By Dr Sanjay Parashar, Consultant Plastic Surgeon, Dubai (DHA licence 00244892) · Performing rhinoplasty since 1993 · Updated October 2026
Quick answer: Not every nose that feels wrong after rhinoplasty needs another operation. In my practice, people asking about revision rhinoplasty fall into five groups. Some need no surgery at all. Some need a small closed correction. Some need an open revision of the tip, some need extra cartilage from the rib, and a few are best helped without surgery.
I have performed rhinoplasty since 1993 and in Dubai since 2005, and revision cases are a regular part of my nose practice. Patients come from Dubai, the wider Gulf, India and further afield, often after surgery elsewhere. The first conversation is always the same: what exactly bothers you, and what can safely be improved?
This article explains how I sort those concerns, so you know what to expect before your consultation.
Why do people need revision rhinoplasty?
People look into revision for one reason: they are not happy with their nose after surgery. What I find on examination decides what, if anything, should be done. Here are the five situations I see.
| Situation | What I usually find | What usually helps |
|---|---|---|
| 1. Unhappy, but the result is appropriate | A nose that is in proportion and healing as expected | No surgery |
| 2. A small, localised defect | A spur, residual hump, tip asymmetry or a patch of scar tissue | Closed revision rhinoplasty |
| 3. A significant problem | Residual asymmetry, a thick or poorly defined tip | Open revision tip rhinoplasty |
| 4. Missing support | Not enough cartilage left to rebuild the structure | Revision with a rib (costal) cartilage graft |
| 5. Not correctable by surgery | Scarring or skin changes surgery would not improve | Steroid injections, camouflage filler, or nothing |
1. You are unhappy, but the result is appropriate
Sometimes a patient is disappointed, yet the nose is in good proportion with the face and is healing normally. In that case, I advise no further surgery.
This is often a question of time. A nose keeps changing for many months as swelling settles, especially at the tip, so an early judgement can be misleading. It can also be a question of expectation. A photo or an image in your mind may not suit your face, skin or bone structure. I will tell you honestly when I think another operation would not make your nose better, because surgery carries risk every time.
2. A small defect that can be fixed: closed revision
Some patients have a real but limited problem. Common examples are a small bony spur, a residual hump on the bridge, a slight tip asymmetry, or a localised area of scar tissue.
These can usually be corrected with a closed revision rhinoplasty. Working through incisions inside the nose, I remove the spur, trim the excess cartilage or clear the scar tissue from that one area. There is no external scar, the operation is shorter, and recovery is usually easier than the first surgery.
3. A significant problem: open revision tip rhinoplasty
Other patients have a more noticeable problem, such as clear residual asymmetry or a thick, poorly defined tip (see bulbous tip). Here the cartilages of the tip often need to be reshaped, repositioned or supported again.
This usually needs an open revision tip rhinoplasty. A small incision across the columella, the strip of skin between the nostrils, lets me see the tip framework directly and rebuild it accurately. The scar is small and usually fades well.
4. When extra cartilage is needed: rib (costal) cartilage grafts
Revision often means working with less material. The first operation may have removed or used much of the septal cartilage, the natural source for grafts. When the nose needs real structural support, such as a collapsed bridge, a weak tip or a saddle deformity, there may not be enough left.
In these cases I take cartilage from the rib (costal cartilage) through a small incision on the chest. Rib cartilage is strong and plentiful, so it can rebuild the bridge or support the tip. For smaller needs, ear cartilage or any remaining septal cartilage may be enough. I decide which source to use only after examining you.
5. When surgery is not the answer
Some concerns cannot be corrected by more surgery, or another operation would carry more risk than benefit. Thick scar tissue, thin or damaged skin, or very small irregularities may fall into this group. Options then include:
- Steroid injections to soften and flatten localised scar tissue, often given as a short course over several visits
- Fillers to camouflage a small dip or irregularity, carefully and only where it is safe (see nose filler vs rhinoplasty)
- Nothing at all, when the change would be too small to justify any risk
I would rather tell you that no treatment is the best option than offer an operation that is unlikely to help.
When should you consider revision, and how is it planned?
I usually advise waiting until the nose has settled before any revision surgery, typically around 12 months after the first operation. The tip is the last part to settle, and operating too early means working on swollen, scarred tissue.
You can still see me earlier. A consultation in the first months helps us identify the concern, keep track of how it changes and plan the right timing.
What to bring to your consultation:
- Photos of your nose before the first surgery
- The operation notes from your previous surgeon, if you can get them
- A list of what bothers you now, in your own words
- Details of any breathing difficulty, injury or filler since the surgery
Your final surgical plan and quote are confirmed only after I have examined you in person. Revision rhinoplasty with me starts from AED 35,000; see rhinoplasty cost for what affects the fee.
What is recovery like after revision?
Recovery depends on which type of revision you have. A small closed revision is usually easier than the first operation. An open revision with a rib graft takes longer, and swelling, especially at the tip, can last many months.
The early steps follow my usual rhinoplasty routine:
- Day 5: I remove the splint, clean the nose and fit a mouldable aluminium splint with tapes. I show you how to take it off and put it back on.
- Day 6 to 7: Patients travelling home can usually fly, with just the tapes.
- From day 8: You can return to the office without the splint, and wear it at home, including overnight, for about a month.
- Follow-up: I see you at 1, 3, 6 and 12 months to check how the nose is settling.
If a rib graft is used, there is also a small chest wound to care for. More detail is on the recovery timeline page.
Why revision needs a surgeon who does both reconstruction and aesthetics
Revision is harder than a first rhinoplasty. Normal anatomy has been changed, scar tissue makes the layers stick together, and grafts often have to be made from scratch.
My own path into rhinoplasty began with reconstruction. My first nose case, in 1993, was rebuilding the tip for a man who had lost his nose. That led to trauma nose reconstruction and craniomaxillofacial surgery training before I moved into aesthetic rhinoplasty. I have since performed more than 3,000 rhinoplasties.
That background matters in revision. I am trained in both open and closed techniques, and I use septal, ear or rib cartilage as each nose needs. The aim is a nose that fits your face and, wherever possible, breathes well.
Frequently asked questions
How long after rhinoplasty can I have a revision?
Usually around 12 months, once swelling has settled and the result is stable. An earlier consultation is still useful to plan.
Is revision rhinoplasty more difficult than the first operation?
Yes. Scar tissue, changed anatomy and limited cartilage make it more demanding, so planning and experience matter more.
Will I need cartilage from my rib for revision rhinoplasty?
Not always. Small corrections need no graft, and some need only ear or septal cartilage. Rib (costal) cartilage is used when the nose needs strong structural support.
Is revision rhinoplasty done open or closed?
Both are possible. Small, localised problems such as a spur, residual hump or scar tissue can often be fixed closed. Tip reshaping and structural rebuilding usually need the open approach.
Can fillers fix my nose instead of revision surgery?
Sometimes, for a small dip or irregularity. Fillers cannot make a nose smaller and are not suitable for everyone.
Can scar tissue after rhinoplasty be treated without surgery?
Often, yes. Steroid injections can soften and flatten localised scar tissue over several sessions.
How much does revision rhinoplasty cost in Dubai?
Revision rhinoplasty with Dr Sanjay Parashar starts from AED 35,000. Your exact fee is confirmed in writing after your consultation.
Book a consultation: if you are unhappy after a previous rhinoplasty, message Dr Sanjay on WhatsApp, book a consultation, or read more about revision rhinoplasty in Dubai.
This article is general information and does not replace a consultation. Every surgery carries risks; results vary between individuals and are not guaranteed.