Revision Rhinoplasty in Toronto

Understanding Revision Rhinoplasty

If you have previously undergone nasal surgery, but the outcome was unsatisfactory, you may require a secondary rhinoplasty (aka revision rhinoplasty). An undesirable outcome can occur for a variety of reasons, whether it be persistent difficulty with nasal breathing or an untoward aesthetic result. This can sometimes be due to over or under-resection of the nasal structures and supports. Often, it’s a consequence of unpredictable healing which cannot be controlled by you or your surgeon. However, in the unfortunate circumstance of a patient requiring a revision procedure, you want to ensure that your surgeon has the skill and experience necessary to improve your nose with a subsequent operation.

Revision rhinoplasty is a highly complex and delicate procedure. While the goal of revision rhinoplasty (and primary rhinoplasty) is improvement, not perfection, if done well it can have a significant positive impact on an individual’s life.

Determining Your Candidacy for Revision Rhinoplasty

An ideal candidate for revision rhinoplasty surgery is in excellent general health and has realistic expectations for the correction of their nasal concerns. Dr. Alexander will help determine your candidacy during your in-depth initial consultation.

Dr. Alexander will be very honest with you in terms of his assessment of your nose, and what he thinks he can improve (or not improve). He will not offer you surgery unless he truly believes he can make a difference for you.

Revision Rhinoplasty Checklist

The nose is very delicate following a nose job, and even small impacts or pressure from your eyeglasses can impact how it heals. If you suffer from any of the following after your initial rhinoplasty, revision rhinoplasty may be right for you:

  • Nasal breathing difficulties
  • A persistently crooked nose
  • An over-projected nasal tip
  • Asymmetrical nasal tip
  • A bridge that lacks sufficient cartilage
  • A bridge that is still too prominent
  • An uncorrected bump or irregular shape to the nose
  • A nose that does not suit your face

Selecting the Right Doctor for the Procedure

Choosing the best plastic surgeon for your revision rhinoplasty in Toronto can be a daunting task. Dr. Alexander is compassionate towards those that feel apprehension, and he understands that trust is earned gradually based on transparency, integrity, and reputation.

Dr. Alexander has completed many prestigious residencies and fellowships, including a facial plastic surgery fellowship at New York University in Manhattan, where he honed the art of rhinoplasty, performing sophisticated, intricate surgeries under the tutelage of the most respected surgeons in the world. Dr. Alexander brings this consummate skill and seasoned technique to his Toronto patients.


As with your initial rhinoplasty, there are two general approaches during revision surgery: the closed rhinoplasty, and the open rhinoplasty. The closed approach consists of incisions made within the nostrils, thus hiding any scarring from view. The open approach favors a single minor incision at the base of the nostrils, which does leave a scar, but Dr. Alexander does his best to minimize this through careful placement. In the majority of cases, the small incision heals into a thin scar that is virtually imperceptible.

Tissue grafting is often a major component of revision rhinoplasty. Cartilage from other parts of the body must be harvested and transferred to the nose to compensate for nasal deformities. If a cartilage graft is required, Dr. Alexander will borrow cartilage from the ears or ribs to augment the nasal structure to provide improved form and function. Additionally, the doctor may opt to employ dermal fillers such as Restylane, Juvederm or Radiesse, all of which can be instrumental in addressing asymmetry and other aesthetic imbalances.

Dr. Alexander focuses on making small, careful changes to the shape of your nose so as to not over-correct any problems. His goal is to make your nose look natural and repair any structural complications. Because the nose is central to your facial balance, small changes can go a long way.

The Recuperation Process

Thanks to Dr. Alexander’s conservative and meticulous approach, his patients generally experience a smooth and speedy recovery. As with primary rhinoplasty, swelling, bruising, soreness and discomfort are to be expected. Dr. Alexander will do his best to ensure you are comfortable throughout the entire process.

Results with revision rhinoplasty take a little longer to settle in since the revision process may involve more tissue grafting or cartilage repair. If you had cartilage grafts, there will also be an incision at the site where cartilage was harvested. The incision is typically very small but will still need standard aftercare to avoid infection. Manipulating the nasal structure for the second time may cause extra swelling, and this may take time to abate. Rest assured, Dr. Alexander will be there for you every step of the way.

The Consultation Process

Dr. Alexander provides an in-depth, personalized consultation in the privacy and comfort of his Toronto offices during which he will help determine the best course of action regarding your revision rhinoplasty. This involves a careful review of your nose, examination of previous surgeries, and a frank discussion of your needs and wishes. Dr. Alexander will explain the revision process to you, mapping out a clear plan for improvement and success.

To best prepare for the consultation, it’s a good idea to jot down all your questions and concerns in advance. You may also want to collect images from magazines and websites that reflect your ideal nose. These can help Dr. Alexander understand your aesthetic preferences. The doctor may also employ our advanced computer imaging software to help you visualize the changes.

Dr. Alexander is passionate about patient education and awareness. For those undergoing rhinoplasty for the second time, this is especially relevant, as the patient may be justifiably cautious after a bad surgical experience. Dr. Alexander does his best to provide you with all the facts, risks, details and surgical information so that you may move forward with confidence and peace of mind. The doctor can also discuss combining treatments, such as revision rhinoplasty and a chin implant or a facelift, for example, which may result in greater cost effectiveness.

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