Expert Revision Rhinoplasty

For most patients, meaningful and significant improvement is achievable. Dr De Silva is direct and honest at consultation about what revision surgery can and cannot achieve in each individual case and for a minority of patients, he will advise against further surgery if he does not believe it can meaningfully improve the outcome.

It is important to understand that previous surgery cannot be fully reversed; scar tissue and changes to the underlying anatomy are permanent features that revision surgery works around rather than eliminates. The goal is substantial improvement, not perfection. A small proportion of patients with particularly complex cases may benefit from two staged procedures rather than one. Dr De Silva will give you an assessment of what is realistically achievable for your nose at consultation, so that any decision to proceed is made with a clear and accurate understanding of the likely outcome.

Yes, a significant proportion of Dr De Silva's revision rhinoplasty patients travel from overseas, and his team has extensive experience coordinating care for international patients. Patients visit his Harley Street practice from more than 70 countries.

A virtual consultation is available as the first step for patients travelling from outside the UK, allowing Dr De Silva to review your photographs, discuss your surgical history and concerns, and advise on suitability before you make the journey. His team will assist with coordinating your visit, including timing your trip around the post-operative period; most patients need to remain in the UK for approximately three weeks following revision rhinoplasty before short-haul travel, and six weeks before long-haul travel. Advanced recovery technology including hyperbaric oxygen therapy and regenerative medicine is available to support faster healing during your stay.

In the majority of cases, meaningful improvement is possible. Revision rhinoplasty, also called secondary or corrective rhinoplasty, is a procedure specifically designed to address unsatisfactory results from a previous nose job, whether that means an unnatural appearance, breathing difficulties, asymmetry, or a result that simply did not meet your expectations.

The key is choosing a surgeon with genuine, dedicated experience in revision cases. The nose is the most technically demanding area of facial surgery, and revision work adds significant complexity - existing scar tissue, altered anatomy, and potentially reduced cartilage all affect what is achievable. Dr De Silva will assess your nose individually at consultation and give you an honest, specific picture of what revision can and cannot improve in your case.

A minimum of 12 months from your original rhinoplasty is Dr De Silva's general recommendation before considering revision surgery. Revision surgery on a nose that has not fully healed is significantly more technically difficult, increases the risk of complications, and makes predicting the outcome much harder.

What many patients do not realise is that the nose takes considerably longer to fully settle than most other procedures. A result that appears unsatisfactory at six months may look quite different at 12 to 18 months once swelling has fully resolved. Attempting revision before that point means operating on tissue that is still changing, which compounds the challenge of already complex surgery. In cases where significant structural concerns are present, a longer wait may be advisable. Dr De Silva will assess the current state of your nasal tissues at consultation before making any recommendation.

Revision rhinoplasty is widely regarded as one of the most technically demanding procedures in facial surgery. Several factors make it significantly more complex than a primary rhinoplasty.

Scar tissue from the original surgery alters the internal structure of the nose, making tissue planes harder to navigate and increasing bleeding risk. Cartilage that was removed or repositioned during the first procedure may be insufficient to work with, requiring Dr De Silva to harvest cartilage from elsewhere, most commonly the ear, to rebuild nasal structure. Skin quality may also be compromised if the previous surgery caused thinning or contracture. Each of these factors requires advanced surgical planning and a level of technical experience that goes beyond routine rhinoplasty. Dr De Silva treats a significant proportion of patients who come to him specifically for revision work, and this volume of complex cases builds the specific expertise revision surgery demands.

The most common concerns Dr De Silva addresses in revision rhinoplasty include irregularities or asymmetry of the nasal bridge, tip pinching or over rotation, a scooped or over-reduced nasal profile, nostril asymmetry or collapse, residual humps or bumps on the bridge, and breathing difficulties caused or worsened by a previous procedure.

Some of these concerns are straightforward to correct, while others; particularly those involving significant structural compromise or skin quality issues, require more complex planning and realistic expectation setting. It is important to understand that while meaningful improvement is achievable in most cases, revision rhinoplasty cannot completely reverse previous surgery or restore the original anatomy. Dr De Silva will be direct about what is realistically achievable for your specific situation at consultation.

Yes, breathing difficulties caused or worsened by a previous rhinoplasty are one of the most common reasons patients seek revision surgery, and restoring nasal function is a central part of what revision rhinoplasty can achieve. Previous surgery can compromise breathing through over-reduction of structural cartilage, weakening of the sidewalls that support the airway, or a deviated septum that was not adequately addressed during the original procedure.

This is distinct from pre-existing breathing concerns in patients who have not had surgery; the presence of scar tissue, altered anatomy and potentially reduced cartilage makes the assessment and correction of post-surgical breathing difficulties more complex. An in-person examination is always required, and in some cases a CT scan may be needed to fully understand the cause before surgical planning can begin. Dr De Silva will assess both the functional and cosmetic aspects of your nose together, as the best revision outcomes address both concerns in a single procedure.