Nose Surgery: Why it’s challenging for Rhinoplasty Surgeons to ‘get it right’ the first time

Rhinoplasty revision - fixing a botched nose job

Rhinoplasty is a popular surgery that can improve NOT only the look of your nose, but the entire appearance of your face.  Yet Revisional Rhinoplasty is not uncommon. Here’s why!

Why is it that Rhinoplasty Surgeons don’t ALWAYS get nose reshaping surgery right the first time?

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Nose reshaping is a very complex procedure. Did you know that there are about 25 sub procedures to a nose operation?

Some main variants of nose reshaping (Rhinoplasty) procedures include:

  • Reduction rhinoplasty, where the nose is made smaller.
  • Augmentation rhinoplasty, where the nose is made bigger.
  • Ethnic rhinoplasty (such as Asian Rhinoplasty), where specific features are addressed
  • Post-traumatic rhinoplasty, where an injury has occurred.
  • Revisional rhinoplasty, where prior nose surgery is corrected.


The right surgeon for a particular type of nose job

To optimise getting the results you want, the first time, you should also select a Surgeon with specific experience in performing the type of Rhinoplasty sub-procedure(s) that you want to have.  (Read more on selecting the right surgeon on our FAQ pages – our top Rhinoplasty expert is Dr Richard Sackelariou. You can also send an enquiry form, below, to request a downloadable copy of tips for differentiating between types of Surgeons).

Highly skilled Surgeons for Rhinoplasty or Revisional Rhinoplasty

Even the most skilled Plastic Surgeon is not able to predict with 100% certainty how a Rhinoplasty (nose job) will go – or how you’ll heal, as an individual.

Plus, no rhinoplasty result is ever completely perfect, just as no two sides of the face are perfectly symmetrical – there are excellent results in comparison to what you’re starting with (and want to change), but there’s just no such thing as an absolutely perfect nose job.

revision rhinoplasty

However, our highly accomplished surgical team use their advanced technical skills, artistic touch and extensive experience – including pre-surgery planning with Vectra 3D technology where warranted – to help you get your nose as close to ‘perfect’ for your facial balance as is possible by a Surgeon.

Our Nose Surgeons are meticulous and aim to get you the best possible results from your first Rhinoplasty

Without a meticulous Plastic Surgeon with extensive experience, however, a nose job will rarely go according to plan. That’s why choosing the most experienced Nose Reshaping Surgeon is so important, and why you’ll want to keep your expectations realistic.

Revisional rhinoplasty is sometimes necessary, however, even with the best surgical approaches for your nose reshaping procedure. 

Here are 3 reasons why rhinoplasty surgeons don’t always get it right the first time.

Reason 1: Some noses are unpredictable

A study by the published in the Pulsus Plastic Surgery Journal showed that there are some noses that could be classified as being “more difficult” or less difficult” in terms of predictability to how the nose will respond to rhinoplasty procedures.

If your nose is particularly challenging to reshape or correct, then it might be necessary for you to have Revisional Nose Surgery (a Revision Rhinoplasty) to get a more obvious result.  In this scenario, the Surgeon ends up crafting more defined contours, or modifying the nose in slight or more moderate ways, after you’ve healed from your FIRST surgery. You may also need to accept that there are certain limits to what can actually be achieved surgically (again, realistic expectations that take into account what you’re starting with, are very important to satisfying nose surgery results).

Reason 2: Your skin thickness impacts the end result of the nose surgery

The same study found that noses with very thick skin do not contract enough after certain types of nose reduction or reshaping surgery. This means that individuals with this type of skin, won’t necessarily be able to achieve much smaller noses.

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During your Rhinoplasty consultation, your Specialist Surgeon will aim to advise you if the desired effect you seek is possible from one nose surgery – or if it is likely that more than one nose surgery will be necessary to get you the results you’re after.

Reason 3: Operated noses heal differently

Patience is very important when it comes to seeing the end result of rhinoplasty surgery.

  • It typically takes a number of months for surgical swelling to go down
  • Rapid Recovery protocols can help, but you will want to be patient and to follow post-op healing instructions exactly
  • Be sure to have good support during the healing phrase, especially in the days or weeks immediately after your surgery
  • During the healing time, which can take months, the final appearance of your new nose won’t be entirely visible.
  • Be prepared to question yourself about having the surgery until you can fully see the final results (this can seem like a very long time)
  • After surgery, you may need to wait for several months to see if your surgeon was able to get it right the first time, or if a second rhinoplasty procedure is needed to get you your dream nose.

Select a Revision Specialist Surgeon the first time

It is extremely important to choose a fully-qualified Plastic Surgeon and nose reshaping specialist with extensive experience in Rhinoplasty procedures, to optimise your changes of getting the best possible results the FIRST time.  Whilst there’s still no guarantee as to how your face and nose will heal and respond to the surgery, you’ll at least know you’re in very capable, highly skilled hands with a specialist who is also sought after for their Revisional Rhinoplasty Surgery expertise.

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Your surgeon should be full trained, accredited and experienced, and it helps to know the difference between Cosmetic Surgeons or Plastic Surgeons and other types of practitioners performing surgery.

At our clinics, Dr Richard Sackelariou and Our Team of Surgeons are our leading Rhinoplasty Specialists.  They each have decades of experience and have successfully completed thousands of Plastic Surgery and Rhinoplasty procedures.

Are you interested in rhinoplasty? Please contact us using the form below. Or phone us during Clinic Hours on (03) 8849 1444 to learn more about the different nose surgeries offered by our expert Surgical team of fully-qualified Plastic Surgeons.

Visit our Downloadable Guides pages

For more information about Cosmetic and Plastic Surgery options and research in Australia.

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Download our free guides or phone (03) 8849 1444 today – and ask for a no-obligation consultation.

Last updated: 27/11/2019
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Dr Richard Sackelariou - MBBS, FRACS, FRCS
Dr Richard Sackelariou, MBBS, FRACS/FRCS, is a leading Sydney Specialist Plastic, Cosmetic & Reconstructive Surgeon who sees patients in two locations: Double Bay, Sydney and Melbourne VIC (Australia). Dr Sackelariou offers extensive experience in attaining natural-looking, excellent surgical results for patients of all ages. Graduate of Sydney University, FRACS, Plastic and Reconstructive Surgery plus additional training in Cosmetic Surgery in Paris at the Clinique Turin in 1994. BIO PAGE: Click here