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 is surgery for someone who has undergone one or more prior rhinoplasty procedures and wants to improve the appearance or function of the nose. It is considered one of the most challenging operations in facial plastic surgery. Scar tissue, previous cartilage changes, and a potentially compromised blood supply create an altered anatomical setting that complicates the surgical approach and healing.
Reasons for revision include a residual dorsal hump, a pinched or asymmetric nasal tip, saddle nose deformity after excessive cartilage removal, nasal obstruction, and internal valve collapse. Approximately 5 to 15 percent of primary rhinoplasty patients undergo revision surgery, although the figure varies by surgical technique, patient population, and study methodology.
Revision often requires cartilage grafting to restore support reduced or damaged during the first operation. Septal cartilage may be used if enough remains. Auricular cartilage comes from the ear, while costal cartilage from the rib is used in more complex cases. The amount of reconstruction required and the cartilage still available determine the graft source.
Patients are generally advised to wait at least 12 months after primary rhinoplasty before pursuing revision. That interval allows residual swelling to resolve, scar tissue to mature, and the result of the first procedure to become apparent. An open approach is used more commonly in revision cases because it provides direct visualization of the altered anatomy.
Dr. Boehm’s stated nasal specialty includes primary, ethnic, and revision rhinoplasty. Revision also has a separate Consona treatment page and price rather than appearing as a footnote to primary surgery. Correcting another surgeon’s result is a different operation with a different starting point, and some surgeons do not accept these cases.
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
- Preoperative assessment maps the remaining nasal framework, including cartilage loss, scar tissue, structural weakness, and anatomical landmarks that remain after the earlier procedure. Computer imaging or photography may also be used to plan the operation.
- Revision rhinoplasty typically uses an open approach, with an incision across the columella for full visualization of the altered anatomy. The nasal skin is carefully elevated through tissue affected by the prior operation while its blood supply is preserved.
- Scar tissue is meticulously dissected and removed to expose the cartilage and bone beneath it. The surgeon then determines which support remains and which areas need to be rebuilt, trimmed, or repositioned.
- Cartilage is harvested when grafting is needed. Septal cartilage is preferred when enough remains. Ear cartilage is used when septal cartilage is insufficient, while rib cartilage is reserved for cases that require substantial structural reconstruction.
- The framework is rebuilt through grafting, suturing, and repositioning. Spreader grafts support the internal nasal valve, tip grafts adjust projection and definition, and dorsal onlay grafts correct contour.
- Once reshaping is complete, the nasal skin is redraped over the reconstructed framework. The incisions are closed, and an external nasal splint is applied for support during initial healing.
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 operation intended to correct or improve the result of an earlier nose surgery. It may address cosmetic concerns such as residual asymmetry or a persistent bump, functional problems such as breathing difficulty that developed after the original procedure, or both.
- Revision rhinoplasty is performed under general anesthesia or sedation, so patients do not feel pain during the procedure. Afterward, discomfort is typically described as pressure and congestion rather than sharp pain and is manageable with prescribed medication. When rib cartilage is harvested, the donor site may remain sore for several days.
- Revision rhinoplasty is generally considered safe when performed by an experienced, board-certified surgeon with specific experience in revision cases. Because the operation passes through tissue altered by prior surgery, the surgeon’s revision rhinoplasty experience is particularly important.
- Most surgeons recommend waiting at least 12 months after the initial rhinoplasty. This gives swelling time to fully resolve, allows scar tissue to mature, and reveals the final result of the first operation. Surgery performed too early may be based on an inaccurate assessment of what needs correction.
- Cartilage may have been removed, weakened, or repositioned during primary rhinoplasty. Revision surgery often requires grafts to rebuild or reinforce that framework. Cartilage may come from the nasal septum, ear, or rib, depending on the amount of reconstruction needed and the donor material available.
- Revision rhinoplasty may not be appropriate when fewer than 12 months have passed since the most recent procedure, when expectations exceed what revision can achieve, or when there is an active infection or a medical condition that increases surgical risk. Candidacy is determined through a thorough evaluation.
- Yes. Revision is part of Dr. Boehm’s stated nasal specialty alongside primary and ethnic rhinoplasty, and it is listed at Consona as a distinct procedure with its own consultation and price. Whether he can improve a particular nose depends on how much cartilage remains, how the tissue has healed, and how far the requested result is from the anatomy as it now exists. That determination requires an examination rather than a phone call.
- Bring the operative report from the first surgery, if it is available, along with photographs taken prior to that procedure. These records matter more in a revision consultation than in a primary one. The report documents what was removed, what remained, and whether grafts were used, which narrows the surgical plan. Earlier photographs show the nose’s original structure. If neither is available, the assessment can still proceed, with more of it based on examination and imaging.
- The $15,500 figure on this page is a ballpark cost. It is higher than the price of primary rhinoplasty because revision is a longer, more technically demanding operation. The amount of rebuilding affects the final fee: using remaining septal cartilage is different from harvesting cartilage from the ear or rib, and the graft source is not known until the nose has been assessed. For qualified borrowers, the surgical fee can be divided into 12 monthly payments with no interest.
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: 2026-09-12