Revision Rhinoplasty


Get your ‘Botched’ nose job fixed

Rhinoplasty is a commonly performed, but difficult operation because the nose must not only look good, but also function for breathing and smell. Unfortunately, the results don’t always turn out the way they were planned. Most people inquire about revision rhinoplasty for one of two issues: “My nose doesn’t look good” or “I can’t breathe through my nose.” This can be frustrating as you already underwent a nose surgery, but there is hope for patients unhappy with their previous rhinoplasty result to get the nose they want. Dr. Compton is highly qualified and experienced in complicated revision rhinoplasty cases. Don’t let his young face fool you, he has performed thousands of nasal surgeries and specializes in complex and revision rhinoplasty for both appearance and breathing issues.

Ideal Candidates for Revision Rhinoplasty

Revision rhinoplasty surgery is ideal for patients who are not satisfied with the results of their primary rhinoplasty procedure. Patients who have trouble breathing or are currently experiencing nasal functionality issues after their primary rhinoplasty are also excellent candidates for revision rhinoplasty.

Full recovery from primary rhinoplasty must be complete before patients can consider a revision procedure. The best candidates are in good overall health with no post-surgery healing issues. Candidates must carefully consider their decision before coming in for a consultation for a revision rhinoplasty surgery.

Your Consultation

Dr. Compton will ask you about your goals for revision rhinoplasty surgery. He will examine your nose thoroughly to get an accurate diagnosis about its current condition. He will look over your medical history, including the records of your previous rhinoplasty procedure.

Dr. Compton will create a personalized surgical plan according to your aesthetic goals. He will discuss the entire surgical plan with you. This may include grafts to secure the structural support for your nose. He will make sure to address any concerns you may have.

Part of the consultation will be providing you with instructions regarding the necessary arrangements you will need to make before your revision rhinoplasty surgery. The cost of the procedure will also be discussed. A surgery date will be scheduled.

“He fixed my septum and now I can finally breathe!”

Dr. Compton is an amazing doctor and a true artist! I had a botched nose and went to him for a complex revision. He fixed my septum and now I can finally breathe! I had the surgery in June 2017, and now I’m 6 months out and I couldn’t be happier. I had done my research with many doctors…When I went on my first consultation I immediately felt comfortable that I had met the right doctor and I was in the right hands. He’s honest, meticulous, and cares about his work and the results. He gave me his 100 percent and he exceeded my expectations. He is genuine and truly an artist. So thankful for him. I wouldn’t trust anyone else!

– N.T.

Before & Afters


Before Rhinoplasty Photo


Revision Rhinoplasty Results

Many plastic surgeons have not had the extensive rhinoplasty training and experience that Dr. Compton does and it is this expertise that is vital to a successful revision rhinoplasty case. Just as important is finding a surgeon who will take the time to find out what your goals are and formulate your personalized surgery. It is normal to feel some anxiety about a revision rhinoplasty and Dr. Compton will take the time to ensure you feel comfortable and all your questions are answered. Dr. Compton provides all of his cosmetic surgery patients his email address for routine questions and his cell phone number to call in case of an emergency. He is a warm and caring doctor, who will ensure you are well taken care of, while pursuing the nose you were always meant to have.

Why did my Rhinoplasty Fail?

The nose is a complex three-dimensional structure that is in the very center of our face and therefore your identity. Each component of the nose has subtle curves and depressions that give the highlights and shadows that define the nose. Minor variations can create large aesthetic and functional differences. An experienced hand is required to correctly balance these structures. Poor rhinoplasty results can occur from a variety of things, some are surgical errors and some are the result of poor healing. Since the final result is a complex interplay between all of the structural components of the nose undergoing inflammation and scarring, occasionally irregularities arise during the healing process. Many times these minor issues can be corrected in the office with minimal discomfort under local anesthesia. Often though, poor results occur due to poor surgical techniques.

Your Revision Rhinoplasty will be performed by Dr. Andrew Compton at Royal Oak Beaumont Hospital, West Bloomfield surgery center or in his office in Troy.

Whether that was overly aggressive removal of cartilage or under correction of a pre-operative problem both can lead to similar dissatisfaction. If the problem was not adequately addressed in the first operation, then repeat surgery will need to be performed aimed at appropriately correcting that issue. This could range from a small incision inside the nose, to open rhinoplasty approach. The approach is less important than the final outcome being as good as possible. If the problem is from too much cartilage having been removed, a larger surgery will likely be required to correct the nasal deformity and breathing issues. Over-resection rhinoplasty (too much cartilage removed) generally results in an irregular appearing nose with a knobby tip, retracted nostrils, over-narrowing of the nose and nostril collapse. In this situation, Dr. Compton likes to use an open approach for structural grafting using your own cartilage.

Rib Graft, Ear Cartilage Graft

Dr Compton would prefer to use cartilage from the nose/ septum if available, but often times this has been removed previously. In this situation, Dr Compton prefers to borrow a 4-5 cm cartilage segment from one of your ribs to rebuild the nose, as it is a very strong material. For less structural problems, he will use the cartilage from your ear. In women, the rib is removed through a 3 cm incision under the breast, where your underwire sits. On gentlemen the incision is generally a little lower. A pain pump is then inserted to numb the chest wall for 72 hours which removes much of the pain from the process. When removed, most people comment that it only is sore when they cough.

