Yes, most noses that look wrong or don’t breathe well after rhinoplasty can be improved with rhinoplasty revision. Surgeons usually wait about a year for swelling to settle, then rebuild weakened structure, often with cartilage from the septum, ear or rib. Revision is more complex than a first operation, so recovery takes longer and results are less predictable.
This page is part of our rhinoplasty overview. It covers how to tell a problem from normal healing, why some rhinoplasty fails, and what a second operation involves.
Signs of a bad nose job
Signs of a nose job gone wrong include a pinched or collapsed tip, a scooped or uneven bridge, a crooked nose, breathing trouble and an over-operated look.
- Breathing worse than before: often from narrowing of the internal valve or septal problems.
- Pinched or bulbous tip: too much or too little tip work.
- Scooped bridge or saddle nose: too much taken off the bridge or loss of septal support.
- Bump left behind or new irregularity: uneven bone or cartilage under the skin.
- Crooked nose: deviation that returned or was never corrected.
- Visible or deviated implant: more common after synthetic implants used to raise the bridge.
Some changes are normal for months. The American Society of Plastic Surgeons (ASPS, US) notes that a nose may look crooked or asymmetric while swelling goes down and that this usually evens out after about a year. A bad result should be judged once that swelling has settled, unless breathing is clearly blocked.
Why rhinoplasty fails
Rhinoplasty fails mainly from too much tissue removed, weak support, misjudged anatomy, implant problems or expectations that didn’t match what surgery can do.
A 2017 systematic review in the International Archives of Otorhinolaryngology pooled 11,035 rhinoplasties. Reoperation followed 2.73% of open and 1.56% of closed primary operations. In revision cases, the most common sites treated were the bridge (27.9%), the tip (22.5%), the bony pyramid (20.1%) and the nasal valve (16.4%). The authors cite dissatisfaction with the result and incorrect technique or assessment as the two main reasons for secondary surgery.
Implants are a separate cause. A 2019 review in Plastic and Aesthetic Research described 52 revision rhinoplasties in Asian patients: 33 (63%) were related to synthetic implants, with deviation, foreign body reaction, extrusion, infection and an unnatural look among the causes. ASPS (US) also lists a rare hole in the septum, which may not be fixable, among rhinoplasty risks.
Rhinoplasty revision: when and how
Rhinoplasty revision usually waits about a year so swelling settles, then rebuilds structure with grafts; infections or blocked breathing may need earlier action.
ASPS says the nose can take up to a year to refine, and an ASPS patient article says final results can take a year if not two. Most surgeons won’t judge or revise a shape before then. Exceptions include an infected or exposed implant, which a 2019 review recommends removing first, controlling the infection and revising later in a staged approach.
Revision is usually done through an open approach. The surgeon assesses what’s left, then rebuilds. Septal cartilage is often used up after a first operation, so ear or rib cartilage is common. That 2019 review notes that the graft volume needed in severe revisions “usually far exceeds available septal cartilage,” and ear cartilage often isn’t strong enough.
| Graft source | Strengths | Limits |
|---|---|---|
| Septal cartilage | Straight, strong, same operative site | Often depleted after a first rhinoplasty |
| Ear cartilage | Curved, useful for the tip | Often not strong enough for major support |
| Rib cartilage | Large volume, strong, keeps volume for years | Can warp; chest scar and donor-site pain; rare pneumothorax |
| Synthetic implant | No donor site | Deviation, extrusion, infection, foreign body reaction |
A question I hear often is whether a second surgery can make the nose “like it was before”. What I tell patients is that we can usually make it better, but revision rebuilds rather than restores, and scar tissue sets limits.
Revision rhinoplasty rib cartilage recovery time
Revision with rib cartilage adds a sore chest for a few weeks to normal nose recovery; skin stitches come out at 7 to 10 days and results are judged at a year.
- First week: nasal splint and swelling as in any rhinoplasty, plus pain at the small chest incision. The 2019 review lists pain, pneumothorax (air around the lung) and a chest scar as donor-site issues; a chest X-ray is advised only if symptoms suggest pleural injury.
- Days 7 to 10: skin stitches removed, according to the same review.
