Failures following sinus surgery for inflammatory disease can be due to a number of variables. These include anatomical, surgical, and patient factors such as patients with severe disease phenotypes (AERD). Incomplete or conservative sinus surgery has shown to be the one of the biggest controllable factors which can be addressed. Revision sinus surgery aims to achieve completeness in surgery, and where already “Full House ESS” has been performed, advanced expanded sinus procedures can be employed with the aim to allow better topical steroid delivery into failed sinuses. This chapter will highlight reasons for failure and advanced procedures to help manage recalcitrant disease.