Revision Rhinoplasty Surgery

Most people who ask about a revision nose job describe one of a handful of problems. Often it’s more than one.

• Pinched tip; too much cartilage came out, and the tip now looks narrow and hard.
• Pollybeak; fullness just above the tip makes the nose look beaked in profile.
• Scooped or collapsed bridge; the bridge dips where the first surgeon took down too much.
• Leftover hump; part of the original hump still shows once the swelling has gone.
• Crooked result; the nose still leans, or now leans the other way.
• Blocked breathing; the airway narrowed after surgery, often at the nasal valve.
• Uneven nostrils; one nostril sits higher, wider or more notched than the other.
• Visible scar; the columella scar healed thick, wide or notched.

Is It Swelling or a Real Problem?

Plenty of patients book a revision consultation eight weeks after surgery, worried. Sometimes they’re right to worry. Often, though, what they see is swelling, and it will keep changing for months.

Dr. Sohrab looks for signs that separate the two. Swelling tends to sit evenly and soften with time, especially at the tip. A real structural issue, like a bridge that dips or a tip pulled to one side, usually shows early and stays put as the swelling drops. He also compares your current nose with photos from before the first operation, if you have them. That comparison often answers the question faster than anything else.

When to Book a Revision Rhinoplasty 

Timing matters more in revision than in almost any other facial surgery. The tissues need at least twelve months to settle after the first operation, and thick skin can take longer. Operating earlier means cutting through active scar tissue, which bleeds more and heals less predictably.

There are exceptions. A breathing problem that ruins your sleep, or an obvious structural collapse, may justify an earlier assessment. Even then, Dr. Sohrab would rather see you, record how the nose looks and plan ahead than rush you into theatre. An early consultation doesn’t commit you to anything, and you leave with a clear timeline.

Reconstructive Rhinoplasty for Breathing and Structure

Cosmetic concerns drive some revisions. Many others start with breathing. When a first surgery removes too much cartilage, the nose can lose the support that holds the airway open, and the sides of the nose may pull inward every time you breathe in.

Revision rhinoplasty rebuilds that support. Dr. Sohrab uses spreader grafts along the bridge to widen the internal valve, strut grafts to hold the tip up, and batten grafts where the sidewalls collapse. A good profile means little if you can’t breathe through it at night, so he plans shape and function together. Anyone with a breathing complaint has each side of the airway checked at consultation, before the conversation turns to looks.

Where the Replacement Cartilage Comes From

Revision cases often need new cartilage, because the first operation used up or removed what was there. Dr. Sohrab takes it from one of three places, depending on how much he needs.

Septal cartilage from inside the nose is the first choice, if enough remains. It’s straight, strong and needs no extra incision. Quite often, though, a previous surgeon already took it.

Ear cartilage comes next. He takes it from the bowl of the ear through a small cut behind it, and the ear keeps its shape. It’s softer and naturally curved, which suits the tip and nostril rims better than the bridge.

Rib cartilage gives the most material and the most strength. Dr. Sohrab uses it for major rebuilding, such as a collapsed bridge. The incision sits on the lower chest, usually hidden in the breast crease for women, and runs just a few centimetres.