Mr Mark Ferguson PhD FRCS (ORL-HNS)

In my practice, I perform a large number of revision rhinoplasty procedures every year. Many of my patients come to me after a previous nose surgery that left them unhappy (whether due to cosmetic concerns or functional issues, or both).

I find revision or corrective rhinoplasty surgery particularly rewarding. I have helped many patients move on from a disappointing result to finally feeling confident in their appearance. Revision rhinoplasty is a highly specialised and complex procedure. It requires not only technical skill, but also a deep understanding of nasal structure, airflow and function.

Revision rhinoplasty is about restoring balance, function, and confidence. I’ll always be upfront about what’s achievable and what’s not advisable. If a request risks your long-term health or the stability of your nose, I won’t perform it. If I don’t feel I can make a huge difference to your nose’s appearance, I will advise you honestly.

In many revision cases, the nose has lost support or structure. That’s why material is often needed to rebuild or reinforce the nose. The most common source is cartilage from the ear, which is soft, curved, and ideal for reshaping the tip or sidewalls.

Every case is different, but I have very high levels of patient satisfaction for Revision Rhinoplasty.

There are many reasons someone may be dissatisfied after a first nose job. Some of the most common complaints that I can help to address are:

1. Asymmetry – the nose may appear crooked or uneven.
2. Too thin or too wide – the bridge or tip may have been over- or under-reduced.
3. Residual bump – not enough of the dorsal hump was removed or scar tissue may create a bump where there wasn’t an issue before.
4. Over-reduction – the nose may look scooped or collapsed (saddle nose deformity).
5. Pinched tip – the tip appears too narrow or lacks support (alar collapse).
6. Visible nostrils – excessive nostril show (alar-columellar disproportion).
7. Short nose – the nose appears too upturned or over-rotated.
8. Prominent nasal bones – the upper third of the nose may still look wide or irregular.
9. Deviated septum – breathing problems that were not corrected, or were made worse.
10. Snoring or nasal obstruction – often due to internal valve collapse or poor support.

These issues can be distressing—especially when you’ve already gone through surgery once. My role is to listen carefully, assess thoroughly, and offer a clear, honest plan for what can be improved.

Revision rhinoplasty is performed under general anaesthetic and typically takes 3 to 4 hours, depending on complexity.

• I usually use an open approach, with a small incision across the columella, to allow full access to the internal structures.
• Scar tissue from the previous surgery is carefully released
• I then reshape or rebuild the nose using grafts—from the ear or donor tissue.
• If functional issues are present, I’ll address them at the same time. This might entail straightening the septum, reinforcing the nasal valves or correcting internal collapse.

Every step is done with precision and care, with the goal of restoring both form and function, while also creating a beautiful and natural looking nose.

Recovery from revision rhinoplasty is similar to primary surgery, but healing may take longer due to scar tissue and the complexity of the procedure.

• Week 1: Plaster is removed. Swelling and bruising are expected.
• Weeks 2–3: Internal nasal splints are removed (more common in revision surgery). Bruising fades. You can usually return to work after 10–14 days.
• Months 3–6: Swelling continues to settle, especially around the tip.
• 12–18 months: Final results become visible.

I’ll see you regularly during recovery to monitor healing and ensure everything is progressing as expected.