Revision Rhinoplasty: What to Expect and When It’s Worth Considering
- mrtimbiggs4
- 4 days ago
- 2 min read
Rhinoplasty is one of the most complex operations in facial surgery. Even in skilled hands, healing can be unpredictable and in a small percentage of cases, patients may not achieve the breathing or cosmetic results they hoped for. This is where revision rhinoplasty (or revision septorhinoplasty) becomes an important option.
As a Consultant ENT & Rhinology Surgeon specialising in functional and cosmetic rhinoplasty in Portsmouth, Fareham and Hampshire, I regularly see patients seeking expert evaluation after previous surgery. Revision rhinoplasty is more challenging, but with proper assessment and realistic goals, it can significantly improve both breathing and appearance.
Why Do Some Patients Consider Revision Rhinoplasty?
There are several reasons a patient may explore revision rhinoplasty, including:
1️⃣ Persistent Breathing Problems
Even after a primary rhinoplasty or septoplasty, the nasal valves may remain weak, the septum may still deviate, or scar tissue may restrict airflow.
2️⃣ Residual Crookedness or Asymmetry
A nose that heals unevenly, drifts off-centre or retains its pre-operative deviation often requires revision.
3️⃣ Over-resection or Collapse
Older rhinoplasty techniques sometimes removed too much cartilage or bone, leading to:
Scooped bridge
Pinched tip
Collapse on breathing
Internal or external valve failure
4️⃣ Unpredictable Healing
Even with excellent surgery, the nose can change during healing — cartilage can warp, swelling can distort the shape, or scar tissue can tighten.
5️⃣ Cosmetic Dissatisfaction
Some patients simply find that the final shape doesn’t match their goals, even if the surgery was technically sound.
What Makes Revision Rhinoplasty More Complex?
Revision surgery is more intricate than primary surgery because:
Scar tissue makes dissection more difficult
Cartilage may be missing or weakened, requiring grafts
Support structures may have been altered or removed
The anatomy may no longer be predictable
This is why revision rhinoplasty should be undertaken by a surgeon with subspecialty rhinology and facial plastic training, comfortable with grafting, reconstruction, and advanced techniques.
At Adnova Clinic, I often use:
Piezo ultrasonic instrumentation for precision reshaping
Dorsal preservation principles where possible
Rib grafts, including donor rib cartilage, for reconstruction when needed
Structural methods to stabilise the valve and septum
When Is Revision Rhinoplasty Worth Considering?
It may be appropriate when:
You’re at least 12 months post-primary rhinoplasty (to allow full healing)
Breathing is still poor despite medical therapy
The nose collapses on inspiration
Cosmetic concerns affect confidence
There is visible asymmetry or deviation
Your surgeon has explained realistic improvements are possible
Revision rhinoplasty is not about perfection — it’s about meaningful, achievable improvement.
What to Expect From a Consultation
A thorough revision assessment includes:
Detailed history of previous surgery
Examination of external shape, internal airflow and valve stability
Discussion of realistic goals
High-resolution photography
Sometimes CT scanning (for airflow or sinus anatomy)
Every revision plan is unique and tailored to your anatomy and expectations.
Summary
Revision rhinoplasty is a specialised procedure designed to correct persistent breathing problems or cosmetic concerns after previous nasal surgery. With advanced techniques and a careful structural approach, it can restore balance, function, and confidence.
For expert revision rhinoplasty in Portsmouth, Fareham, Winchester and Hampshire, consultations are available with Mr Tim Biggs — Consultant ENT & Rhinology Surgeon at Adnova Clinic.
To enquire or book an assessment:
📍 Adnova Clinic
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