What if I’m not happy with my nose job?

Have you just gone in for rhinoplasty surgery, but haven’t ended up with the nose you’ve always dreamed of? Is your nose still swollen from the operation? Are you worried it all went wrong? We talked to top ENT surgeon and facial plastic surgery expert Mr Raj Lakhani, who answered a question asked by many patients: what if I’m not happy with my nose job?

Do I need to just wait?

It’s important to consider how recently you’ve had the rhinoplasty. Even up to eight weeks after surgery, there will be a significant amount of swelling as the tissues that have been operated on within the nose settle.

Over the first 6-8 weeks, you’ll see some reduction in swelling, but this can take time. It can feel quite difficult immediately after rhinoplasty as the nasal swelling does affect the appearance of the nose, but don’t worry immediately! The initial result is rarely a reflection of what can be expected in 6-12 months!

Swelling can persist up to six months and even up to a year, particularly in the nasal tip region for certain skin types. People with very thin skin may well have some shape change up to a year after surgery, secondary to the reduction in swelling.

It is very important to have selected a well-trained and suitably qualified rhinoplasty surgeon in the first instance, and they will provide you with this information from the outset. One of the most concerning things for patients is when they are not informed of this as a possible outcome after the surgery. Possible outcomes and potential recovery times should be discussed thoroughly before any rhinoplasty operation to ensure a smoother post-operative recovery.

It is important that you do report concerns to your rhinoplasty surgeon and get reviewed by them to ensure that the healing process is normal.

Can I get a second medical opinion?

First, I would recommend revisiting your primary rhinoplasty surgeon (the surgeon who did your first surgery) to discuss the outcome and potentially review post-surgery pictures with those from before the surgery and try and highlight any concerns you have.

A second opinion can be very helpful in patients who are unhappy with their primary surgery and if you are considering a revision rhinoplasty, then it would be sensible to consider opinions from other doctors for anything other than minor refinement.

How does revision rhinoplasty work?

Before anything else, anyone considering revision rhinoplasty surgery should carefully consider what they are unhappy with about their nose.

It’s very useful to:

• Draw up a list of concerns about your nose and an idea of what your ideal result would be.
• Bring examples of the nose that they would like to achieve, e.g. photos of other people or celebrities.
• Research carefully and potentially get two or three opinions prior to undergoing revision surgery as this will be a technically more challenging procedure and have slightly higher risk associated with it.

It is imperative to have realistic and achievable goals for revision rhinoplasty. This is where your initial preparation is important, as your surgeon will be able to guide you as to whether the result you’d like is really achievable.

How can I avoid being disappointed again?

My main advice would be:

• Ensure you have a clear understanding of what you are unhappy about regarding your nose.
• Make sure you have considered two or three second opinions prior to deciding to undergo surgery again as they can be very valuable.
• Select a surgeon you have a good relationship with AND is also experienced and well-trained in rhinoplasty and revision rhinoplasty – they should be able to give you an honest, realistic, and achievable opinion regarding the result that can be obtained using revision rhinoplasty.