Reported cases of revision surgery requests in rhinoplasty, and the factors causing dissatisfaction
According to reports, cases seeking revision surgery after rhinoplasty are said to reach about 23%.
- The background behind requests for revision surgery
- The top 5 reasons for "dissatisfaction" common in research reports
- Changes that can occur after surgery (over time)
- Risks to keep in mind in terms of both appearance and function
Many people feel anxious that the results of rhinoplasty may not turn out as ideal. Here we explain in detail a perspective based on medical data.
What does "dissatisfaction" refer to? The background of revision
The figure of about 23% requesting revision surgery comes from a study published in Plastic and Reconstructive Surgery in 2018 (n=400, targeting rhinoplasty patients in the U.S.), shown as 92 out of 400. Note that this is the result of a single study, and the percentage may vary depending on the target population, procedure, and evaluation method.
Because "dissatisfaction" in cosmetic medicine tends to be influenced by patient subjectivity, this article treats "the desire for revision surgery" as one indicator.
Furthermore, it has been reported that patients seeking revision have undergone an average of about two prior procedures.
The top 5 causes of unsatisfactory rhinoplasty results shown by research
We present results derived from research data, which differ from anecdotes on the internet and social media. It has become clear that the types of concerns differ between those who underwent a first surgery and those seeking revision. The top 5 main reasons for dissatisfaction identified are as follows.
No. 1: Crookedness and asymmetry of the nose (38%)
A common reason for revision is crookedness or asymmetry of the bridge or tip. There are many cases where asymmetry becomes more conspicuous as a result of surgery.
Cases have been reported where, due to distortion of the septal cartilage or scar contraction, the issue begins to bother patients over time.
*These percentages are based on a study published in Aesthetic Surgery Journal in 2015 (n=500, multiple answers allowed), surveying the main reasons for dissatisfaction among those seeking revision in a multiple-choice format. That is why the total exceeds 100%.
No. 2: Functional impairment such as nasal congestion (36%)
Beyond appearance, the functional problem of "difficulty breathing" is also a major factor. Narrowing of the nasal valve is cited as the main cause.
If only beauty is pursued, insufficient consideration for function can cause nasal congestion, which may also become prolonged.
No. 3: Roundness of the nasal tip (33%)
There are persistent voices that the resolution of the "bulbous nose" is insufficient. Due to skin thickness or insufficient cartilage strength, roundness can reappear without appropriate revision.
No. 4: Size of the nose (25%)
These are cases where the nose feels too prominent. This may be due to a reduction procedure that does not consider overall facial balance, or to post-operative swelling.
No. 5: Asymmetry of the nasal tip (22%)
Left-right differences in the nasal tip after surgery are also a common concern among those seeking revision. Post-operative adhesions or misalignment of cartilage sutures are contributing factors.
The reality of change — the nasal profile after surgery
It's commonly assumed that "once the swelling subsides one month after surgery, it's complete," but in reality this is where the change begins.
It has been reported that the height of the nasal tip may decrease over the course of recovery.
Through the disappearance of tissue swelling and scar contraction over several months to several years, the nose steadily changes. Feeling that "the shape changed after six months" may be part of a natural tissue change.
The importance of overall facial balance
Harmony with the face is more important than "how many millimeters higher will make it beautiful."
As for the width of the nostrils, while there are general aesthetic guidelines, the differences due to each individual's features must be fully taken into account.
Not just "making it higher" or "making it smaller"—if overall facial balance is not emphasized, the result can be unnatural.
Considerations and risks
Surgery carries risks such as relapse and deformity, so building a sturdy foundation is important.
For example, forming a solid foundation using ear cartilage or costal cartilage is an indispensable process for achieving post-operative stability.
If you're wondering, "What about my case?"
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Summary of key points and consultation guidance
- Put into concrete words "where dissatisfaction is likely" before consulting (crookedness / nasal congestion / roundness of the tip, etc.).
- Check not only appearance but also ease of breathing (nasal congestion / nasal valve) at the same time.
- Since the shape can change over time after surgery, record and evaluate "when, what, and to what degree" it changed.
- If you are considering revision, bring materials that can share the details of your previous surgery (procedure, graft material, course of recovery).
If you have any details or concerns about rhinoplasty, please consult a specialist. Our clinic provides consultations grounded in scientific evidence.
References
- Rohrich R, Malafa M, Ahmad J, et al. Managing Alar Flare in Rhinoplasty. Plastic & Reconstructive Surgery. 2017 (DOI)
About the author
Tetsu Shaku Physician
Chairman, SUNSET Medical Corporation — Zetith Beauty Clinic Ginza, Osaka, Fukuoka
He specializes in rhinoplasty grounded in anatomical evidence, with an annual case volume among the top in the industry. He is known for procedure designs that emphasize structural support and an approach that pursues long-term stability.