limited correction or a much more extensive reconstruction.
Reasons patients seek revision include:
persistent nasal asymmetry;
residual dorsal hump;
an over-reduced bridge;
a pinched appearance;
nasal valve collapse;
a crooked nose;
tip asymmetry;
a drooping or poorly supported tip;
excessive tip rotation;
insufficient tip rotation;
contour irregularities;
visible or palpable grafts;
breathing that is worse following the original operation;
excessive scar formation;
loss of structural support;
an unnatural or "operated" appearance; or
dissatisfaction with the overall balance of the nose.
In a number of revision cases, what initially appears to be a cosmetic problem is actually the external manifestation of an underlying structural problem.
This distinction is important.
Revision rhinoplasty often involves rebuilding the nose, rather than simply reshaping it.
How is revision rhinoplasty different from primary rhinoplasty?
In an untouched nose, the surgeon begins with relatively predictable anatomy.
The septum, nasal bones, upper lateral cartilages and tip cartilages are usually identifiable in their normal anatomical positions.
After previous surgery, this can be very different.
Revision surgery may involve:
scar tissue;
distorted tissue planes;
altered blood supply;
missing cartilage;
weakened cartilage;
previous grafts;
previous sutures;
irregular bone;
changes to the septum;
loss of nasal valve support; and
uncertainty about exactly what was done during the original procedure.
Even when an operative note is available, it does not always tell the whole story.
The actual anatomy may only become completely apparent during surgery.
This is why revision rhinoplasty requires flexibility in planning and why I want appropriate graft material available before the operation starts.
Why does rhinoplasty sometimes need revision?
No surgeon can guarantee a perfect rhinoplasty result.
The nose is a three-dimensional structure made from bone, cartilage, skin, soft tissue and scar tissue. It continues to heal and remodel for many months after surgery.
A revision does not necessarily mean that the first operation was performed badly.
Potential reasons include:
Healing and scar tissue
Even technically well-performed surgery is followed by a biological healing response.
Scar contraction can alter tip position, asymmetry or contour.
Residual asymmetry
Almost every face and nose is naturally asymmetric.
Some asymmetry can remain following surgery and, occasionally, becomes more noticeable as swelling resolves.
Cartilage memory and movement
Cartilage is flexible biological tissue. It can bend, twist or partially return towards its previous position.
Structural weakness
Removing too much cartilage can weaken the nose and lead to problems that may become apparent months or years later.
Nasal valve collapse
The internal or external nasal valve may narrow or lose support, causing obstruction or visible collapse during inspiration.
You can read more in my article Why Nasal Valve Collapse Is Often Missed – Even After ENT Review.
Over-resection
Historically, some rhinoplasty techniques relied heavily on removing cartilage and bone.
Excessive reduction can produce an over-operated appearance and compromise structural support.
Under-correction
A hump, deviation or tip problem may persist.
Trauma
An injury during the healing period or later in life can alter the result.
What does an over-reduced nose look like?
One of the more challenging revision problems is the over-resected nose.
Features can include:
an excessively low bridge;
a scooped profile;
an inverted-V appearance;
narrowing or pinching of the middle third;
visible transition between the nasal bones and cartilage;
excessive tip rotation;
a shortened nose;
retracted nostril margins;
nasal valve narrowing; and
difficulty breathing.
In these cases, further reduction is clearly not the answer.
The missing support needs to be restored.
This may require structural cartilage grafting to rebuild the bridge, middle vault, septum, nasal valves or tip.
I show examples of both primary and revision cases on my rhinoplasty before-and-after page.
What is a pinched nose after rhinoplasty?
A pinched appearance usually relates to loss of support in the middle third, tip or nostril margin.
It may be accompanied by functional narrowing of the airway.
From the front, the nose may look unusually narrow.
From below, the nostrils or tip may look distorted.
During inspiration, the sidewall can sometimes visibly move inwards.
The solution is usually not simply cosmetic camouflage.
The structural weakness needs to be assessed and, where necessary, reconstructed.
This is particularly relevant to the nasal valve, the narrowest part of the nasal airway.
Can revision rhinoplasty improve breathing?
Yes, when the cause of the obstruction is structural and can be corrected surgically.
I approach revision rhinoplasty from both an aesthetic and rhinological perspective.
