Undergoing rhinoplasty once is enough for most patients, but the requirement of a follow-up surgery to fix a problem that occurred during the initial rhinoplasty is not a pleasant thought even for the most stoic patient. A follow-up surgery to correct the primary rhinoplasty is called rhinoplasty revision. Patients seek to have revision surgery because they may not be satisfied with the aesthetic results of the first surgery, or due to obstructed breathing following primary surgery. Revision rhinoplasty is a complex surgery that requires a great deal of skill and medical knowledge. Since the nose has already been operated one once, it may be necessary to use synthetic materials on the structure of the nose or to graft cartilage from another area to the nose. If a patient is dissatisfied with his/her rhinoplasty, then he/she should seek a consult from a board certified plastic surgeon, and perhaps one with extensive experience in facial reconstruction. Fixing a problematic nose job is much harder than the primary surgery, so make sure this is not your plastic surgeon’s first rodeo with revision rhinoplasty. Michael Eisemann, M.D. is a triple board certified plastic and reconstructive surgeon in Houston who has over 30 years of experience in revision procedures.