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PREMIUM AESTHETIC

AVA's Golden Ratio
Completing Dimensionality

Not just raising the nose, but meticulously designing the natural angle from forehead to the tip.

By TypeAlar ReductionRevision
Revision
AVA Plastic Surgery Revision Rhinoplasty

Revision Rhinoplasty

Revision rhinoplasty is not a single standardised procedure. Implant displacement · capsular contracture · infection · asymmetry · unnatural contours — every case has a completely different underlying cause, and no single solution can be applied universally. Because the work must be done on top of anatomy that has been altered by previous surgery and a support structure that has been weakened, revision rhinoplasty is fundamentally a staged approach of remove → assess → reconstruct. Ultimately, the surgeon's experience and judgement determine the outcome. We do not over-promise. Potential temporary asymmetry, swelling, reduced tip sensation (6–12 months), and donor-site discomfort are disclosed in full before surgery. Only a conservative, staged reconstruction is undertaken. ※ AVA's revision rhinoplasty algorithm is informed by Park KS, Kim SS, Lee WS et al. (Archives of Craniofacial Surgery 2017, 18(2):97–104) — "The Algorithm-Oriented Management of Nasal Bone Fracture according to Stranc's Classification System" — and rib cartilage utilisation follows the anatomical principles of Gunter JP's Dallas Rhinoplasty. Individual results and recovery may vary.

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Surgery Duration3–4 hours
AnaesthesiaIV sedation
HospitalisationNot required
Suture Removal7 days post-op
Follow-up Visits3 or more
Initial Recovery2+ weeks

Check Point Highly Recommended For

Implant shifting to one side or becoming visible through the skin
Contracture causing the tip to rotate upward or the nose to appear shortened (contracture nose)
Unnatural or asymmetric tip contour or dorsal line
Recurring inflammation, redness, or pain
Unsatisfactory results despite multiple previous surgeries
Previous autologous cartilage (septal · auricular) already harvested and depleted

Revision Rhinoplasty Procedure

STEP 01
Detailed Diagnosis & Root-Cause Analysis

A comprehensive evaluation of existing implant type and position, capsule thickness, remaining septal and cartilage volume, skin thickness, degree of contracture, and breathing function is performed to classify the case type.

STEP 02
Implant & Capsule Removal

The displaced or inflamed implant is removed, and the thickened scar capsule is carefully dissected and excised. As the capsule is the primary driver of contracture, this step is the most critical in the entire procedure.

STEP 03
Structural Reconstruction (Autologous Rib Cartilage)

When septal and auricular cartilage are insufficient, autologous rib cartilage is harvested to perform staged reconstruction: septal extension graft (SEG), spreader grafts for dorsal support, and tip definition grafts.

STEP 04
Dorsal & Contour Refinement

The dorsal line is redesigned over the patient's current skin thickness and the newly reconstructed support framework, using either a dorsal implant or autologous cartilage alone. Excessive height is avoided in favour of structural stability.

STEP 05
Tension-Free Closure & Recovery Monitoring

The columellar incision and alar border are closed with tension-free sutures. Revision patients are followed up at scheduled visits to monitor implant position, capsule formation, and functional recovery on an ongoing basis.

The AVA Difference

Autologous Rib Cartilage Rhinoplasty (Especially Revision)

Reduces implant-related concerns by reconstructing nasal architecture
using the patient's own 6th–7th rib cartilage.

Park-Kim-Lee Revision Algorithm

A Stranc classification-based revision algorithm (Archives of Craniofacial Surgery, 2017)
that considers structural defects and respiratory function together.

Patient Satisfaction Defines Completion

Surgery is complete not when sutures are removed,
but when the patient smiles in front of the mirror.