Breathing problems after previous rhinoplasty may result from:
residual septal deviation;
septal perforation;
internal nasal valve narrowing;
external nasal valve collapse;
excessive narrowing of the middle vault;
weak lateral nasal walls;
nostril collapse;
scarring; or
combinations of these problems.
A revision assessment should therefore include an examination of function as well as appearance.
Simply making the nose look wider does not necessarily improve airflow.
The location and mechanism of obstruction need to be identified first.
You can read more about the functional side of nasal surgery in my rhinoplasty techniques guide.
Why is structural reconstruction important in revision rhinoplasty?
In primary cosmetic rhinoplasty, the surgeon may be able to reshape existing cartilage.
In revision surgery, there may simply not be enough useful cartilage left.
In that situation, new structural material may be required.
Cartilage can be used to:
restore septal support;
rebuild the bridge;
reconstruct the middle vault;
strengthen the nasal valves;
lengthen a shortened nose;
support the nasal tip;
correct nostril retraction;
camouflage contour irregularities; or
replace cartilage removed during previous surgery.
The graft material used depends on what needs to be achieved.
Options include:
septal cartilage;
ear cartilage;
rib cartilage; and
donor rib cartilage.
Fascia can also be useful as a soft-tissue covering or camouflage layer.
Septal cartilage in revision rhinoplasty
Septal cartilage is an excellent grafting material.
It is straight, relatively rigid and is harvested from the same operative field.
The problem in revision rhinoplasty is availability.
Many patients have already had a septoplasty or septorhinoplasty, meaning that much of the usable septal cartilage has already been removed.
A previous surgeon may also have retained only the minimum amount of cartilage necessary to support the nose.
This means I cannot assume before revision surgery that there will be sufficient septal cartilage available.
Ear cartilage in revision rhinoplasty
Ear cartilage is another useful source of graft material.
It has the advantage of being the patient's own tissue.
The incision can usually be hidden behind the ear or within its natural contour.
However, ear cartilage has a natural curvature and is relatively flexible.
That makes it excellent for some applications, particularly softer contour or lateral-wall grafts, but less suitable when long, strong, straight structural grafts are required.
For significant reconstruction, rib cartilage provides considerably more material and strength.
When is rib cartilage needed for revision rhinoplasty?
Not every revision rhinoplasty requires rib cartilage.
This is an important correction to a common misconception.
A small revision may require little or no graft material.
Septal or ear cartilage may be entirely adequate for some procedures.
Rib becomes particularly useful when substantial structural reconstruction is required, for example:
severe over-resection;
major loss of septal support;
saddle deformity;
significant nasal valve collapse;
reconstruction following several previous operations;
major bridge augmentation;
lengthening a shortened nose;
major tip reconstruction; or
when septal cartilage has already been exhausted.
Rib cartilage is attractive because there is enough material to fashion strong structural grafts.
It can provide the framework required when the nose needs to be rebuilt rather than simply refined.
What is donor rib cartilage?
Donor rib cartilage is costal cartilage obtained from a donor and processed specifically for surgical implantation.
The principal advantage is that it avoids the need to harvest rib cartilage from the patient's chest.
This means there is:
no chest incision;
no chest scar;
no donor-site pain;
no risk of chest-wall contour change; and
no additional harvesting procedure.
For selected revision cases, I use donor rib cartilage when substantial structural graft material may be required.
The evidence surrounding processed and fresh-frozen donor rib has developed considerably.
A recent systematic review and meta-analysis of 25 studies involving 2,322 patients compared autologous and cadaveric costal cartilage. Reported infection and warping rates were low across graft types, although the authors appropriately noted heterogeneity between studies and the need for better long-term comparative evidence.
As with any grafting material, donor rib has potential risks, including infection, resorption, displacement, warping and the possibility of further surgery.
Its use needs to be considered in the context of the individual reconstruction rather than assuming it is automatically preferable to a patient's own cartilage.
Why do I have donor rib available for revision cases?
Revision rhinoplasty is less predictable than primary rhinoplasty.
Pre-operative examination and photographs tell us a great deal, but scar tissue can conceal the exact condition of the underlying framework.
Occasionally, the amount of usable cartilage remaining only becomes clear once the nose is opened.
