Revision Rhinoplasty

Conveniently located to serve the areas of Newport Beach and Orange County, CA

A revision rhinoplasty is a plastic surgery procedure that adjusts the results of a previous rhinoplasty, or nose job. Most patients choose to have a rhinoplasty out of a desire to alter the way they look or due to difficulty breathing through the nose. The rhinoplasty is widely regarded as one of the most complicated and difficult cosmetic plastic surgery procedures. The operation involves altering the structure of the nose to achieve a more aesthetically pleasing result while simultaneously maintaining the structure of the airways to preserve respiratory function. Although it is an extremely difficult procedure, it is one of the most commonly performed aesthetic surgeries.(1) Despite their best efforts, some surgeons’ rhinoplasty results are unsatisfactory. A revision rhinoplasty is then performed to achieve a better result. Dr. Wael Kouli is a renowned, sought-after specialist for his cosmetic surgery expertise. Published in multiple medical journals and board-certified in both general and cosmetic surgery, Dr. Kouli has helped countless people achieve the nose of their dreams and he can help you too. If you’re ready to achieve the beautiful nose you’ve always wanted, then contact the Esthetica Center for Cosmetic Surgery today to schedule a consultation. You can reach our offices in Newport Beach by calling 949.721.1113.


Rhinoplasties do not always require secondary operations to achieve the results desired. However, in a 2016 study of over three hundred rhinoplasty surgeries, 15.4% resulted in patient dissatisfaction and 9.8% required revision rhinoplasties to achieve the desired result.(2) Other sources report revision rates as high as 15%.(3) Revision rhinoplasties are even more difficult to perform than regular rhinoplasties because of scar tissue, and nasal structure that may have been compromised during the initial procedure. It can be a difficult decision to undergo surgery and recovery for the second time. However, the statistics for revision rhinoplasties are encouraging!  A study from 2012 on one hundred fifty patients who underwent secondary or revision rhinoplasties, reported that 97% of them were happy with the result.(3) 

Refining and reshaping the nose after a prior rhinoplasty is a task that requires incredible skill and experience. For these reasons, you should place your trust in a proven medical professional who can get you the results you desire.

Before and After Photos


Refining and reshaping your nose for function and aesthetics can make you look better, feel better, and breathe easier. Making your nose look the way you want it to can provide you with a series of dramatic benefits ranging from enhanced confidence and self-esteem and an improved quality of life. Rhinoplasty revisions are performed to:

  • Adjust the size of the nose
  • Alter the shape of the tip of the nose
  • Reshape the bridge of the nose
  • Change the size, shape, or angles of the nostrils
  • Fix a deviated septum
  • Improve nasal breathing function
  • Improve the appearance of the nose as well as overall facial aesthetic


If you have undergone a rhinoplasty procedure that didn’t turn out as you had hoped, you are not alone, and Dr. Kouli is here to help. There are many potential complications that can arise after a primary rhinoplasty including:

Internal Nasal Valve Dysfunction

The airways inside the nose can become blocked by a weakened nasal structure, which can result from cutting away too much cartilage, usually during dorsal hump reduction. This can cause the upper section of the nasal soft tissue to collapse when breathing, and cause the nose to appear overly narrow. This can be repaired by repositioning the upper lateral cartilage, or by placing cartilage grafts to reinforce the airways.

Nasal Deformities

Grafts can also be placed to correct a “saddle nose” in which a dip in the nasal profile forms above the tip of the nose. Open roof deformity is another unfortunate complication from dorsal hump reduction, and causes the bridge of the nose to look overly flat and wide. These are the result of overaggressive reduction of cartilage. Grafts can be taken from the cartilage in the patient’s ribs or ears to fill the concave appearance, and straighten out the nasal profile.

Pollybeak Deformity

Nearly half of all revision rhinoplasties are performed to correct this complication. Patients with a pollybeak deformity have a nasal tip that is angled downwards, creating an appearance similar to that of a parrot’s beak. Surgeons can correct this by removing excess cartilage from above the tip of the nose, using strut graft to lift the tip of the nose upwards, or by placing sutures to correct the angles of the lower pieces of cartilage that form the tip of the nose. 

These are just a few of the complications that can be corrected with a revision rhinoplasty. If you’re concerned about your ability to breathe or the appearance of your nose after an initial rhinoplasty, you may be a good candidate for a revision rhinoplasty. The best way to know what your options are is to schedule an appointment for a personal consultation. 

Personal Consultation

All patients at Esthetica are provided with a personal consultation so that Dr. Kouli can learn more about their treatment goals, and so that he can examine their areas of concern. Dr. Kouli will be able to identify and alert you to any possible risks, complications, or considerations for the procedure. He’ll review your medical history and the operative report from your initial surgery, and perform an examination to better understand the changes that have been made to your nasal anatomy and skin thickness. You’ll also be able to look at before and after photographs from previous operations on areas of concern similar to your own so that you know what kind of results you can expect. Dr. Kouli will explain his recommendations for the best way to alter your nose for the desired aesthetic and function. We perform digital imaging during consultations, so you’ll have a realistic picture of what your nose will look like after surgery!


