Revision Rhinoplasty in Beverly Hills

Some patients actually believe that a surgical revision rhinoplasty is to be expected, or is the norm. That is incorrect. The rhinoplasty super-specialists generally have a very low rate of revision rhinoplasty.
- A. Norman Enright
Medical Writer

Dr. Robert Kotler is a revision rhinoplasty specialist in Beverly Hills that has performed thousands of secondary nose jobs. When other less experienced surgeons have not achieved the natural result their patients were hoping for, Dr. Kotler is the best rhinoplasty revision doctor people turn to as he is the nose super specialist. 

Due to the practice’s predominant focus on perfecting the nose, any prospective patient can view our unmatched collection of revision rhinoplasty before and afters from our happy patients that have experienced a rhinoplasty gone wrong just like you may have before seeing Dr. Kotler.

After his board certification and fellowship training, Dr. Kotler had the privilege of studying under one of the most renowned nasal surgeons in the world. And for the past several decades, Dr. Kotler has been performing several types of revision rhinoplasty, including ethnic revision rhinoplasty and permanent non-surgical revision nose jobs. Patients can find comfort in knowing Dr. Kotler is truly the most experienced revision nose surgeon and the best doctor in Beverly Hills for anybody seeking their secondary rhinoplasty. 

Revision Rhinoplasty Before and Afters


Dr. Kotler’s high level of training and specialization has given him unique insight into the common problems that may occur during and after rhinoplasty. Dr. Kotler is proud to have successfully performed this highly complex surgery on thousands of patients. Whether your initial rhinoplasty has left you with cosmetic defects or you are simply unhappy with the results rhinoplasty surgeon, Dr. Kotler, can help you achieve the results you deserve.

Most revision rhinoplasty patients are particularly worried of how your revision rhinoplasty will look, but at our practice you don’t have to be because there are no surprises. Dr. Kotler has computer imaging technology so you can see what your secondary nose job will look like before you have the procedure done. This visual will give you a good idea of what to expect and provides an open door of communication for sharing your desired results with Dr. Kotler. 

How Long Should Patients Wait Before Undergoing Secondary Rhinoplasty?

After cosmetic nose surgery, it’s common for swelling and postoperative effects to obscure the results. If you are still unsatisfied with your results by six months after the initial surgery, then it might be time to consider revision rhinoplasty. The standard timeframe to wait is about a year after surgery – this gives the nose time to heal fully.

Why Revision Rhinoplasty?

Collapsed Bridge

Cartilage plays an important role in supporting the nose and giving it shape. If too much cartilage is removed during rhinoplasty, certain parts of the nose may eventually collapse. This typically occurs over several years. Patients may notice the dorsum (the bridge) develop a depression until it gradually collapses. Depending on the severity of the collapse, it may obstruct the inside of the nose and cause breathing problems. Bridge collapse can also occur after removing a dorsal hump, especially if it involved removal of dorsum cartilage.

To rebuild the supporting structure of the nose, Dr. Kotler can use cartilage grafting to restore form and function. In some cases, he can also use the permanent filler, Silikon 1000, to build up the nasal structure. Both techniques are also used in primary rhinoplasty if the patient has a naturally flat or low dorsum and is seeking a balanced profile.

Uneven Nostrils

In some cases, rhinoplasty patients end up with asymmetric nostrils. When altering the delicate structures of the nose, special care must be taken not to overcorrect or remove too much cartilage and bone. When certain parts of the nose lack support, these weak points may collapse in and protrude to the other side, causing nostril asymmetry from the frontal view. While a certain level of asymmetry is normal, it can be frustrating to be left with a nose that appears more crooked after rhinoplasty.

Dr. Kotler addresses nostril asymmetry by correcting the protruding cartilage and building up the foundational structure of the nose. This also helps prevent future defects from developing.

A Drooping or Upturned Nose

Like many post-rhinoplasty defects, a drooping or upturned nose is frequently caused by overcorrection. When the nose lacks proper support, the nasal tip collapses backward and becomes over-rotated. Conversely, the nasal tip may become under-rotated and droop forward without adequate support. This causes an upturned appearance. An upturned nasal tip can also be caused by the contracture of scar tissue, which essentially pulls the tip backward. Dr. Kotler can reverse this cosmetic defect by restoring the supporting structure of the nose and releasing scar tissue when needed.

