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wasperformed FacialSurgery.com
Steven M. Denenberg, M.D.
Dr. Denenberg's articles on Medium.com.


Should I have the same doctor perform my revision rhinoplasty?

The short answer: probably not.

The long answer: it depends.  Rhinoplasty is by far the most difficult of the facial plastic surgery operations.  Few plastic surgeons are expert at rhinoplasty; most are mediocre at best.  If your rhinoplasty didn't turn out at all how you expected it, and you suspect that your surgeon was not expert at the operation, then you should not have him perform the revision.  A revision operation is even far more difficult than a first-time, or primary, rhinoplasty, and if your surgeon didn't have the skill to get the nose right in the first operation, he will be completely lost during the second procedure.  You will wind up looking for a third operation, which is much harder yet than a second operation.  You're digging a deeper and deeper hole.

On the other hand, a rhinoplasty never goes perfectly all of the time in even the most expert of hands, so patients of the very best doctors sometime require a revision rhinoplasty.  If you did excellent research on your doctor and know him to be highly competent to perform a rhinoplasty (follow this link for directions on how to find a competent surgeon), and the problem with your nose after surgery is a well-defined, isolated problem, then you are probably safe having him perform your revision.

There are monetary motivations and dangers that can push you toward having your original surgeon perform your revision rhinoplasty, even if you know he's not the right one.  When a surgeon revises a nose that he operated on originally, it is typical for him to greatly reduce or completely waive his surgical fee, and you'll pay only for the operating facility expenses.  If you have another surgeon perform your revision, however, you are a new patient to him, presenting with a much more difficult problem than you had before your first operation, so your revision in his office will probably be more expensive than your primary rhinoplasty.  Still, you must think long and hard before allowing the mediocre surgeon to perform your revision at a greatly reduced rate; you may well wind up in more trouble.  That's no bargain.

In any case, you should have a blunt and open discussion with your doctor about what you notice and what you would like to have changed.  That discussion can help you figure out if you should allow your surgeon to perform the revision or if you should seek more opinions.

Note that, even if your doctor is an expert rhinoplasty surgeon, he might not be able to make the corrections that you are seeking.  See the FAQ on What can be improved during a revision rhinoplasty for more information.

For those of you who can stomach looking at photographs taken during surgery, the Rhinoplasty Tutorial's chapter on Revision Rhinoplasty will give you a much better idea of why the revision is so more difficult than a primary rhinoplasty. 

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