Revision Nose Job Specialist | San Diego Revision Rhinoplasty Surgeon


Sometimes It Is Not the Wrong Surgeon, but the Wrong Philosophy. Start With the Right Philosophy.  Revision rhinoplasty is an advanced procedure that requires highly sophisticated training, expert techniques and the hands of a specialist.

Medicine is constantly evolving with new techniques, knowledge and philosophies. Recent advances in nasal surgery are replacing methods that were once considered state-of-the-art. Ten years ago, many surgeons shared the philosophy of removing a significant amount of cartilage to reshape the nose. This would frequently lead to overly narrowed, pinched tips and scooped bridges.

While a dissatisfying outcome in nasal cosmetic surgery is possible even in the most skilled hands, more commonly it comes from the hands of the occasional nasal surgeon. Revision rates with inexperienced physicians have been reported to be as high as 20%.

The decision to have a revision surgery can be a difficult and often emotional one. Dr. Kolstad believes in approaching the procedure as your partner. He works with you to ensure that all of your concerns are discussed and that he clearly understands your goals. Dr. Kolstad believes that those seeking revision surgery need to be advised honestly about what they can expect.

Dr. Kolstad’s analytic approach distinguishes him from his colleagues. He believes in a customized approach that is specific to the way that your nose will harmonize with your face.

Dr. Kolstad learned his technique from one of the best rhinoplasty surgeons in the world. He spent an entire year in New York working exclusively with one of the world’s premier Facial Plastic Surgeons.

“You do not learn plastic surgery from a book or by watching a video. You learn to become the best by working with the best.”

Revision nasal surgery is more challenging than primary rhinoplasty for several reasons. Patients that have had a previous surgery will have scar tissue which increases the complexity of the procedure.

During the first nasal surgery distorted cartilage is typically removed to reshape the nose. Consequently, during revision rhinoplasty the cartilage needed for reconstruction is no longer available. Borrowing cartilage from the patient’s ear or rib may be required to restore nasal form and function.

Dr. Kolstad prefers an open approach to the nasal framework. With this technique, incisions are primarily located inside of your nostrils, with only a small incision placed across the columellar skin, the vertical strip of tissue between your nostrils. When sutured together properly, this incision heals so well that only you and your facial plastic surgeon should know its there.

The open approach allows for a direct view of the nasal structures leading to a more predictable result. Dr. Kolstad will use cartilage from your septum, (possibly ear or rib in revision cases) to enhance the definition of your nose and to provide support.

You can choose to reduce or increase the size of your nose, change the tip or the bridge, narrow the span of the nostrils or change the angle between your nose and your upper lip.

Dr. Kolstad will evaluate the structure of your nose in relation to the shape of your face, the thickness of your skin, your height and your age. He will work with you to try to make your nose complement your other facial features.

Case #1.

This patient did not like the shape or proportion of her nose.  She had a rhinoplasty in the past and was unhappy with the results of her surgery.  She felt like the bridge was too scooped on profile view.  She was concerned that the tip of her nose was asymmetric and looked unnatural.  She had difficulty breathing through her nose.

Revision Nose Job San Diego

Case #4.

This patient did not like the results of a previous rhinoplasty surgery.  She was concerned that the tip of her nose was too rotated creating an unnatural nostril flare.  She felt like the bridge was too scooped on profile view.  She was concerned that the tip of her nose was asymmetric and looked unnatural.  She had difficulty breathing through her nose.

Case #8.

This patient had a rhinoplasty surgery several years ago.  She was concerned the results of her first nose surgery.  She felt like she had a bump on the bridge of her nose.  She was concerned that the bridge of her nose was deviated on the front view.   She was concerned that the tip of her nose was asymmetric and looked unnatural.  She had difficulty breathing through her nose.

Revision Rhinoplasty Expert San Diego

Case #10.

This patient had two rhinoplasty surgeries and was concerned with the outcome.  She had difficulty breathing through her nose and did not feel like her previous rhinoplasties created a refined appearance.  She was concerned with a bump on the bridge of her nose.  She did not like the tip of her nose thinking that it was asymmetric and looked unnatural.

Frequently Asked Questions

The rhinoplasty cast will stay on for one week. After removal of the splint, your nose will be a little swollen and “puffy”. However, even when swollen, your nose will look better than it did before surgery.

It takes two to three weeks for the majority of swelling to be reabsorbed from your nose. As the swelling is removed, your nose will become more contoured and the definition will enhance.

It takes a full 12 months for 100% of the swelling to be completely gone. The nasal skin must shrink-wrap to the new framework and definition. This takes time. Throughout the postoperative period, Dr. Kolstad will use medicines to contour the nasal skin and enhance your result.
It is common for some bruising under your eyes. With frequent use of ice packs the bruising is typically minimal and does not bother the majority of people. Dr. Kolstad recommends that his patients obtain cover-up make-up prior to surgery to help camouflage any postoperative bruising.
A frequent concern of our patients is looking plastic after rhinoplasty. There are limitless examples of unnatural, operated results. When surgeons remove too much structure, the nasal tip can look overly narrow.

It is very important to choose a plastic surgeon that specializes in operating on the face. Dr. Kolstad is an expert in nasal cosmetic surgery and is known as the face specialist, because put simply, that is all he does.

Dr. Kolstad – Double Board Certified Facial Plastic Surgeon

PDFRhinoplasty Before and After Surgery Instructions

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