Skip to content 
Revision Rhinoplasty: Complex Nose Surgery for Functional & Cosmetic Correction
Introduction to Revision Rhinoplasty
Revision rhinoplasty is widely considered the most complex and technically demanding form of nasal surgery. Unlike primary rhinoplasty, revision surgery must correct problems created by one or more prior operations while working with scar tissue, altered anatomy, and reduced structural support.
Common challenges in revision rhinoplasty include:
- Structural damage from previous surgery
- Significant internal scar tissue
- Unpredictable swelling and healing patterns
- Increased risk of infection
- Limited native cartilage
- The frequent need for advanced grafting techniques
Because of these factors, revision rhinoplasty requires exceptional surgical planning, experience, and precision.
Why Revision Rhinoplasty Is So Complex?
It is common in revision rhinoplasty to require additional donor materials due to terminal damage discovered during surgery. This damage may include:
- Loss or collapse of the caudal septum
- Severely damaged or absent tip cartilage
- Over-resection of the nasal bridge requiring full reconstruction
The more prior surgeries a patient has undergone, the more difficult and unpredictable revision rhinoplasty becomes. This is due to:
- Increased scar tissue burden
- Reduced blood supply to nasal tissues
- The need for more extensive and aggressive grafting
While perfection is never achievable in either primary or revision rhinoplasty, significant functional and cosmetic improvements are routinely accomplished by experienced surgeons
It can take 2-3 years to fully heal from a Primary Rhinoplasty (see Recovery), and often even longer for a Revision Rhinoplasty. Perfection is never achieved in Primary surgery, and certainly not in Revision surgery. However, major functional and cosmetic improvements are routinely accomplished.
How Revision Rhinoplasty Works
Revision rhinoplasty typically requires substantially more operative time and reconstruction than primary rhinoplasty.
-
Primary rhinoplasty: 2–4 hours
-
Revision rhinoplasty: 4–6+ hours
Due to depletion of septal cartilage from previous surgeries, rib cartilage grafting is required in approximately 95% of revision rhinoplasty cases.
Grafting Options
-
Autologous rib graft (patient’s own cartilage)
-
Fresh frozen cadaveric rib graft
Both options provide the strength and durability required for long-term structural support.
Rib Grafting in Revision Rhinoplasty
Dr. Ziad Katrib performs approximately:
- 120 revision rhinoplasty surgeries per year
- 115 rib graft harvests annually
Rib cartilage is harvested through a small (~18 mm) incision, typically placed about 4 cm below the right breast fold.
What to Expect from Rib Grafting
- Mild to moderate soreness lasting 1–4 weeks
- Temporary stiffness of the nose
- Strong, stable, long-lasting structural results
This technique allows for reliable reconstruction in severely damaged noses, which is critical in revision cases.
Scar Tissue Management
Scar tissue is present in all revision rhinoplasty cases and requires meticulous surgical technique.
The degree of scarring depends on:
- Individual genetic healing tendencies
- Number of previous nasal surgeries
Careful dissection and, when necessary, selective removal of scar tissue are essential to:
- Restore nasal airflow
- Improve symmetry
- Achieve durable aesthetic results
How The Recovery Works
Recovery After Revision Rhinoplasty
Recovery after revision rhinoplasty is longer and more variable than after primary rhinoplasty
Similar to Primary Rhinoplasty, internal nasal splints and an external splint are placed for 1 week. Upon removal, the nose is taped daily for 6+ weeks, depending on the degree of swelling.
Immediate Post-Operative Care
- Internal nasal splints + external splint for 1 week
- Daily nasal taping for 6+ weeks, depending on swelling
Scar Management
Steroid injections may be required in ~5% of revision cases if excess scar tissue develops
Infection Prevention
- Antibiotic ointment and nasal soaks twice daily for 2–3 months
- Oral antibiotics used in all cases
Follow-Up Schedule
Local patients:6 weeks, 4 months, 1 year, 2 years
Out-of-town patients:
In-person visits at 3 months and 1 year are strongly recommended
Because revision rhinoplasty continues to heal for an extended period, final results may take longer than primary rhinoplasty, often exceeding 2–3 years.