Revision Rhinoplasty

Had a rhinoplasty and are not happy with the result? Breathing worse than before, a crooked nose, a drooping tip or a result that does not look natural? You are not alone, and in most cases there is a solution. Revision rhinoplasty, also called secondary rhinoplasty, is the surgery that corrects the result of a previous rhinoplasty.

At Clínica do Nariz e Face, around 40% of the rhinoplasties performed by Prof. Dr. Miguel Gonçalves Ferreira are revisions of surgeries carried out elsewhere. It is one of the areas the clinic is most sought after for, by patients from Porto, Braga, the whole of Portugal and abroad.

The most frequent reasons that bring patients to a revision consultation are:

• Difficulty breathing after the first surgery, due to nasal valve collapse, a still-deviated septum or excessive removal of structures.
• Crooked or asymmetric nose that was not corrected or has deviated again.
• A drooping, over-rotated or irregular tip.
• Irregularities on the bridge, a residual hump or, on the contrary, a saddle nose, sunken in the middle.
• An artificial result, an “operated” nose that does not suit the face.
• A result that fell short, where the change was too small or exaggerated.

The nose takes about a year to settle into its final result, especially at the tip. That is why, as a rule, revision rhinoplasty is done at least 12 months after the first surgery. Significant breathing problems may justify an earlier assessment. Even before that, the consultation is useful to understand what is going on and plan ahead.

In a revision, the surgeon works on a nose that has already been operated on: there is scar tissue, the skin may be thicker or thinner, and cartilage removed in the first surgery is often missing. That is why revision rhinoplasty requires more experience, more planning and, very often, cartilage grafts to rebuild the support of the nose.

At Clínica do Nariz e Face, primary rhinoplasties are performed with preservation techniques, which keep the natural structures of the nose. In revisions, where those structures have already been altered, Prof. Dr. Miguel Gonçalves Ferreira uses structural techniques, which rebuild the support of the nose for a stable result and free breathing.

Revision rhinoplasty at Clínica do Nariz e Face is performed by Prof. Dr. Miguel Gonçalves Ferreira, a specialist in Otolaryngology, Head and Neck Surgery, with a subspecialty in Facial Plastic Surgery (Portuguese Medical Association no. 35109).

• He has been operating since 2001, has performed more than 9,000 rhinoplasties and currently performs between 200 and 300 a year.
• PhD from the University of Porto in 2020, with a thesis on rhinoplasty.
• Fellowship in New York, at the Manhattan Eye, Ear and Throat Hospital, in 2005.
• Creator of a nasal dorsum preservation technique, which he has taught to more than 100 surgeons from over 40 countries.
• More than 600 lectures at international facial plastic surgery congresses. Member of the EAFPS (European Academy of Facial Plastic Surgery) and of the RSE (Rhinoplasty Society of Europe).

As an ENT surgeon, he assesses the shape and the breathing of the nose in the same consultation, which is especially important in a revision. See the full career of Prof. Dr. Miguel Gonçalves Ferreira.

1. Conversation: what bothers you about the current result, what was done in the first surgery and what you would like to change. If you have the surgical report or photographs from before the first surgery, bring them.
2. Examination of the nose outside and inside: shape, skin, scars, tip support and breathing assessment.
3. Crisalix 3D simulation: the surgeon shows you, on a 3D model of your face, the result the surgery aims to achieve.
4. Surgical plan: what can be corrected, whether grafts are needed, what the limits are and the recovery time. The quote is presented once the plan is defined.

Read more about what the rhinoplasty consultation is like and about the Crisalix 3D simulation.

Revision rhinoplasty is performed under general anaesthesia, at Hospital da Luz Arrábida, in Vila Nova de Gaia, or at Hospital da Ordem de S. Francisco, in Porto. In most cases you go home the same day. When the bone needs reshaping, ultrasonic rhinoplastycan be used, which is more precise and causes less swelling. If breathing also needs correcting, it is done in the same surgery, in a septorhinoplasty.

Recovery is similar to that of a first rhinoplasty, but the swelling may take longer to subside, because the tissues have already been operated on. The final result settles over 12 to 18 months. See the evolution stage by stage in recovery week by week.

What is a revision rhinoplasty?

It is a rhinoplasty performed to correct the result of a previous rhinoplasty, for aesthetic reasons, breathing reasons or both. It is also called secondary rhinoplasty.

Can I have the revision with a different surgeon?

Yes. At Clínica do Nariz e Face, around 40% of rhinoplasties are revisions of surgeries performed elsewhere.

How long should I wait before a revision?

As a rule, at least 12 months after the first surgery, so the nose can settle. The consultation can take place earlier.

Can a revision improve breathing?

Yes. Correction of the septum, the nasal valves and the support of the nose can be done in the same surgery.

Is revision rhinoplasty more expensive?

The cost depends on the complexity of the case and is only defined after the consultation. We explain why in how much does rhinoplasty cost.

Can I have the consultation in Braga?

Yes. The consultation can take place at the Porto or Braga practice. Surgery is performed in the Porto area.

If you are not happy with your rhinoplasty, the first step is a consultation, with no obligation to have surgery. It can take place at our rhinoplasty in Porto or rhinoplasty in Braga. See real results in rhinoplasty before and after and in our clinical cases, or read more about rhinoplasty.

Book your consultation or contact us on WhatsApp.

This content is for information purposes only and does not replace a medical consultation. Results vary from person to person.