Unsatisfactory Results

Like many post-rhinoplasty defects, a drooping or upturned nose is frequently caused by overcorrection. When the nose lacks proper support, the nasal tip collapses backward and becomes over-rotated. Conversely, the nasal tip may become under-rotated and droop forward without adequate support. This causes an upturned appearance. An upturned nasal tip can also be caused by the contracture of scar tissue, which essentially pulls the tip backward. Dr. Kotler can reverse this cosmetic defect by restoring the supporting structure of the nose and releasing scar tissue when needed.

What To Expect From Surgery And Recovery

Objective: Cosmetic and/or functional nasal surgery aims to create a better-appearing and better-functioning nose. To render your nose more compatible with the other facial features. The changes Dr. Kotler proposes will not make the nose look “unnatural,” or “done.” The goal is to create a natural-looking nose that is pleasing and not recognized as having had surgery.

Anesthesia: Anesthesia administered by a physician-anesthesiologist specializing in facial procedures. Under anesthesia, there is no pain and no awareness. An intravenous is started and you “drift off” to sleep.

Total Surgery Time: Approximately 1 hour in the operating room.

Recovery Room: Usually 1 hour in a fully monitored and state-of-the-art recovery room at the surgery center.

Convalescence: Professional care is optional. If you choose to recover at home, someone must be with you the first night. As with all of our procedures, precise instruction/direction sheets are a “care package” of supplies and medications are provided.

Stitch Removal: Since most nasal procedures are performed entirely internally, dissolving stitches are placed into the nasal interior. These generally need not be removed.

The First Week: If your surgery has been only cosmetic, you will remove the internal nasal packing at home the day after surgery. Approximately 5 days after surgery, you will return to the office for removal of the protective cast. For patients who have functional surgery, with or without a cosmetic improvement, the packing will be removed in the office 5 days after surgery, at the same time the protective cast is removed. Contact lenses can be worn 2 to 3 days after surgery. 

At this time, you are free to return to work and usual activities and functions except for strenuous exercise. If there is any bruising at this time, it should disappear within the next 2 to 3 days and can be easily concealed with make-up (we will provide instruction). If you wear eyeglasses, we will teach you to suspend them from the forehead so that the glasses do not rest on the nasal bridge. This precaution must be observed for 5 weeks after surgery.

After That First Week: Any residual swelling rapidly diminishes. The nasal airway improves daily. Since the nasal interior tends to be somewhat dry after surgery, we provide a soothing saltwater nasal spray to refresh the healing internal tissues. Optimal breathing is generally achieved within 1 month. 

Generally, you will be seen twice weekly in the first month after surgery to check healing and answer your questions. Thereafter, visits are infrequent. Postoperative photos are taken no sooner than 3 months after surgery. Just in case you long to see what your “old nose” looked like, we provide copies of your preoperative photos for you.

Are There Other Options Besides Surgical Nose Revision?

In some cases, cosmetic irregularities after nose surgery do not require additional surgical intervention. With Silikon 1000, Dr. Kotler can permanently fill in minor depressions and divots on the nose. This procedure takes just minutes to perform, and it is virtually painless when accompanied by a topical anesthetic. Post-op bumps that have developed on the nose may also be flattened and smoothed away using cortisone injections.

For patients interested in pursuing the non-surgical route, our Beverly Hills practice offers the Kotler Saline Demo. Using saline injections, Dr. Kotler can show patients what results they can ultimately achieve if they decide to go with a permanent filler after rhinoplasty. The saline is safely absorbed by the body about two hours later, allowing patients to “test drive” a non-surgical rhinoplasty revision before making the final decision.



Revision Nose Job Reviews

Hear from actual patients in need of a revision rhinoplasty and their experience with Dr. Kotler.