For this reason, in cases where reconstruction may be necessary, I prefer to plan so that appropriate material is available rather than discovering during surgery that the reconstruction cannot be completed as intended.
At Adnova Clinic, my revision pricing therefore makes provision for donor rib cartilage and fascia where required.
If these materials are not required, the associated cost is refunded.
What is fascia and why might it be used?
Fascia is a thin layer of biological connective tissue.
In revision rhinoplasty it can be useful for camouflage and contour smoothing, particularly where the nasal skin is thin or previous surgery has produced small surface irregularities.
It is not a substitute for cartilage when strong structural support is required.
Instead, fascia may be layered over structural grafting to help create smoother transitions beneath the skin.
Revision surgery frequently requires both a structural and a soft-tissue strategy.
Autologous rib versus donor rib cartilage
There is no universally correct graft source.
Autologous rib
This is cartilage harvested from the patient's own chest.
Advantages include:
the patient's own tissue;
excellent availability;
strong structural support.
Disadvantages include:
an additional surgical site;
chest scar;
post-operative chest discomfort;
longer surgery; and
small but recognised donor-site risks.
Donor rib
Advantages include:
no chest harvest;
no chest scar;
no donor-site pain;
reduced operative work associated with harvesting;
readily available structural cartilage.
Potential disadvantages include:
cost;
possibility of infection, warping or resorption;
reliance on processed donor tissue; and
less very-long-term comparative evidence than exists for autologous cartilage.
A 2026 systematic review and meta-analysis reported low pooled infection and warping rates across autologous, fresh-frozen and irradiated rib cartilage groups, although differences in study design and follow-up mean these data should not be interpreted as proving that one source is universally superior.
The choice should therefore be individualised.
Can Piezo ultrasonic surgery be used in revision rhinoplasty?
Yes.
I use Piezo ultrasonic instrumentation for bony rhinoplasty work.
Piezo instruments use ultrasonic vibration to cut or reshape mineralised bone with high precision.
This is particularly useful in revision surgery where previous osteotomies, asymmetric healing or irregular bony contours may make further bone work technically demanding.
Potential applications include:
precise osteotomies;
correction of bony asymmetry;
smoothing of irregular nasal bones;
treatment of residual bony humps;
narrowing a widened bony vault; and
controlled mobilisation of previously operated nasal bones.
You can read more in my detailed guide: Piezo Rhinoplasty: Patient FAQs on Ultrasonic Nose Surgery.
Piezo is a surgical instrument rather than a type of rhinoplasty in itself.
The underlying reconstructive plan remains more important than the tool used to perform it.
Can dorsal preservation be used in revision rhinoplasty?
Sometimes — but this needs careful qualification.
Dorsal preservation rhinoplasty relies upon having useful native dorsal anatomy to preserve.
After a previous reduction rhinoplasty, the dorsal surface may already have been opened, resected, reconstructed or scarred.
This means a classic preservation operation is often no longer possible.
However, preservation principles can sometimes still be applied selectively.
My overall philosophy is:
preserve useful anatomy where it remains favourable and reconstruct structures that are deficient.
You can read more about the technique in my detailed guide to dorsal preservation rhinoplasty and on my rhinoplasty techniques page.
What is hybrid revision rhinoplasty?
Modern rhinoplasty does not always fit neatly into categories of "structural" versus "preservation".
A complex revision may involve:
structural cartilage grafts in one part of the nose;
preservation of an untouched area elsewhere;
Piezo correction of the nasal bones;
septal reconstruction;
nasal valve grafting;
tip reconstruction; and
fascia camouflage.
The operation is therefore designed around the problems that actually exist.
This is much more logical than attempting to apply a single named technique to every nose.
What can revision rhinoplasty realistically achieve?
The objective of revision surgery is meaningful improvement, not perfection.
Depending upon the starting anatomy, revision rhinoplasty may:
improve nasal symmetry;
improve nasal breathing;
restore structural stability;
rebuild an over-reduced bridge;
support collapsed nasal valves;
correct a pinched middle vault;
improve tip position;
reduce visible contour irregularities;
correct residual deviation;
restore more natural facial proportions; and
produce a nose that appears less obviously operated.
However, there are important limitations.
Previous surgery cannot be undone completely.
Scar tissue cannot be converted back into untouched tissue.
