This week, Vanichi has rhinoplasty revelations through the sound advice of Dr. Dhir as he details the Differences Between Primary & Revision Rhinoplasty.

As much as we would all like to believe our personality is the first thing people notice about us, the honest truth is that how we look and our physical appearance almost always leads our introduction. A warm smile or kind eyes are welcoming facial features that can ease people into wanting to know more about our personality, but if we are uncomfortable with the appearance of our nose, our most prominent facial feature, we might not feel so confident and welcoming when meeting new people.

When considering a nasal procedure, it is first important to understand the cause for change. Are there breathing problems present, such as trouble sleeping or decreased in breathing capacity. Or is the call for change more for aesthetic purposes; the desire for a nose that is closer to your desired self-image. Whatever the reason, special care and precaution are required for any nasal procedure.

A major portion of my practice is dedicated to the art of both primary (first-timers) and revision (modifying a previous result) nasal surgeries. Although both procedures involve making adjustments to the nose, they also are very different in approach.

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When someone is requesting a surgical nasal procedure, I typically spend between 45 -60 minutes with them during their consultation. I use this time to get acquainted with the patient and try to understand them on a personal level. It is very important for me to spend this time so I am best able to discuss the motivations, goals and expectations of each patient as well offer all the options available to jointly emerge with the most tailored treatment plan.  This experience is a journey with each patient that I enjoy.

For primary nasal procedures including septoplasty (correction of a deviated septum causing nasal obstruction) and rhinoplasty (addressing aesthetic form), the physical examination by a board certified surgeon is imperative. In general, primary surgical procedures are low risk procedures and garner excellent results for both functional and aesthetic concerns.  The goal is to be evaluated for all possible outcomes to minimize the need for revision surgeries in the future by addressing all the nuances that are specific to one’s own nose.


What must be clarified when discussing revision nasal surgery is that revision surgery does not always imply that something was wrong with the first procedure. In fact, most of the great nasal surgery specialists commonly perform a certain percentage of revision surgeries – including their own cases when necessary.  The human body’s natural healing ability can, sometimes, humble the best of surgeons and can affect the kindest of patients.  Sometimes the final healing process cannot be foreseen and revision surgery may be necessary.

That being said, revision nasal procedures offer their own sets of challenges; both emotionally for the patient, and technically for the surgeon.  The reason to undergo a revision nasal surgery varies from breathing concerns after cosmetic rhinoplasty or cosmetic concerns for a multitude of reasons.  It is understandable that the revision patients are emotionally drained from a previous surgery and do not want to undergo a second procedure.  Also, there are often technical challenges for the surgeon such as scar tissue that must be discussed.

Despite the differences between primary and revision surgical procedures, I firmly believe that education is most important for both types of patients.  I recommend finding a board certified surgeon with whom you feel a strong connection with, and who evaluates all the possible outcomes based on your specific needs. Whether you are a primary or revision patient, it is important to focus on the future and go in with a positive attitude.  Rhinoplasty for breathing and/or aesthetic reasons can be one of the most satisfying procedures in one’s life for both the surgeon and patient alike.  I wish you the best of luck and hope I helped you feel more comfortable.

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ABOUT DR. DHIR | Dr. Dhir is a double board certified facial plastic & reconstructive surgeon trained at the prestigious Mt. Sinai Hospital in New York City. He currently practices in Beverly Hills and continues to teach the art of Facial Plastic Surgery as an Assistant Clinical Professor at UCLA –Harbor. His interests include cosmetic and “better- breathing” functional rhinoplasty, revision rhinoplasty, natural face lifting techniques, volumizing filler implants, botox, fillers, blepharoplasty and custom cheek and jaw implants. Above all else, Dr. Dhir takes pride in his patient relationships and makes himself available throughout the healing process to garner the best possible results and care. Click here to visit Dr. Dhir online.