If you are considering undergoing revision cosmetic surgery, it is key to understand what can be different in a revision procedure. From choosing a surgeon to timing your procedure, we are discussing the differences you should know in order to show up to your revision cosmetic surgery consultation well-informed.

What is revision cosmetic surgery?

Revision cosmetic surgery is a procedure performed in order to adjust a result from an earlier cosmetic procedure. For example, revision breast augmentation may be performed to replace breast implants after a capsular contracture complication, or a revision rhinoplasty may be performed to correct an asymmetrical nasal tip or difficulty breathing after surgery.

The importance of choosing a highly-qualified cosmetic surgeon

While it is to be expected that certain patients will require a revision despite having worked with the best of cosmetic surgeons, revisions are less common in the hands of those at the top of the field. There are many variables in a successful result, but your surgeon’s skill and artistry are paramount to safely achieving the result you had in mind, and thus avoiding additional surgeries.

Revisions are less common in the hands of those at the top of the field.

One primary mark to look for: board certification in cosmetic surgery. The American Board of Cosmetic Surgery promotes patient safety and excellence in cosmetic medicine by exclusively certifying safe, skilled, and ethical cosmetic surgeons; you can learn more about cosmetic surgery board certification here or find a surgeon in our database here.

Revision surgery vs. secondary surgery

“Revision surgery” is usually performed to correct an unsatisfactory result from a previous surgery, while “secondary surgery” commonly refers to an update to one’s look or a “touch-up” performed at a later date. Many patients seek a second procedure simply to update their results. It is quite common to seek a second facelift, for example, about a decade after the initial procedure to address the continued effects of aging. Many surgeons also perform certain procedures in a multistage process for optimal results; for instance, with fat transfer (i.e. Brazilian butt lift or BBL), a second liposuction and fat injection procedure may be required for patients who desire more volume than can be effectively injected in a single procedure, since how much fat will “take” at a time varies between patients.

Why do patients seek revision surgery?

There are a few reasons patients may seek a revision surgery:

  • They are unhappy with the cosmetic outcome of the procedure.
  • They have a complication and require surgery to correct it.

Patients may also seek a “secondary surgery” once they are ready for an aesthetic change, i.e. if their surgical results have aged and they would like a touch-up.

Choosing an experienced, communicative cosmetic surgeon can go a long way toward preventing revision surgery based on an unsatisfactory outcome or a complication. First of all, an excellent board certified cosmetic surgeon will be sure to fully understand your goals before advising you on procedure(s) that can help; this avoids the common pitfall of a patient seeking a procedure that falls short of meeting their aesthetic goals and leaves them dissatisfied. Our surgeons also prioritize safety, carefully vetting patients’ pre-surgical health and operating only in accredited surgical centers that meet extremely high medical standards.

What do I need to know if I’m considering a revision surgical procedure?

Revision surgery comes with a number of unique considerations for you to take into account as you search for a surgeon and decide on surgical timing.

You may not be able to achieve perfect results. Your revision surgery will not be the same as a first-time cosmetic procedure with the same end goal. After surgery, your body deposits scar tissue and your tissues will be in a different condition, requiring nuance and specific experience with revisions on the part of your surgeon. For some procedures, including rhinoplasty, this may mean that a perfect result is not possible, even after revision. A board certified cosmetic surgeon will speak honestly about these risks so that you can make an informed decision about whether or not revision surgery is the right choice for you.

Wait until your full results develop before having another procedure. It’s important to take your time. In most cases, your revision surgeon will want you to wait about 1 year before re-operating. During this time, equip yourself with as much information as possible in order to be fully confident as you vet cosmetic surgeons and discuss your desired results.

Make sure you and your surgeon are on the same page. Communication is paramount: it isn’t easy to explain the image you have in mind to your cosmetic surgeon, but fortunately, there are many tools available to help you. Your surgeon should educate you about how they will work with your anatomy to adjust your result in understandable terms. Some surgeons use visualization software, and all surgeons should use before and after photos to show you what they’ve accomplished for other patients. Together, you should come to a crystal-clear understanding of your desired results.

The constraints of revision surgery may mean that your surgeon has to temper your expectations in certain cases, and they should share this with you ahead of time if it is a concern. Remember that it’s always acceptable to get a second opinion at any point in your surgical journey.

Which cosmetic procedures have the highest rate of revision surgery?

Rhinoplasty is a procedure known to require a high level of skill and nuance to achieve each patient’s desired aesthetic and functional goals. As such, it is thought to be one of the cosmetic procedures with a higher-than-average rate of revision. Revision rates are around 10% according to a 2013 study of one private practice; from 0%-10.9% according to a review of available research published in 2020; and possibly as high as 20% for certain surgeons according to an international survey. According to the 2020 article, revision is the most common “adverse event” after rhinoplasty, and is typically performed for cosmetic reasons.

Rhinoplasty is thought to be one of the cosmetic procedures with a higher-than-average rate of revision.

Breast augmentation may have a similarly high rate of revision surgery. Capsular contracture is a fairly common complication to arise after breast augmentation, and severe cases require a revision surgery to address the issue. This complication is thought to occur in 10.6% of patients, with some potential variation in rates based on incision location and other details of the procedure.

Do cosmetic surgeons perform revision surgery for free?

Some surgeons offer a lower fee for revision surgery if you have both procedures with them, but it varies from one practice to another. According to a 2009 survey of a selection of U.S. surgeons who perform rhinoplasty, 60% of the survey respondents charge only a facility fee if a patient requires a revision procedure. Other surgeons may also include a surgeon’s fee, or other fees.

How do I choose a cosmetic surgeon for my revision surgery?

There is a tangible benefit in returning to your original surgeon for revision surgery, if they have proven experience in successfully revising results: they are familiar with the details of your primary operation. However, if you question your original surgeon’s skills or ability to meet your needs and are seeking a new surgeon, you are likely aiming to make a careful choice. Look for these as evidence of a highly-trained, experienced, and understanding surgeon who will prioritize both your safety and your goals:

  • Results you admire in the before and after gallery. Surgeons’ online before and after galleries (and/or social media pages) are excellent meters of the surgeon’s aesthetic taste. A surgeon should showcase consistent results you admire. (Note that most surgeons have additional before and after photos they will show you at your in-person consultation.)
  • Positive reviews and referrals from other patients. Reviews demonstrate that your surgeon has worked with other patients who are very happy with their outcomes. For an extra level of trust, you may ask friends and family who have had a similar procedure.
  • Experience with revision surgery, especially in the procedure you seek. Look for specific experience with the revision procedure you seek. It is completely acceptable to ask the surgeon how many of such revision procedures they perform a year and request patient results to back up their experience claims. Ideally, you will find a specialist who has a passion for your desired procedure and holds extensive revision experience; in some cases you may need to travel to a larger metro area to find a good fit.
  • Board certification from the American Board of Cosmetic Surgery (ABCS). For highly-vetted surgeons who meet rigorous standards and who have proven their experience in achieving beautiful cosmetic surgery results safely, look for ABCS surgeons in your area.

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