Skin quality cannot always be changed.
Very thin skin can continue to reveal minor underlying irregularities.
Very thick or heavily scarred skin can limit definition.
The blood supply may have been altered.
Some asymmetry may remain.
And each additional operation generally makes the anatomy more complex.
Research using patient-reported outcomes does demonstrate significant improvement in satisfaction following revision rhinoplasty, but outcomes tend to be less predictable than after primary surgery.
For this reason, realistic expectation-setting is one of the most important parts of the consultation.
How long should I wait before revision rhinoplasty?
In most cases, at least 12 months should pass after the previous rhinoplasty before considering revision surgery.
I generally do not assess patients for a second opinion regarding a previous rhinoplasty until they are at least one year after their original operation.
There are several reasons.
Swelling takes a long time to settle
The nasal tip in particular may remain swollen for many months.
Scar tissue changes
Scar tissue initially feels firm and can contract or soften as it matures.
The shape continues to evolve
A concern present at three months may improve considerably by 12 months.
Revision becomes easier to plan
Operating on an actively healing nose can make surgical dissection considerably more difficult.
There are exceptions.
Earlier assessment may be appropriate if there is an urgent functional problem, infection, significant structural collapse or another complication requiring timely treatment.
But for routine aesthetic revision, patience is usually important.
My article What If I Don't Like My Rhinoplasty Result? explains why early rhinoplasty results should be interpreted cautiously.
What happens at a revision rhinoplasty consultation?
A revision consultation is deliberately detailed.
I need to understand both what has happened anatomically and what you would like to change.
Assessment may include:
your original concerns before the first operation;
what operation you were told was performed;
operative notes, if available;
previous photographs;
current photographs;
external nasal examination;
septal examination;
assessment of nasal airflow;
nasal valve assessment;
dynamic examination during inspiration;
skin quality and thickness;
scar tissue;
residual septal cartilage;
tip support;
bridge support; and
realistic treatment objectives.
It is very useful to bring your previous operative report if you have it.
However, lack of an operative report does not prevent assessment.
For broader advice on consultations, see Essential Questions to Ask at Your Rhinoplasty Consultation.
Can 2D/3D simulation be used for revision rhinoplasty?
Simulation can still be useful, particularly for discussing profile, tip position and overall direction of change.
However, it is especially important in revision surgery to understand what simulation is — and what it is not.
A morph is a communication and planning tool.
It cannot show exactly how scarred tissue will behave, guarantee symmetry or predict every technical limitation discovered during surgery.
The more complex the revision, the more important this distinction becomes.
Is revision rhinoplasty always performed using an open approach?
Complex revisions are commonly performed through an open approach.
An incision is made across the columella and connected to internal incisions, allowing the skin and soft tissues to be carefully elevated from the nasal framework.
This provides direct access to:
previous grafts;
scar tissue;
tip cartilages;
septum;
middle vault;
nasal valves; and
structural grafts.
The scar generally heals very well.
You can read more in Rhinoplasty Scars: What to Expect and Why They're Almost Invisible.
Very limited revisions can occasionally be treated through a closed approach, but technique should follow the anatomical problem rather than a desire to avoid a small external incision.
What is recovery like after revision rhinoplasty?
The initial recovery is broadly similar to primary rhinoplasty, but swelling can persist for longer.
A typical timeline is:
First week
A nasal splint remains in place.
Swelling, congestion and bruising are expected.
Around 7 days
The splint is usually removed.
The nose will already look different, but it remains significantly swollen.
10–14 days
Many patients feel comfortable returning to desk-based work and routine social activities.
3–4 weeks
Light exercise can usually resume according to individual healing and post-operative advice.
6 weeks
The nasal bones have gained substantial stability, although contact and trauma should still be avoided according to your surgeon's advice.
3 months
A significant amount of swelling has settled and the overall shape is much clearer.
6 months
Further refinement occurs.
12 months and beyond
The result is considerably more mature.
With complex revision surgery, significant scar tissue or thick skin, 18 months or occasionally longer may be required before every subtle change has settled.
Revision patients therefore need more patience than primary rhinoplasty patients.
Is revision rhinoplasty more painful?
Not necessarily.
The nose itself is usually described as uncomfortable, congested or pressured rather than severely painful.
