Revision Rhinoplasty in Delafield
A second chance to breathe and to balance.
Revision rhinoplasty is a secondary surgical procedure performed to correct or improve results from a prior rhinoplasty. It addresses residual cosmetic concerns, functional breathing problems, or new deformities that developed after the initial surgery. Revision rhinoplasty is typically more complex than primary rhinoplasty due to altered nasal anatomy, scar tissue, and potentially weakened or deficient cartilage.
At a Glance
- Approximately 5 to 15 percent of primary rhinoplasty patients undergo revision surgery[4]
- Revision rhinoplasty often requires cartilage grafting from the septum, ear, or rib to rebuild nasal structure[2]
- Patients are generally advised to wait at least 12 months after primary rhinoplasty before considering revision[3]
- The open surgical approach is more commonly used in revision cases to navigate scar tissue and altered anatomy[1]
Overview
Revision rhinoplasty applies to any patient who has previously undergone one or more rhinoplasty procedures and seeks improvement in the appearance or function of the nose. The procedure is considered one of the most challenging operations in facial plastic surgery because the surgeon must work within an altered anatomical environment where scar tissue, previous cartilage modifications, and compromised blood supply complicate both the surgical approach and the healing process.
Common reasons patients seek revision rhinoplasty include persistent cosmetic concerns such as a residual dorsal hump, pinched or asymmetric nasal tip, saddle nose deformity from excessive cartilage removal, and functional issues such as nasal obstruction or internal valve collapse. Approximately 5 to 15 percent of primary rhinoplasty patients undergo revision surgery, with the variation depending on surgical technique, patient population, and study methodology.
Revision rhinoplasty frequently requires cartilage grafting to rebuild structural support that was reduced or damaged during the prior surgery. Graft sources include the nasal septum (if sufficient cartilage remains), auricular (ear) cartilage, and in more complex cases, costal (rib) cartilage. The choice of graft material depends on the amount of structural reconstruction needed and the availability of donor cartilage.
Patients considering revision rhinoplasty are generally advised to wait at least 12 months after their primary procedure before pursuing revision. This allows residual swelling to resolve, scar tissue to mature, and the final result of the initial surgery to become apparent. The open approach is more commonly used in revision cases because it provides the direct visualization needed to navigate altered anatomy.
What to expect
- Comprehensive consultation including nasal analysis, review of prior surgical records, and discussion of patient goals and realistic expectations
- Preoperative assessment of residual nasal anatomy, airway function, skin quality, and available cartilage donor sites
- Administration of general anesthesia or intravenous sedation with local anesthesia
- Open approach incision across the columella to provide direct visualization of the nasal framework
- Careful elevation of the nasal skin through scar tissue while preserving blood supply
- Dissection and removal of scar tissue to expose the underlying cartilage and bone
- Assessment of remaining structural support and identification of deficiencies
- Harvesting of cartilage grafts from the septum, ear, or rib as needed
- Reconstruction and reshaping of the nasal framework using grafts, sutures, and repositioning techniques
- Closure of incisions, placement of internal splints, and application of an external nasal splint
How a revision rhinoplasty works
- The surgeon evaluates the nasal framework through a thorough preoperative assessment, identifying areas of cartilage loss, scar tissue, structural weakness, and remaining anatomical landmarks. Computer imaging or photography may be used to plan the surgical approach.
- An open approach is typically used, with an incision across the columella to provide full visualization of the altered nasal anatomy. The nasal skin is carefully elevated, navigating through scar tissue from the prior surgery while preserving the blood supply to the skin envelope.
- Scar tissue is meticulously dissected and removed to reveal the underlying cartilage and bone framework. The surgeon assesses what structural support remains and what needs to be rebuilt, trimmed, or repositioned.
- Cartilage grafts are harvested as needed from available donor sites. Septal cartilage is preferred when available; auricular (ear) cartilage is used when septal cartilage is insufficient; and costal (rib) cartilage is reserved for cases requiring substantial structural reconstruction.
- The nasal framework is rebuilt using a combination of grafting, suturing, and repositioning techniques. Common grafts include spreader grafts for internal valve support, tip grafts for projection and definition, and dorsal onlay grafts for contour correction.
- After reshaping is complete, the nasal skin is redraped over the reconstructed framework, incisions are closed, and an external nasal splint is applied for support during the initial healing period.
When it's recommended
- Residual dorsal hump or irregularity following primary rhinoplasty
- Pinched, asymmetric, or overly narrowed nasal tip
- Saddle nose deformity from excessive cartilage removal
- Nasal obstruction or breathing difficulty caused by internal structural changes
- Pollybeak deformity (fullness or convexity of the supratip area)
- Inverted V deformity from disrupted upper lateral cartilage attachments
- Nasal valve collapse causing airway restriction
- Asymmetry or crookedness that persists or developed after primary surgery
- Visible grafts, implant displacement, or contour irregularities
- Combined aesthetic and functional concerns from a prior rhinoplasty
Is a revision rhinoplasty right for you?
Reach out to learn more from Dr. Lucas Boehm.