- Weeks 2 to 6: chest soreness eases; avoid strenuous exercise for at least six weeks (ASPS patient article).
- Months 3 to 12: swelling settles more slowly than after a first operation because of scar tissue and grafts.
- One year: outcome assessment. The review authors note warping can still occur after surgery and may need the graft recarved or replaced with diced cartilage in fascia.
Call your surgeon at once for sudden shortness of breath or chest pain after a rib graft.
Rhinoplasty revision cost
Rhinoplasty revision cost is usually higher than a first rhinoplasty because surgery takes longer and may involve rib or ear grafts.
ASPS reports a 2024 US surgeon-fee range of $7,500 to $12,500 for rhinoplasty in general, without a separate figure for revision. The ASPS cost page says fees exclude anesthesia and facility costs and vary with surgeon experience, technique and location. If part of the revision corrects blocked breathing, ASPS notes that functional surgery may be covered by insurance with an exam and prior authorization. If you had surgery abroad, check what your original clinic covers; see rhinoplasty abroad.
Finding a revision specialist
Choose a rhinoplasty revision specialist who does revisions regularly, assesses breathing, uses rib cartilage when needed and shows real revision results.
- Ask how many revisions they perform each year and what share involve rib grafts.
- Bring your original operative notes if you can. They save guesswork.
- Expect a breathing assessment as well as a photo review.
- Ask what is realistic with your skin and scar tissue, and what isn’t.
Our guide to rhinoplasty by nose type explains how thick skin and grafts affect results, and the recovery timeline shows normal healing so you can tell it apart from a problem.
Frequently Asked Questions
FAQ
Answers on waiting times, success, revision photos, rib grafts and how common it is for a nose job to go wrong.
How long should I wait before revision rhinoplasty?
Most surgeons wait about a year, because the nose keeps changing as swelling settles, and ASPS notes final results can take a year or two. Infection, an exposed implant or severe breathing blockage are reasons to act sooner, under specialist care.
How common is a nose job gone wrong?
In a 2017 systematic review of over 11,000 rhinoplasties, reoperation followed about 1.6% to 2.7% of first operations. Dissatisfaction is more common than true complications, so a careful consultation and realistic goals matter as much as technique.
What do rhinoplasty revision before and after photos show?
They usually show a straighter or better-supported nose, a rebuilt bridge or a tip that’s less pinched. Changes are often more modest than after a first operation because of scar tissue. Ask for photos at a year, including side views and breathing outcomes.
Is rib cartilage safe for revision rhinoplasty?
It’s widely used and keeps its volume for years, according to a 2019 review. Risks include warping, chest pain, a chest scar and, rarely, pneumothorax. Older women are more likely to have calcified rib cartilage, which can make harvesting harder.
Can a bad nose job affect breathing?
Yes. Over-narrowing the internal valve, a weakened septum or a collapsed side wall can block airflow. ASPS lists trouble breathing among rhinoplasty risks. Revision often uses grafts to reopen the valve while improving appearance.
If you’re unhappy with a previous nose job, you can request a revision assessment at Metropole Clinic by ABmedi. For an overview of all rhinoplasty options, return to our rhinoplasty guide.
This article is for general education and does not replace a personal medical consultation.
References
Show sources
- Crosara PFTB, et al. Rhinoplasty Complications and Reoperations: Systematic Review. Int Arch Otorhinolaryngol. 2017;21(1):97-101. scielo.br
- Won TB, Jin HR. Revision rhinoplasty using autologous rib cartilage in Asians. Plast Aesthet Res. 2019;6:6. oaepublish.com
- Rhinoplasty: Risks and Safety. American Society of Plastic Surgeons (ASPS, US). Accessed 2026. plasticsurgery.org
- Rhinoplasty: Recovery and Cost. American Society of Plastic Surgeons (ASPS, US). Accessed 2026. plasticsurgery.org
- What to expect from your rhinoplasty recovery. American Society of Plastic Surgeons (ASPS, US). 2022. plasticsurgery.org
- 2024 Cosmetic Procedures: Average Cost. American Society of Plastic Surgeons (ASPS, US). 2025. plasticsurgery.org