If the patient's own rib cartilage is harvested, the chest donor site can contribute additional discomfort.
One advantage of donor rib cartilage is avoiding this separate donor-site recovery.
What are the risks of revision rhinoplasty?
Revision rhinoplasty carries the general risks associated with rhinoplasty as well as risks relating to previous surgery and grafting.
These include:
bleeding;
infection;
swelling;
bruising;
scarring;
numbness;
asymmetry;
contour irregularity;
persistent breathing problems;
nasal valve dysfunction;
septal perforation;
skin problems;
graft visibility;
graft displacement;
graft resorption;
rib-cartilage warping;
dissatisfaction with appearance; and
the possibility of further revision surgery.
Because the soft tissues and blood supply have already been affected by previous surgery, certain complications may be more relevant in complex revision cases.
I discuss these issues in more detail in Rhinoplasty Risks: What Can Go Wrong With Nose Surgery?.
How much does revision rhinoplasty cost in the UK?
Revision rhinoplasty is generally more expensive than primary rhinoplasty because it may involve:
longer operating time;
complex dissection through scar tissue;
structural reconstruction;
cartilage grafting;
additional graft materials;
nasal valve reconstruction;
increased technical difficulty; and
more extensive planning.
At Adnova Clinic, my current revision rhinoplasty package price is £13,000.
This includes:
surgeon's fee;
consultant anaesthetist;
hospital/theatre costs;
standard follow-up care; and
provision for donor rib cartilage and fascia where these are potentially required.
Because it may not be possible to know with certainty before surgery whether donor rib or fascia will ultimately be needed, these are available if required.
If donor rib cartilage and fascia are not used, approximately £1,500 is refunded after surgery.
In other words, the operation is planned with appropriate reconstructive material available, without requiring the patient to pay for graft material that was ultimately unnecessary.
Fees can change, so current pricing should always be confirmed at consultation or on my prices page.
Why is revision rhinoplasty more expensive than primary rhinoplasty?
It is important to understand that revision surgery is not simply "another rhinoplasty".
The additional cost reflects the nature of the operation.
A complex revision may require:
a longer procedure;
meticulous scar-tissue dissection;
reconstruction of structures that are no longer present;
donor cartilage;
fascia;
complex nasal-valve work;
multiple grafts; and
more extensive surgical planning.
In other words, complex revision rhinoplasty is often reconstructive surgery as well as aesthetic surgery.
Cost should therefore be considered alongside the complexity of the individual problem, not simply compared with primary-rhinoplasty fees.
Does revision rhinoplasty need an ENT or rhinology assessment?
Where breathing has been affected, detailed understanding of nasal airway anatomy is particularly valuable.
Revision problems may involve both appearance and:
septal deviation;
internal valve narrowing;
lateral-wall collapse;
turbinate enlargement;
septal perforation; or
altered internal anatomy from previous surgery.
As a Consultant ENT Surgeon and Rhinologist as well as a facial plastic surgeon, my revision assessment considers the inside and outside of the nose together.
An attractive nose that does not breathe well is not a successful rhinoplasty outcome.
How should I choose a revision rhinoplasty surgeon in the UK?
Revision rhinoplasty is a subspecialist area.
Questions worth asking include:
Does the surgeon regularly perform revision rhinoplasty?
Do they perform structural reconstruction?
Are they experienced in nasal valve surgery?
Can they use septal, ear and rib cartilage?
Do they assess nasal breathing as well as appearance?
Can they manage complex post-traumatic noses?
Do they use modern bone techniques such as Piezo where appropriate?
Do they have access to appropriate graft materials?
Can they show examples of revision cases?
Do they discuss the limitations of further surgery?
What happens if the anatomy encountered during surgery differs from the pre-operative plan?
Around 30% of my rhinoplasty practice is revision surgery, so reconstruction, nasal-valve work and management of previously operated noses form a significant part of my practice.
You can also read my article Where to Find a Revision Rhinoplasty Expert in the UK.
Revision rhinoplasty at Adnova Clinic, Hampshire
I am Mr Tim Biggs, Consultant Rhinologist and Facial Plastic Surgeon.
My practice includes primary cosmetic rhinoplasty, functional septorhinoplasty and complex revision rhinoplasty.