Concerns it addresses
Recovery & aftercare
- An external nasal splint is typically worn for 1 to 2 weeks after surgery
- Internal splints, if placed, are usually removed within the first week
- Swelling and bruising around the eyes generally resolve within 2 to 3 weeks
- Initial healing occurs over 2 to 4 weeks, during which strenuous activity is restricted
- Swelling in revision cases tends to persist longer than after primary rhinoplasty due to scar tissue and repeated tissue manipulation
- Most patients return to desk work within 1 to 2 weeks
- Strenuous exercise and contact sports should be avoided for at least 6 weeks
- The final nasal contour may take 12 to 18 months to fully refine, which is often longer than after primary rhinoplasty
Alternatives
- Nonsurgical rhinoplasty using injectable dermal fillers (for minor contour irregularities only; does not address structural or functional problems)
- Continued observation if the concern is residual swelling that may resolve with time
- Camouflage techniques such as filler injections to smooth minor contour irregularities
Related treatments
How much does a revision rhinoplasty cost?
A revision rhinoplasty at Consona with Dr. Boehm costs around $15,500. The exact amount depends on your unique goals and treatment needs. Schedule a consultation today to learn more and receive a personalized quote.
Frequently Asked Questions
- Revision rhinoplasty is a secondary surgical procedure performed to correct or improve results from a prior nose surgery. It can address cosmetic concerns such as residual asymmetry or a persistent bump, as well as functional problems like breathing difficulty that developed after the original procedure.
- Revision rhinoplasty is performed under general anesthesia or sedation, so patients do not feel pain during the procedure. Postoperative discomfort is typically described as pressure and congestion rather than sharp pain, and is manageable with prescribed medication. If rib cartilage harvesting is involved, the donor site may cause additional soreness for several days.
- Revision rhinoplasty is generally considered safe when performed by an experienced, board-certified surgeon with specific expertise in revision cases. Because it involves operating through previously altered tissue, selecting a surgeon with revision rhinoplasty experience is particularly important.
- Most surgeons recommend waiting at least 12 months after the initial rhinoplasty before considering revision. This waiting period allows swelling to fully resolve, scar tissue to mature, and the final result of the first surgery to become apparent. Operating too early may lead to inaccurate assessment of what needs correction.
- During primary rhinoplasty, cartilage may be removed, weakened, or repositioned. Revision surgery often needs to rebuild or reinforce this structural framework. Graft sources include the nasal septum, ear cartilage, or rib cartilage, depending on how much reconstruction is needed and what donor material is available.
- Revision rhinoplasty may not be appropriate for individuals who have not waited at least 12 months since their last procedure, those with unrealistic expectations about what revision can achieve, patients with active infections, or individuals with medical conditions that increase surgical risk. A thorough evaluation during consultation helps determine candidacy.
Revision Rhinoplasty risks & candidacy
Who should avoid this
- Less than 12 months since the most recent rhinoplasty (final results are not yet apparent and swelling has not fully resolved)
- Body dysmorphic disorder or unrealistic expectations regarding surgical outcomes
- Active nasal or sinus infection
- Uncontrolled bleeding disorders or anticoagulant use without medical clearance
- Active cocaine use (causes mucosal inflammation and vascular compromise)
- Significant medical conditions that increase surgical risk (uncontrolled diabetes, severe cardiopulmonary disease)
- Poorly controlled psychiatric conditions (surgery should be deferred until stabilized)
- Active smoking (impairs tissue healing and increases risk of complications in revision cases)
Possible risks
- Increased scarring compared to primary rhinoplasty due to prior surgical trauma and scar tissue
- Skin irregularities or contour deformities, especially in thin-skinned patients
- Partial or complete graft resorption or displacement over time
- Nasal septal perforation
- Persistent or new breathing difficulty despite surgical correction
- Infection at the surgical site or cartilage graft donor site
- Asymmetry or aesthetic result that does not meet expectations
- Compromised blood supply to nasal skin, particularly in patients with multiple prior surgeries
- Donor site morbidity (ear cartilage harvest may cause temporary discomfort; rib cartilage harvest involves additional incision and recovery)
- Need for additional revision surgery (revision rhinoplasty carries a higher re-revision rate than primary rhinoplasty)
Your surgeon
Care that respects what makes you, you.
Dr. Lucas Boehm is a Wisconsin native, board-certified, fellowship-trained plastic surgeon and the founder of Consona Plastic Surgery and Aesthetics. His practice is dedicated exclusively to aesthetic surgery of the face, nose, breast, and body, with particular expertise in deep plane facelifts, rhinoplasty, and aesthetic breast surgery. He completed his undergraduate education at the University of Wisconsin–Madison, earned his medical degree from the Medical College of Wisconsin, and completed his plastic surgery residency there as well. He then pursued an Aesthetic Society-endorsed fellowship in aesthetic surgery under the mentorship of Dr. Bradley Calobrace in Louisville, Kentucky. Known for meticulous attention to detail, he approaches each case with precision and intention. His philosophy emphasizes harmony and balance – enhancing what is already beautiful while ensuring every change feels natural, thoughtful, and uniquely you.
- Board-certified
- Am. Board of Plastic Surgery
- Fellowship-trained
- Aesthetic surgery
- 12+ years
- In practice
Sources & references
This article draws on 5 sources, including peer-reviewed research, leading medical institutions.
Government & research
Medical institutions
Educational & general
Medically reviewed by Dr. Lucas Boehm, MD · Last reviewed: 2026-06-13