Revision Rhinoplasty - SM Plastic Surgery

There is no absolute limit, but with each operation the tissue grows more complex. Up to 2–3 revisions are generally held to be comparatively safe; beyond that, autologous tissue (rib cartilage) becomes essential. At SM Plastic Surgery, whether surgery is possible is judged after detailed assessment.

Swelling largely subsides within one to two weeks, and the natural shape of the nose settles over three to six months. A return to daily life is possible after about two weeks, and the final result can be seen at six months to a year. Recovery can take somewhat longer than after a primary rhinoplasty, though a stable long-term result can be expected where autologous tissue is used.

This is a phenomenon in which the capsule around a silicone implant thickens, the nose shortens and hardens, and the tip turns upward. It can occur from several months to several years after the implant is placed, and calls for removal of the implant and reconstruction with autologous tissue. SM Plastic Surgery specialises in revision for contracted noses using autologous rib cartilage.

The cost of revision rhinoplasty differs from person to person with the state left by the earlier surgery, the extent of reconstruction and the material used (autologous rib, septal or ear cartilage). SM Plastic Surgery sets out an accurate plan and cost after an in-person consultation. It is more demanding than a primary rhinoplasty, so the cost tends to be higher.

This method rebuilds the structure of the nose using cartilage harvested from your own rib. Its compatibility with the body is high and the risk of contracture low, so it is regarded as a material with good safety for repeated revision or a severely contracted nose. The harvest site is opened with a small incision, and the scar becomes almost invisible over time.

Stop smoking two weeks before surgery, and discontinue medicines that affect blood clotting such as aspirin and ibuprofen. Sleep well the night before and come in fasting on the day (8 hours for sedation; 12 hours where rib cartilage is harvested or general anaesthesia is used). Bringing a summary of your earlier surgery — the date, the materials used and the clinic — helps the consultation.

A primary rhinoplasty is the first operation; revision rhinoplasty corrects problems that arose after an earlier one. Revision must account for tissue that has already been altered, scarring and adhesion, so it is more demanding and often requires autologous tissue. For that reason it matters to have the surgery with a specialist experienced in revision.

Yes. After the implant is removed it can be replaced with autologous tissue, or left in its natural state if that is what you prefer. Where an implant has been in place for a long time, however, the surrounding tissue may have altered, so whether further correction is needed after removal is decided in consultation.

In most cases, surgery is performed through a columellar incision (under the nasal septum), and scarring in this area tends to become less visible over time. With an endonasal (closed) approach, only the inside of the nose is incised, so no visible skin incision is made. If autologous costal cartilage is harvested, a roughly 2cm incision is needed below the chest. The degree of scar healing varies by individual.

Yes. The records of the earlier surgery and the current state are evaluated together at examination, and a plan that suits is drawn up. Revision after surgery elsewhere is a core part of SM Plastic Surgery's practice.

We recommend waiting at least 6 months to 1 year after the earlier surgery; accurate correction is only possible once the tissue has settled. In urgent situations, however — infection, implant exposure, marked difficulty breathing — please consult at once.

It is performed under general anaesthesia or sedation. The method is decided by the extent of surgery and the expected duration, and general anaesthesia is used where rib cartilage is harvested. Blood tests and an ECG before anaesthesia confirm suitability.

It takes about 1.5 to 3.5 hours. This varies with the state left by the earlier surgery and the extent of reconstruction, and can run somewhat longer where rib cartilage is harvested. More important than the length of the operation is precise assessment and planning, and SM Plastic Surgery takes the time needed to operate accurately.

Using autologous tissue greatly reduces the risk of re-contracture. Compared with a silicone implant, autologous cartilage tends to form less capsule, and the long-term course is comparatively stable. Regular follow-up matters: at SM Plastic Surgery the course is checked in line with how recovery is progressing.

Yes. A combined operation corrects both the nasal obstruction from a deviated septum and the aesthetic problems of the earlier rhinoplasty. Functional correction (septoplasty) and aesthetic correction (revision) are handled in one operation, easing the burden.