Revision surgery may combine:
structural reconstruction;
nasal valve reconstruction;
septal reconstruction;
septal, ear or rib cartilage;
donor rib cartilage;
fascia camouflage;
Piezo ultrasonic bone surgery;
tip reconstruction; and
preservation principles where appropriate.
Operations are planned according to the patient's actual anatomy rather than applying the same technique to every nose.
Revision rhinoplasty is performed at Adnova Clinic in Fareham, Hampshire.
You can:
view my rhinoplasty techniques;
read about Piezo ultrasonic rhinoplasty;
understand nasal valve collapse;
read about rhinoplasty risks;
read about rhinoplasty scars;
understand dorsal preservation rhinoplasty;
contact the practice to discuss consultation.
Frequently Asked Questions About Revision Rhinoplasty
What is revision rhinoplasty?
Revision rhinoplasty is surgery performed after a previous rhinoplasty or septorhinoplasty to address unresolved or new problems with appearance, nasal function or both.
It ranges from relatively minor refinement to major structural reconstruction.
Why is revision rhinoplasty more difficult?
Previous surgery creates scar tissue and changes the normal anatomy. Cartilage may have been removed, grafted or weakened, and the nasal blood supply and tissue planes may also have changed. Revision surgery therefore tends to be less predictable and technically more demanding than primary rhinoplasty.
How long should I wait before revision rhinoplasty?
For routine revision assessment, I generally advise waiting at least 12 months after the previous operation. This allows swelling to settle, scar tissue to mature and the final result to become apparent. Earlier assessment may be appropriate if there is a significant complication or functional problem.
Will I need rib cartilage?
Not necessarily.
Minor revisions may require no grafting at all, while septal or ear cartilage may be sufficient for others.
Rib cartilage is most useful when substantial reconstruction or strong long-term structural support is required, particularly when previous surgery has depleted the septal cartilage.
What is donor rib cartilage?
Donor rib cartilage is processed costal cartilage obtained from donated human tissue and prepared for surgical grafting. It can provide strong structural material without requiring cartilage to be harvested from the patient's own chest.
Is donor rib safe for revision rhinoplasty?
Published evidence suggests low rates of infection and warping for appropriately processed donor costal cartilage, although no graft material is risk-free and longer-term comparative evidence continues to develop. The risks and benefits should be considered for each patient individually.
Why use donor rib instead of my own rib?
Using donor rib avoids an additional chest incision, chest scar and donor-site discomfort. Autologous rib remains an excellent graft source and may be preferred in some circumstances. The choice depends on the reconstruction required and the individual patient.
Can ear cartilage be used instead?
Yes. Ear cartilage is very useful for some types of reconstruction, particularly where softer curved cartilage is helpful. It does not provide the same quantity or straight structural strength as rib cartilage.
Can revision rhinoplasty fix an over-reduced nose?
Often, significant improvement is possible.
An over-reduced nose may require cartilage grafting to restore the bridge, middle vault, nasal valves or tip. The achievable result depends upon the remaining anatomy, skin and scar tissue.
Can a pinched nose be corrected?
A pinched appearance caused by loss of cartilage support can often be improved by rebuilding the weakened structures. If nasal valve narrowing is also present, reconstruction may improve both appearance and breathing.
Can revision rhinoplasty improve my breathing?
Yes, if the breathing problem is caused by a correctable structural abnormality such as septal deviation, internal nasal valve narrowing or lateral-wall collapse. Functional assessment is therefore an important part of revision planning.
Can nasal valve collapse happen after rhinoplasty?
Yes. Removal or weakening of structures supporting the middle vault or nostril can contribute to nasal valve narrowing or collapse. It may present as obstruction, particularly during inspiration.
Can Piezo be used during revision rhinoplasty?
Yes. Piezo ultrasonic instrumentation can be particularly useful for precise bony correction, osteotomies and smoothing of irregular bone in previously operated noses.
Can dorsal preservation be used for revision surgery?
Occasionally. Classic dorsal preservation requires intact native dorsal anatomy, which may no longer be present after previous rhinoplasty. However, preservation principles can sometimes be incorporated as part of a hybrid reconstruction.
Will I have another scar?
Most complex revision rhinoplasty is performed using an open approach, which usually involves a small incision across the columella. This typically heals to a fine, inconspicuous scar, although all surgical scars are permanent and individual healing varies.
