A revision rhinoplasty is an operation on a nose that has already been operated on. Patients come because the shape did not turn out as hoped, because a good early result changed as swelling went down, or because breathing became worse. Many of them are anxious, having already been through one recovery, and the first job of the consultation is a calm and honest assessment of what can realistically be improved.
Revision is more complex than a first rhinoplasty. Scar tissue has replaced the natural planes between skin and cartilage, some cartilage has usually been removed, and the skin may be thinner or tethered. This is why Dr. Teker treats revision as a reconstruction rather than a refinement. The first question is what has to be put back, before any tissue is taken away.
Common reasons for revision
Over-reduction. Too much of the bridge or tip was removed, leaving a scooped profile, a pinched tip or a nose that looks too short.
Under-correction. A hump or a wide bridge is still visible, or an asymmetry remains.
Loss of support. The tip has dropped, the side walls collapse when you breathe in, or a visible step known as an inverted V has appeared on the bridge.
Pollybeak. Fullness above the tip that makes the profile look convex, caused by scar tissue or a residual hump.
Breathing problems. Narrowing of the internal valve after the bridge was lowered.
Why grafts matter
Almost every revision needs cartilage. It restores the height of the bridge, supports the tip and holds the nasal valves open. The patient’s own tissue is usually used: the septum first, ear cartilage for small and flexible grafts, and rib cartilage when a strong straight framework has to be rebuilt. Rib is taken through a short incision that usually heals to a fine line.
Timing and expectations
Dr. Teker prefers to wait at least a year after the previous operation. Swelling in the tip continues to change for that long, and operating on a nose that is still settling means chasing a moving target. At the consultation you will hear a clear opinion, including when a revision is unlikely to help; some noses are better left alone, and saying so is part of the job.
Recovery is slightly longer than after a first operation and swelling lasts longer, but the aim is the same as for any rhinoplasty: a nose that suits your face and breathes well.