The reason rib grafts are so useful is that rib cartilage is very strong and can be shaved very thin while still maintaining its strength. This allows it to be placed into the nose to strengthen it without adding excess bulk. As the larger piece of rib is cut into smaller pieces, some of the grafts are straight and some are curved. This natural curve works great to support the nostrils and the straight pieces for adding strength/ straightening the middle of the nose. Other pieces can be used to add height to the tip or bridge of the nose, tip definition or really any other application. It is very versatile. Dr. Compton always soaks the rib graft in an antibiotic solution as he is working on it to reduce the incidence of infection on the graft.

Use of this type of donor rib graft in the nose has been done for many decades is very well accepted as a safe method, with an excellent success rate. Many of the revision rhinoplasty patients pictured in the photo gallery have been corrected with this technique.

In select cases, Dr Compton may use a cadaveric donor rib graft. While this presents less pain for the patient, this graft has a higher rate of resorption and is technically more challenging to carve. Dr. Compton only uses donor grafts from the leader in this field, Musculoskeletal Transplant Foundation WWW.MTF.ORG. They only accept 3% of donors due to their very strict criteria and then thoroughly test and process the graft for blood-borne pathogens, including HIV, Hepatitis, and many others, most of which the general public has not even heard of.

How long does Revision Rhinoplasty take to heal?

Recovery from revision rhinoplasty will not necessarily be worse and the experience is often times better than the first surgery. Patients do tend to have a longer duration of recovery though due to the scar tissue present from the previous operation as well as the larger amount of work that is required. Initial bruising and swelling are similar to primary rhinoplasty with most patients able to return to work in 1 week with bruising resolving in 2 weeks. Swelling is improving by the end of the first week and is 80-90% gone by 1 month but the remaining swelling may take up to a year to gradually resolve. This process may be longer in multi-revision cases. Dr. Compton will follow up with you on multiple visits for at least 1 year after surgery then on an annual basis after that. These visits are all included in the surgical fee for most patients. It is important to monitor the healing process as it is occurring and intervene when at the appropriate time.

How Much Does Revision Rhinoplasty Cost? Is Revision Rhinoplasty covered by insurance?

Revision rhinoplasty cases are significantly more challenging than primary cases and require much more time and intensive techniques. Components of the nose that have been damaged or removed during the previous surgery need to be rebuilt with your own living tissues. Unfortunately, it is not safe to replace nasal structures with off the shelf parts like they do in a knee replacement. Collecting these tissues from other parts of the body and shaping them into functional components takes time. It is also significantly more challenging to rebuild useable pieces in the nose that are damaged. This kind of complex nasal reconstruction ranges from 5-10 hours of intense, meticulous, physically demanding operative time depending on how many parts of the nose require rebuilding. Because of this, and the fact that most patients don’t appreciate the incredible difficulty of reconstructing the nose, many surgeons refuse to do revision rhinoplasty. Revisions take 2-3 times longer than primary surgeries, are exceedingly more complex, and require a much higher level of expertise.

Revision rhinoplasty is considered cosmetic surgery by insurance companies, so the entire surgery will never be fully covered by insurance. There may be certain portions of the surgery that are covered, based on what problems need to be addressed and why. There will be out of pocket costs for the remainder of the surgery to cover the extra time and complexity required for revision cases. Depending on insurance, and the work required to rebuild your nose, the out of pocket cost could range from $5,000-$20,000. The most common out of pocket cost is around $9,000- $12,000. While this is a large expense, you must consider that the nose is a three dimensional, living sculpture in the center of your face that must be structurally sound for decades, withstand basic trauma, not change with scar formation, function well for breathing and sinus drainage but not be too big to look bad, and be shaped exactly right to within 1/2 mm. Each of the 1,000+ steps to these cases must be precise and exacting, but unique for each patient. Rhinoplasty is HARD!

Remember, all surgeons have different techniques and different results. Also every nose and face is unique, so often 1 technique works great for some and terrible on other patients. Each surgeon has their own techniques and aesthetic ideals. Review the before and after results of each surgeon and consider their surgical experience. Then consider the value of their surgery in conjunction with the monetary cost. You will find that more experienced surgeons with longer track records and better results, will cost more.

There is no such thing as a perfect nose, but there can be a huge difference between different surgeon’s results. Not all rhinoplasties are created equal. Dr Compton is a master at creating a well-balanced, aesthetic nose that breathes well and looks natural. Make this surgery your last and best nose surgery. As he says, “It’s just what I do.”

Schedule Your Appointment

If you are experiencing issues or are unhappy with your nose after rhinoplasty, contact Andrew Compton MD, ENT and Facial Plastic Surgery about revision rhinoplasty in Troy. Call 248.289.7300 to schedule an appointment today or provide your information to the right.

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