Is revision rhinoplasty more painful than primary rhinoplasty?
Not necessarily. Patients more commonly describe congestion and pressure than severe nasal pain. Recovery may be somewhat longer because of additional scar tissue and reconstruction. Harvesting a patient's own rib adds a separate chest donor site, whereas donor rib avoids this.
How long does revision rhinoplasty take to heal?
Most patients are socially presentable within approximately two weeks, but internal healing and swelling take considerably longer. The overall result becomes clearer over several months, while final refinement may take 12–18 months or longer in complex cases.
Can revision rhinoplasty achieve a perfect result?
No rhinoplasty can guarantee perfection.
Revision surgery aims for a meaningful improvement in appearance, structure and/or function. Previous scar tissue, altered anatomy, skin characteristics and loss of cartilage place limitations on what can safely and predictably be achieved.
What happens if I have had several previous rhinoplasties?
Multiple previous operations generally make reconstruction more complex because additional scar tissue develops and less native cartilage may remain. Rib cartilage and more extensive structural reconstruction may therefore be required.
Can revision rhinoplasty correct asymmetry?
Often, yes, although perfect symmetry cannot be guaranteed. All faces are naturally asymmetric and scar tissue, previous surgery and cartilage behaviour can limit complete correction.
How much does revision rhinoplasty cost with Mr Tim Biggs?
The current revision rhinoplasty package at Adnova Clinic is £13,000. This includes surgeon, anaesthetist, hospital costs, standard follow-up and provision for donor rib and fascia when required. If donor rib cartilage and fascia are not needed, approximately £1,500 is refunded. Current pricing should always be confirmed before surgery.
Where is revision rhinoplasty performed?
My cosmetic and revision rhinoplasty surgery is performed at Adnova Clinic in Fareham, Hampshire.
How do I know whether another operation is worth considering?
The first question is whether there is an identifiable problem that can realistically be improved.
A detailed examination should identify what is causing the concern, whether surgery can address it safely and what limitations previous surgery creates. A good revision consultation should sometimes conclude that further surgery is not in the patient's best interests.
References
Abbas OL. Revision rhinoplasty: measurement of patient-reported outcomes and analysis of predictive factors. SpringerPlus. 2016;5:1472. doi:10.1186/s40064-016-3166-5.
Primary and Revision Rhinoplasty: A Single Surgeon Experience and Patient Satisfaction. Plastic and Reconstructive Surgery Global Open. 2021. The study compared characteristics and patient-reported outcomes in primary and revision rhinoplasty patients.
Frozen Cadaveric Rib Grafts in Primary or Revision Rhinoplasty: A Systematic Review and Meta-analysis. Plastic and Reconstructive Surgery Global Open. 2025. The review evaluated complications including warping, infection, resorption and further revision following fresh-frozen costal cartilage grafting.
Rib Grafts in Rhinoplasty: A Systematic Review and Meta-analysis of Autologous, Fresh-frozen, and Irradiated Cartilage. Plastic and Reconstructive Surgery Global Open. 2026. The review included 25 studies and 2,322 patients and reported low pooled infection and warping rates across graft types, while highlighting heterogeneity and the need for higher-quality comparative evidence.
Clinical Outcomes of Rib Graft Use in Rhinoplasty: A Meta-analysis. 2025. The review examined structural stability, complications and outcomes associated with costal cartilage grafting in complex primary and revision rhinoplasty.
About the author
Mr Tim Biggs, PhD, FRCS (ORL-HNS) is a Consultant Rhinologist and Facial Plastic Surgeon specialising in cosmetic rhinoplasty, functional septorhinoplasty and revision nasal surgery.
He completed advanced fellowship training in rhinology and facial plastic surgery and is Royal College of Surgeons Board Certified in Cosmetic Nasal Surgery.
His revision practice includes structural reconstruction, nasal valve surgery, donor rib cartilage, fascia grafting and Piezo ultrasonic rhinoplasty.
Cosmetic and revision rhinoplasty surgery is undertaken at Adnova Clinic, Fareham, Hampshire.
Private Secretary:
Natasha ReadEmail: timbiggssec@adnovaclinic.com
Telephone: 01489 663273
Website: www.timbiggs.co.uk