Our staff at Esthetica will make sure you’re prepared for both before and after the operation at your pre-op appointment. Our boutique cosmetic surgery center has two consultants who will walk you through each stage of the procedure so that you know exactly what to expect. You will need to fill out a medication sheet to avoid the risk of any side effects or interactions that could lead to complications. Patients will be asked to refrain from taking any over-the-counter pain medications or consuming alcohol in the days leading up to the procedure. You’ll also need to plan to have a trusted adult to pick you up after your procedure, and to make sure that you have a comfortable place to recover. The team at Esthetica can help with these arrangements so that you have the best possible experience. 


On the day of the procedure you’ll have the chance to discuss any last-minute questions or concerns, and you’ll meet your anesthesiologist, operating room technician, and recovery room nurse. You will be administered general anesthesia so that you’ll remain comfortable for the duration of your operation. Dr. Kouli will make the necessary adjustments to the underlying structure of the nose in order to address your concerns and achieve your desired results. Once the procedure is completed, you will be awakened from the anesthesia and taken to the recovery room where you will be able to relax until you are ready to go home.


Follow-up appointments after a rhinoplasty are always done the day after the procedure, as well as three to four days after. One week after the procedure, patients will have an appointment to remove the nose splint and see their new nose. Some of our patients have been brought to tears of joy at the sight of their new nose and it is something that our entire office enjoys tremendously. Most patients are extremely happy with the immediate results of the procedure, however, the full effect will not be noticeable until several months after. A majority of the swelling from nasal surgery will take a few months to resolve, and the final remnants of swelling can take up to a year to resolve entirely.

We provide each patient with a post-operation goody bag that contains a variety of items to help with your healing and comfort after the procedure. Some patients resume their normal activities within a few days after the procedure. Others spend a week or two recovering from the operation and resting at home. Our boutique cosmetic surgery center will ensure that you have a seamless recovery and monitor your progress. All patients are given the personal cell-phone numbers of our doctors so that they can stay in touch throughout the recovery process. 


While no ethical surgeon can entirely guarantee the results you desire, Dr. Kouli’s extensive experience and technical expertise make him well-qualified. Nearly all of Dr. Kouli’s patients have been satisfied with the results of their procedures – both aesthetically and in regards to improvements with their breathing. 

Corresponding & Complementary Procedures 

Often, a rhinoplasty is performed in combination with other procedures such as a chin augmentation or submental liposuction in order to give the patient a nicely balanced profile and defined jawline. 

How Much Does a Rhinoplasty Cost in Orange County?

Rhinoplasty procedures vary in price significantly depending on the specific details and extent of the treatment. Our team of experts at Esthetica will give you a price assessment for your procedure and treatment during your personal consultation. Contact us today to schedule your personal consultation and find out more.


What is a rhinoplasty?

A rhinoplasty, commonly referred to as a nose-job, is a plastic surgery procedure that alters the structure or shape of the nose in order to improve the patient’s appearance or breathing ability.

What is a revision rhinoplasty?

A revision rhinoplasty, also known as a secondary rhinoplasty, is a rhinoplasty that is performed on a patient who has already received a rhinoplasty. Its purpose is to achieve desired results that were not obtained from the previous rhinoplasty, or to fix damage to the nose from a previous operation. 

Are rhinoplasties covered by insurance?

If you have sustained trauma to the nose, then your insurance company would likely cover nasal reconstructive surgery for function, appearance, or both. If the procedure is done without a history of trauma solely for improving the appearance of the nose, then it is considered cosmetic and would not be covered.


  1. Rohrich RJ, Ahmad J. Rhinoplasty. Plastic and Reconstructive Surgery. 2011;128(2):49e73e. doi:10.1097/prs.0b013e31821e7191
  2. Neaman KC, Boettcher AK, Do VH, et al. Cosmetic Rhinoplasty: Revision Rates Revisited. Aesthetic Surgery Journal. 2013;33(1):31-37. doi:10.1177/1090820×12469221
  3. Constantian MB. What Motivates Secondary Rhinoplasty? A Study of 150 Consecutive Patients. Plastic & Reconstructive Surgery. 2012;130(3):667-678. doi:10.1097/prs.0b013e31825dc301
  4. Hacker S, Pollock J, Gubisch W, Haack S. Differences between Primary and Revision Rhinoplasty: Indications, Techniques, Grafts, and Outcomes. Plastic and Reconstructive Surgery. 2021;148(3):532-541. doi:10.1097/PRS.0000000000008216
  5. Cuzalina A, Qaqish C. Revision rhinoplasty. Oral and Maxillofacial Surgery Clinics of North America. 2012;24(1):119-130. doi:10.1016/j.coms.2011.10.003