Dr. Kotler is the best surgeon in Beverly hills. He is a master at nose jobs, especially revisions. I am so happy with his work that people don't even notice that I had my nose done..its beautiful. Its so natural , people think I went to the spa or had botox because they can't figure out what's changed, or my lips look fuller. He is truly skilled surgeon and is an artist. He has changed my life and his work made me feel confident about myself..... Thank. You Dr.Kotler for changing my life and Mary Jaku for making the whole experience wonderful. Mary, you are a gem!!!!
Rebecca S.
🙂 First, I want to say how wonderful, kind and caring Dr. Kotler, Mary and his whole staff are! From my very first consultation to all my check-ups, they have always been consistently amazing. Dr. Kotler Is the best rhinoplasty doctor in the world. I would know because I have had numerous consultations with the top rhinoplasty revision doctors and he, by far, has more knowledge and experience than any of them. When I had my consultation with him I knew right away, with no hesitation, that he was the doctor that could fix my nose. I had a primary rhinoplasty with a different doctor years ago and have had two accidents that broke my nose and left me with a deviated septum. My nose was a mess; I knew It would be a challenge to repair. During my consultation with Dr. Kotler, he addressed all my concerns, answered any questions I had, and was so patient with me through the whole process. He took the time to explain the healing process to me and let me know that it might take a while for my swelling to go down but my nose would continue to look better and better as time went by. I unfortunately take longer than the average person to heal, so I was swollen for a very long time, which is why I have waited a year to write this review, so I could show accurate before-and-after photos now that the majority of the swelling has gone down. At all of my check-up appointments with Dr. Kotler, he assured me that the swelling would go down and my nose would look more refined as the months went by. It took a very long time for the swelling to decrease, but I had complete trust in him and waited patiently and confidently, knowing that he is an expert in his field. It was definitely worth the wait! He did a beautiful job fixing my nose, I can breathe perfectly, and I love the way it looks. He exceeded all my expectations and I am so pleased with the outcome. Dr. Kotler truly cares about his patients and Is there every step of the way to support you before and after your surgery. I also want to add that my surgery was not painful, with only a bit of pressure, and I could breathe right after surgery, because Dr. Kotler uses his invention, the Kotler Nasal Airway (there was no packing in my nose) so I was comfortable right after surgery. Dr Kotler's skills are most evident in his work; he is the best of the best! Check out my photos.
Words cannot express how happy & grateful I am to have met Dr Kotler! Back in 2015, I had undergone a rhinoplasty/septoplasty procedure w/ a different surgeon who shall not be named because honestly...I was not happy at all with the final result. Looking back, I wish I had done much more research on not only the procedure itself, but exploring what skills, experience and artistic vision makes for a masterful surgeon. Long story short, I ended up with a nose I was NOT happy with. No matter how many months, years and angles I tried to convince myself, I knew in my heart it wasn't the result I had hoped for. It simply did not fit my face. It was too short, too skinny and too sharp from every angle. I started doing research on ways I could fix it. I had only ever heard of revision rhinoplasty (which I really didn't want to do) and/or non-permanent filler injections, which to my knowledge, only last about 6-12 months. It didn't take long for me to discover DR. KOTLER as being the top searched surgeon and nose specialist on Google. I started reading through his list of accolades, his published works, his beautiful gallery of before and after patient procedures. I read about his advancements in the field of permanent non-surgical rhinoplasty procedure using silicone. I had no idea this was even an option but I scheduled a consultation as quickly as I could to learn more. His office is gorgeous, warm and inviting. I was greeted by Mary who was incredibly knowledgeable and honest about what I could expect from the procedure. She also went down the list of multiple financing options, which was very helpful. Upon consultation, Doctor acknowledged that I was the perfect candidate for the permanent non-surgical rhinoplasty using the medical grade silicon injections. He assured me not too much silicon would be needed to get the desired results because I already had a little bit of cartilage grafting added near my bridge during my original procedure. My first injection set took about 10 minutes. Dr. Kotler took photos of every angle of my nose and walked me thru all the areas that needed a little more building. It took about 4-5 short little injections that felt to be the equivalent of an ant bite (after a topical numbing cream was applied). There was an instant difference! My nose had already begun to look so much more natural. The key for me was looking at the way the light in the room hit it. I could not shut up about it. This really is permanent?!" I kept asking in my excitement. Doctor confirmed it with a smile, "yes, and it will only get better looking following the next set." ...and it has! I'm due in on September 15 for my final injection. I'm so happy to have not only discovered that this procedure existed but that Dr Kotler specifically, was able to work his magic and revive my self confidence. I only wish I had done this sooner, but alas, our paths crossed just as they were meant to. I'm very grateful that they did. More updates soon!
Dr. Kotler performed a revision rhinoplasty on me in late Oct and the results are amazing!!! His patented breathing tubes made all the difference in my comfort during recovery. I could actually breathe immediately following the surgery!!!!!! I had been unhappy with my nose, cosmetically and functionally, for years before going to Dr. Kotler but was terrified to have another bad result. I am so thankful that I was referred to him by a friend. He has changed my life... He is truly a master of his craft. I can't thank him and his staff enough for the 5 star service I have received.