Cosmetic rhinoplasty: revision rates revisited

Neaman KC, Boettcher AK, Do VH, Mulder C, Baca M, Renucci JD, VanderWoude DL.

What this paper says

Across 369 consecutive cosmetic rhinoplasties at one multi-surgeon practice over ten years, the complication rate was 7.9%, dissatisfaction 15.4% and revision 9.8%, with prior nasal surgery or fracture, incomplete correction and complications all linked to revision.

Overview

Published revision rates for rhinoplasty vary widely and risk factors are poorly defined. The authors reviewed all primary rhinoplasty, septorhinoplasty and revision cases at a plastic surgery group between 1998 and 2008 to measure complications, dissatisfaction and revision, and to find what predicted them.

Sections of note

Retrospective chart review, 369 consecutive cosmetic rhinoplasties, 1998 to 2008, multi-surgeon practice.
Open approach in 279 (72.7%).
Complication rate 7.9%; dissatisfaction 15.4%; revision 9.8%.
Surgeons judged 87% of patients to have had successful anatomical correction.
Associated with both revision and dissatisfaction (P < .05): previous nasal operation or facial fracture, lack of anatomical correction, postoperative complications.
Failure to address the tip at the primary operation was associated with higher dissatisfaction.
Level of evidence 4.

What it means for a patient

About 1 in 10 patients in this practice had a revision and about 1 in 6 were dissatisfied.
A previous nose operation or broken nose raises the odds of needing a revision.
Leaving the tip untouched when it needed work was linked to unhappiness.
Satisfaction and anatomical success were judged from charts, largely by the operating surgeons, without validated patient questionnaires.

Why this paper matters

It gives a real-world revision rate from a group practice rather than a single expert, and identifies modifiable risk factors. Follow-up length per patient and the definition of dissatisfaction are not given in the abstract.

Terms

Revision rate: the share of patients who have a further operation on the nose.
Septorhinoplasty: rhinoplasty combined with septal surgery.
Open approach: rhinoplasty through a small cut across the columella, lifting the skin.
Anatomical correction: the surgeon's judgment that the structural deformity was fixed.
Risk factor: a characteristic linked to a higher chance of an outcome.
Level 4 evidence: a case series without a comparison group.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

From the abstract

“Cosmetic rhinoplasty has great potential to change a patient's appearance. It also carries the very real risk of patient dissatisfaction and request for revision. Although there have been many published patient series studying various aspects of rhinoplasty, questions remain regarding revision rates, as well as risk…”

Excerpt; the full abstract is on PubMed.