Functional and Aesthetic Factors Associated with Revision of Rhinoplasty

Bouaoud J, Loustau M, Belloc JB.

PubMed 30349780 Publisher (DOI)Free full text (PMC)

What this paper says

Among 732 closed rhinoplasties over 10 years, 62 patients (8.6 percent) needed revision, with preexisting breathing problems and wide or deviated nasal bones raising the risk and camouflage grafts lowering it.

Overview

Reported revision rates in rhinoplasty range from 5 to 15 percent, but the factors predicting revision are less clear. This single-center case-control study compared patients who returned for revision against those who did not, drawing on medical records and photographs.

Sections of note

Single-center case/control study of 62 revision patients among 732 who underwent closed rhinoplasty between 2005 and 2015.
Surgical revision rate was 8.6 percent.
Data were collected from medical records and photographs, and analyzed statistically.
Four factors were independently associated with revision on multivariate analysis.
Preexisting respiratory functional disorder: odds ratio 3.30, 95% CI 1.47 to 7.76, P 0.004.
Wide nasal bone and side walls: odds ratio 3.94, 95% CI 1.49 to 11.25, P 0.007.
Deviated nasal bone and side walls: odds ratio 2.68, 95% CI 1.14 to 6.58, P 0.02.
Use of camouflage grafts: odds ratio 0.26, 95% CI 0.07 to 0.89, P 0.04, meaning reduced odds of revision.

What it means for a patient

Roughly 1 in 12 patients here needed a second operation.
A nose that is already blocked, wide, or crooked before surgery carries a higher revision risk, roughly 3 to 4 times.
Camouflage grafts were associated with about a quarter the odds of revision, though the confidence interval is wide.
Limits: single center, retrospective, closed technique only, and the study identifies associations rather than causes.

Why this paper matters

Revision rate is the number patients most want and surgeons least often publish, and this puts a figure on it with the risk factors attached. It also finds that closed rhinoplasty revision rates resemble those of open technique. The associations come from one surgeon's practice and may not transfer.

Terms

Revision rate: The proportion of patients who go on to have a second operation.
Case/control study: A design comparing those with an outcome against those without it.
Odds ratio: How many times more likely an outcome is in one group than another; below 1 means less likely.
Confidence interval: The range within which the true value probably lies.
Camouflage graft: Material placed to disguise an irregularity rather than to support structure.

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

Abstract

Background: Surgical revision rate of rhinoplasty is from 5% to 15% in literature. The aims of our study were to define the rate and the predictive factors for surgical revision of rhinoplasty.

Methods: We have realized a single-center case/control study including 62 patients who underwent surgical revision among 732 patients who underwent closed rhinoplasty between 2005 and 2015. Data of each rhinoplasty were collected from medical records and photographs. Statistical analyses were used.

Results: The surgical revision rate was 8.6%. After multivariate analysis, 4 factors were statistically significant and independently associated with surgical revision: "preexisting respiratory functional disorder" [odds ratio OR = 3.30; 95% CI (1.47-7.76); P = 0.004], "wide nasal bone and side walls" [OR = 3.94; 95% CI (1.49-11.25); P = 0.007], "deviated nasal bone and side walls" [OR = 2.68; 95% CI [1.14-6.58]; P = 0.02] and the use of camouflage grafts [OR = 0.26; 95% CI [0.07-0.89]; P = 0.04].

Conclusions: Closed rhinoplasties have similar revision rate to open techniques. Revision surgeries are justified by functional or aesthetic disorders. The interests of this study are to better inform patients and to adapt operative management. We provide here some recommendations with focus on the keys to successful rhinoplasty surgery.

Abstract as indexed by PubMed; the article is open access (PubMed Central).