Refining Your Results with Revision Rhinoplasty
Revision rhinoplasty corrects issues from prior nose surgery, restoring balance, function, and confidence.
Restore Harmony, Confidence, and Function
A successful rhinoplasty should bring the nose into harmony with the face, enhancing both aesthetics and function. Unfortunately, not every procedure delivers the desired outcome. Whether you’re dealing with cosmetic concerns, structural complications, or both, revision rhinoplasty offers a second chance at results that reflect your vision.
Dr. Richard Balikian is highly regarded for his skill in secondary rhinoplasty, also known as revision rhinoplasty. As one of the most challenging procedures in plastic surgery, it requires advanced training, deep anatomical knowledge, and a refined surgical technique, all of which Dr. Balikian brings to each case.
Why Choose Revision Rhinoplasty?
You may be a candidate for revision rhinoplasty if you’ve experienced:
- An unnatural or overdone appearance from your initial surgery
- Persistent breathing problems or structural issues
- Asymmetry, deformities, or residual irregularities
- Changes to nasal function or appearance over time
Dr. Balikian’s approach is grounded in honesty, artistry, and deep facial expertise. His goal is simple: to help you look and feel more like yourself, with natural refinement and restored confidence.
Cosmetic Improvements
If your previous rhinoplasty left you with visible irregularities or results that don’t align with your goals, Dr. Balikian uses advanced aesthetic techniques to restore facial harmony. These may include:
- Refining a bulbous or drooping nasal tip
- Correcting asymmetry or irregular contours
- Reducing or reshaping a dorsal hump
- Adjusting nostril size or flare
- Rebuilding nasal structure using cartilage grafts for support and definition
With an artistic eye and deep understanding of facial balance, Dr. Balikian focuses on creating results that look natural, refined, and uniquely suited to your features, so you still look like yourself, just better.
Functional Improvements
If your previous rhinoplasty has caused or failed to resolve breathing issues, Dr. Balikian applies functional rhinoplasty techniques to improve airflow. These may include:
- Septoplasty for a deviated septum
- Spreader grafts and strut grafts for internal or external valve collapse
- Turbinectomy for enlarged turbinates
By rebuilding the structural foundation of the nose, Dr. Balikian can often restore both appearance and breathing function in a single revision procedure.
Patient Transformations
The Revision Rhinoplasty Procedure
Revision rhinoplasty is a delicate and highly customized procedure that requires exceptional precision, especially when correcting issues caused by prior surgery. Each revision is different, depending on the patient’s nasal anatomy, previous surgical changes, and desired outcome.
Most revision rhinoplasty procedures are performed using the open rhinoplasty approach, which involves a small incision across the columella (the tissue between the nostrils). This provides Dr. Balikian full visibility and access to the underlying structures of the nose, allowing for more accurate correction of both cosmetic and functional concerns.
During the procedure, Dr. Balikian may:
- Remove scar tissue or irregular cartilage left from a previous surgery
- Reposition or reshape cartilage to create better structural support and improve nasal contour
- Use cartilage grafts from the septum, ear, or rib if needed to rebuild the nasal framework
- Address airway issues, such as collapsed nasal valves or a deviated septum, to restore proper breathing function
Because of the complexity involved, revision rhinoplasty typically takes longer than a primary nose surgery. However, under the hands of a double board-certified facial plastic surgeon like Dr. Balikian, patients can expect an advanced, carefully planned procedure with long-lasting results.
What to Expect After Revision Rhinoplasty
Your procedure is performed as an outpatient surgery. Dr. Balikian applies a nasal splint immediately after surgery to help your nose heal in the correct shape. Notably, he does not use nasal packing, making recovery significantly more comfortable than traditional methods.
Recovery Timeline:
- Swelling and bruising are normal and subside over several weeks
- Mild discomfort is easily managed with medication
- Strenuous activities should be avoided during the early healing period
- Results begin to emerge in a few months and refine for up to a year
To accelerate healing and improve comfort, Dr. Balikian may recommend medical-grade light therapy after surgery.
This noninvasive treatment uses specific wavelengths of light to support tissue repair, calm inflammation, and reduce the appearance of bruising and swelling. Sessions are quick, there is no downtime, and the treatment is painless.
Are You a Candidate for Revision Rhinoplasty?