Q&A

Q.When is the right time to have revision surgery?
A.As a general principle, waiting 6–12 months after the initial surgery — until the tissues have fully stabilised — is appropriate. Before that point, residual capsule and swelling make accurate assessment and clean dissection more difficult. However, if you are experiencing infection, redness, significant pain, marked asymmetry, or progressive contracture, you should attend for evaluation promptly regardless of how much time has passed.
Q.Is revision rhinoplasty genuinely more difficult than primary rhinoplasty?
A.It is fundamentally different in nature. Normal anatomy has been altered by previous surgery, primary autologous cartilage sources (septum · ear) are often already depleted, and rib cartilage may be needed for structural reconstruction. The dissection of thickened capsule, rebuilding of a weakened support framework, and protection of thinned skin involve substantially more steps — making the procedure longer and technically more demanding than a standard rhinoplasty. The surgeon's cumulative experience is ultimately what determines the outcome.
Q.How is a contracture nose corrected?
A.Contracture occurs when the scar capsule that forms around an implant thickens and tightens over time, rotating the tip upward and shortening the nose. The key steps are: meticulously dissecting and excising the capsule, then using autologous rib cartilage to perform a septal extension graft (SEG) that repositions the tip downward and forward. Depending on the severity of the contracture, correction may be completed in one stage or approached in planned stages.
Q.Why is autologous rib cartilage used?
A.Revision patients frequently have insufficient primary autologous cartilage because the septum and ears have already been harvested. Rib cartilage is available in adequate quantity and has sufficient structural strength for rebuilding a collapsed septum, reinforcing the dorsum, and defining the tip — making it a reliable material in complex reconstructions. Being the patient's own tissue, it carries no rejection risk and remains stable long-term. The harvest scar (lower chest) measures approximately 4–5 cm and is positioned where it is concealed by clothing.
Q.Can surgery performed at another clinic be revised at AVA?
A.Yes. Even without previous operative records, the implant type, degree of contracture, and remaining cartilage can be assessed during consultation through photographs, CT imaging, and physical examination. That said, if you are aware of the type of implant used or whether cartilage was previously harvested, sharing that information will significantly improve the accuracy of the surgical plan.
Q.Is it possible to simply have the implant removed without reconstruction?
A.It is possible. However, removing the implant alone can result in a more unnatural appearance due to contracture and skin laxity. Simultaneous minimal structural reconstruction using autologous cartilage is therefore generally recommended. During consultation, the surgical plan is tailored to the patient's goal — whether that is returning to the natural pre-surgery nose or maintaining a refined contour through reconstruction.
Q.Is there a chance of needing another revision after this one?
A.Because revision surgery by its nature involves responding to the variables left by a previous procedure, there are more unpredictable factors than in primary surgery and the range of possible outcomes is wider. At AVA, possible scenarios are discussed openly during consultation, and regular follow-up visits after revision surgery track implant position, capsule formation, and functional recovery over time. A carefully staged reconstruction plan is prepared with the aim of making this the final intervention.
Q.How much longer is the recovery compared with primary rhinoplasty?
A.This varies depending on the extent of dissection and whether rib cartilage is harvested. Major swelling subsides within 1–2 weeks, but donor-site discomfort (chest) may persist for 1–2 weeks, and residual nasal swelling continues to resolve over 6–12 months. A full assessment of the final result is recommended at one year post-op or later — longer than the timeline for primary rhinoplasty.
Q.Is revision rhinoplasty more expensive than primary rhinoplasty?
A.In general, yes — the additional steps of rib cartilage harvest, extended dissection time, and multi-stage reconstruction mean that revision rhinoplasty is priced higher than primary surgery. The exact cost depends on the case type (implant exchange only vs. full structural reconstruction) and will be provided after your consultation.
Q.Can functional problems such as nasal obstruction be addressed at the same time?
A.Yes, they are assessed together. If previous surgery has caused a deviated septum or compromised breathing function, septal correction is performed concurrently with the revision procedure so that both aesthetic and functional concerns are resolved in one operation. Breathing assessment and nasal endoscopy are included as part of the consultation.
Post-op Instructions
  • Do not rub the surgical area strongly for about a week.
  • Avoid alcohol and smoking for at least 2 weeks as they delay recovery.
  • Swelling and bruising vary individually but will gradually improve.
  • Light walking or stretching helps reduce swelling.
PERSONALIZED CONSULTATION

Curious About This Procedure?

Our head surgeon provides a one-on-one assessment and a tailored treatment plan just for you. Results and recovery may vary by individual.

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