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Sieber Plastic Surgery San Francisco

Revision (Secondary) Rhinoplasty: Are You a Candidate?

Revision rhinoplasty or secondary rhinoplasty is performed for many reasons. Some patients undergo an initial rhinoplasty and even after full recovery, they are simply unhappy with the results. It’s even possible for those features the patient is unhappy with to not develop until several years after surgery — at which point they seek a secondary procedure. Other patients have more pressing issues after primary rhinoplasty, such as problems with their breathing.

Whatever your reason for seeking more information about revision rhinoplasty, know that it is a technically demanding surgery that requires a fully competent and experienced plastic surgeon to perform. Fortunately, Dr. David Sieber is one of the most well-known revision rhinoplasty surgeons in the San Francisco area. He completed his training under the best rhinoplasty experts in the world and has extensive experience successfully performing the procedure himself.

In this article, we’ll outline the basics of revision rhinoplasty and discuss whether you would be a good candidate for such a procedure.

What Is Revision Rhinoplasty and What Can It Correct?

Revision rhinoplasty is simply another term for a secondary nose job. The patient has already had one nose job (or sometimes more), and they are looking for additional changes.

Revision rhinoplasty can correct any of the following:

  • Asymmetry
  • Unsatisfactory nasal tip rotation and projection
  • Unsatisfactory nostril width
  • Nasal dorsum collapse
  • Crookedness of the nasal dorsum
  • Rough or bumpy nasal contours
  • A nose that is overall disproportionate to the rest of the face
  • Breathing problems

Are You a Good Candidate for Revision Rhinoplasty?

As long as you are in good physical health and have realistic expectations about the outcome of your surgery, it is ultimately your decision whether to have revision rhinoplasty surgery.

Most patients who choose this surgery have breathing problems due to their first surgery or are unhappy with their first surgery’s results. Your first surgeon may have promised to change your nose in one particular way, and other changes may have occurred as an indirect result, or alternatively, over time, you may have become unhappy with the way your nose appeared against your other facial features.

To know for sure whether you are a good candidate for revision rhinoplasty, book a consultation appointment with Dr. Sieber. He will be able to assess your past results as well as your current physical health and make a decision.

What Does the Surgery Entail?

Revision rhinoplasty surgery is an outpatient procedure, which means you’ll be allowed to go home to rest and recuperate on the same day as your surgery. It typically takes between three and four hours. General anesthesia is used for the comfort of the patient.

The surgery itself is much like primary rhinoplasty surgery. However, it will be slightly different as your surgeon will be addressing different issues this time around. Furthermore, revision surgery requires much more technical skill. One key difference with revision rhinoplasty is that Dr. Sieber may need to take cartilage from behind your ear (or sometimes from the rib area) to supplement lacking septal cartilage in the nose. This extra cartilage is needed for the proper restructuring of the nose. You will, of course, know that this is going to occur ahead of time. It will be something you discuss in your first consultation with Dr. Sieber.

During surgery, Dr. Sieber will start by making a small incision at the base of the nose as well as one inside the nostrils. This will allow him to reshape and restructure your nose with the use of the supplemental cartilage. In some cases, skin grafts will be necessary to fix the nasal airways — often damaged due to scarring.

Is Recovery from Secondary Rhinoplasty More Difficult Than Recovery from Primary Rhinoplasty?

Because the patient must fully recover from their primary rhinoplasty before undergoing secondary rhinoplasty, the recovery will be largely the same. Swelling of the nose and the area around the nose is perfectly normal and likely to last for many months (up to a year) post-surgery. It is usually at its worst in the first three months after the procedure. Sometimes, the swelling goes does at different rates around the nose, so don’t be alarmed if one area still has a lot of swelling while another area has gone down.

In some cases, patients who needed to have bones moved during surgery will also experience black eyes. These will go away slowly in the first few weeks after surgery.

As is the case after primary rhinoplasty, you will have splints in your nose and be required to wear a cast and tape on your nose for a short time. During your initial follow-up appointment with Dr. Sieber, he will remove the cast, tape, and splints.

How Do You Prepare for Revision Rhinoplasty?

If changes to your nose, dissatisfaction with initial rhinoplasty results, or breathing problems have caused you to consider revision rhinoplasty, your first task is to book a consultation appointment with an experienced, board-certified plastic surgeon. At this appointment, your surgeon can assess the results from your first rhinoplasty surgery as well as how much cartilage you have left for a possible second surgery. They will discuss with you what you are unhappy with and possible ways to ameliorate these problems.

Once you have agreed upon a solution, you can schedule your surgery and start making the necessary preparations in your personal life for the procedure itself and your recovery. You’ll need to make sure you have someone responsible to take you home after surgery, and of course you’ll need to take some time off from work or school.

Approximately two weeks before your procedure, you will be asked to cease taking any supplements or medications which could cause increased risk of bleeding. Other pre-surgery steps may need to be taken as well, which Dr. Sieber will discuss with you during your initial preparatory appointments.

Book Your Revision Rhinoplasty Consultation Appointment

Because revision rhinoplasty is one of the most technically demanding and challenging plastic surgeries available, it is imperative to find a plastic surgeon with experience and expertise in this area. San Francisco residents looking for the best revision rhinoplasty surgeon regularly turn to Dr. Sieber for the procedure and are happy they did.

To book a consultation appointment with Dr. Sieber today, give our office a call at 415-915-9000.





Dr. Dave Sieber and his staff are so awesome! Dr. Sieber is personable yet professional, his work is impeccable. He listens to his patient and works with them to achieve what they want. He’s like my hair dresser, a magician, you just want to do a happy dance with the results, only these results are lasting. Ok, but seriously, the procedure was very smooth, the staff and the doctors (Dr Sieber and the anesthesiologist) had great communication and made sure I was comfortable with very clear and concise pre op and post op directions. The healing process was very easy and the results are FABULOUS. Side note, Dr. Sieber has really awesome skin, I feel like this is impressive and important because really, would you trust a dentist with bad teeth? I am so elated and satisfied with the results, the size is perfect and they look and feel very natural. They are exactly what I wanted.*

SF Scientist

Dr. Sieber is a doctor who is not only extremely knowledgeable about the latest in cosmetic procedures, but a doctor who truly cares about his patients. I highly recommend him!*


Dr. Sieber is a doctor who is not only extremely knowledgeable about the latest in cosmetic procedures, but a doctor who truly cares about his patients. I highly recommend him!*


Dr. Sieber is attentive, responsive, and well trained. I had seen him for Botox and filler and he had done both without any pain or bruising and more importantly the results were fabulous. He has met with me on time at each appointment. He communicates what to expect, made sure I was comfortable throughout the procedure, checked on my healing every day post procedure. He couldn’t be more delightful not more talented. I had seen other plastic surgeons for in office treatments over the past decade and Dr. Sieber is at the top of the list in terms of delivering the desired outcome and high quality care.*

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