Ideal candidates:
- Are in good physical health
- Have realistic expectations about what revision surgery can achieve
- Are seeking improvement in cosmetic results, nasal function, or both
- Understand that revision surgery may involve more complexity than the first operation
Dr. Balikian will help you determine whether revision rhinoplasty is the right path based on your goals, anatomy, and previous surgical history.
Your Revision Rhinoplasty Consultation
During your consultation, Dr. Balikian will:
- Examine your nose inside and out
- Review operative notes from your prior surgeon (if available)
- Use digital imaging to establish realistic goals
- Explain both endonasal (closed) and open approaches, typically favoring the open method for precise revisions
Dr. Balikian is experienced in correcting a wide range of issues, including a bulbous tip, wide bridge, asymmetry, collapsed valves, large nostrils, and more.
He also brings unique experience in ethnic rhinoplasty and works closely with patients to maintain their cultural identity, if desired.
Creating Your Surgical Plan
Revision rhinoplasty requires a customized, carefully planned approach. Dr. Balikian will:
- Diagnose cosmetic and functional concerns
- Develop a detailed surgical plan
- Determine whether cartilage grafts (ear or rib) are necessary to support the nasal structure
- Discuss expected outcomes, limitations, and the healing process
Each step is designed to correct prior mistakes while ensuring a beautiful, functional and balanced result.
Revision Rhinoplasty FAQs
How long should I wait before a revision?
Most patients wait 12 months after the first surgery. Swelling must settle and tissues must soften so the plan reflects your true baseline. Select functional problems may be addressed sooner on a case-by-case basis.
Why is revision rhinoplasty more complex?
Scar tissue, altered anatomy, and missing cartilage increase difficulty. The operation often requires structural grafting and meticulous release of scar to restore support and shape.
Can revision rhinoplasty improve my breathing?
Yes, functional problems can be treated during revision. Techniques may include septoplasty, spreader grafts for the internal valve, batten grafts for the external valve, and turbinate treatment as needed.
Can a polly-beak or inverted-V deformity be corrected?
Yes, these are common revision concerns. Smoothing the dorsum, restoring the middle vault with spreader grafts, and refining tip support can correct these shapes.
What grafts are used in revision rhinoplasty?
Your own cartilage is preferred. Septal cartilage is used when available. Ear cartilage works well for contour and soft support. Rib cartilage is chosen when stronger, larger grafts are required.
Will rib cartilage look or feel unnatural?
Rib provides strong structure and is shaped to match your framework. Techniques that minimize warp and careful contouring help it look and feel natural over time.
Where do grafts come from and what is donor site recovery like?
Ear cartilage is taken from a hidden incision behind the ear and rib cartilage from a small chest incision. Donor areas are sore for a short time and typically heal well.
I have thick skin and little definition. What are my options?
Stronger tip support and precise shaping help definition show through. Expect subtle, refined changes that respect your skin envelope.
Will 3D imaging be used for planning?
3D imaging is a helpful communication tool. It previews likely changes and sets shared goals, while the final outcome depends on healing and intraoperative findings.
What is the recovery timeline after a revision?
Plan similar early downtime with a longer refinement phase. Many patients return to desk work in about one week, resume light exercise at two weeks, and see swelling refine for 12 to 18 months, especially at the tip.
How painful is revision surgery?
Discomfort is usually mild to moderate and well controlled. Congestion and pressure are more common than sharp pain.
Is revision rhinoplasty covered by insurance?
Cosmetic changes are self-pay. Functional procedures such as septoplasty and valve repair may have coverage based on medical necessity and your plan.
Trust Your Face to a Facial Plastic Surgeon
Dr. Richard Balikian is a renowned facial plastic surgeon known for his dedication to patients throughout Southern California.
With more than two decades of experience and double board certification in Facial Plastic and Reconstructive Surgery and Otolaryngology – Head and Neck Surgery, he brings together surgical precision and an artist’s eye.
Dr. Balikian is among a select group of specialists whose advanced training is devoted entirely to procedures of the face and neck.
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The Balikian Experience
Patients choose Dr. Richard Balikian for precision facial procedures, personalized care and results that look naturally you.
Learn More About Facial Plastic Surgery
Richard V. Balikian, MD, FACS
Double Board-Certified Facial Plastic Surgeon
Balikian Facial Plastic Surgery: Richard V. Balikian, MD, FACS
Tyler Frew, MD
Board-Certified Plastic Surgeon