West Orange Facial Plastic Surgeons

"Scar Tissue Bump" is It Permanent or Will It Go Away? (photo)

I had a rhinoplasty April 16, 2011. A bump has formed on the bridge of my nose. My doctor say's it's scar tissue and it's so noticeable because I'm thin. I got a steroid injection at my last visit, but it didn't seem to help. Will this go away, or is it permanent? You can't see it in a picture taken in May of 2011. When he massages it, it will go down for the rest of the day, and then come back the next day.

I read your concern and reviewed your photos:

Your photo from 5/11 does not show this irregularity since you're still swollen 1 month post-rhinoplasty. Now that you're 10 months post-op, nearly all of the swelling in your bridge is gone, and we may be seeing an irregularity of your underlying cartilage or bone. You appear to have thin skin, so even small irregularities could be visible in your nose. I would not suggest more steroid injections as this can lead to further thinning of your skin.

You may benefit from a second opinion from a reputable rhinoplasty surgeon to confirm the cause of this bump, since it may not be "scar tissue".

I can't be certain without seeing you, but you appear to have an indentation below your "bump". A carefully placed Injectable Filler might help improve this appearance. My personal preference is to use Silikon-1000, an off-label filler for permanent results.

Hope this helps.

Dr. Joseph

Eric M. Joseph, MD

West Orange Facial Plastic Surgeon

How Common is This Post-rhinoplasty Procedure? Benefits? Risks? (photo)

I had a limited rhinoplasty done. My surgeon says that my nasal bones have shifted outward, back towards their original position. This has left noticeable protrusions in my nose at the upper bridge (pictured below). My doctor has suggested putting me under local anesthesia and doing some "carpentry" on these areas. How common is this "shifting" and required "carpentry" occurrence? Is this procedure likely to work given the degree of protrusion? Risks? Thanks in advance for your help.

I reviewed your concerns and photos:

If the photo on the left is "before", and if the photo on the right is "after", you do not appear to have had a significant change in your appearance.

If you're concerned by the protrusion of your nasal bones high up on your bridge, my personal preference would be to address this under general anesthetic. You may require osteotomies to reposition your nasal bones, and in my view, this is best performed with your airway protected and general anesthetic.

Hope this helps you.

Dr. Joseph

Eric M. Joseph, MD

West Orange Facial Plastic Surgeon

Will my Surgeon Be More Likely to Do a Better Job on my Rhinoplasty if I'm His First Surgery of the Day or the Last?

I know it seems like a silly question but its really not. Take for example my hair stylist. I've found she does a much better job if I'm her very first client of the day. Verses being the last when she;s worked all day and tired. I know a stylist goes through a lot more clients in a day then a surgeon, so their not comparable. But i'm still wondering if it makes a difference? I've researched my surgeon and am confident in him but i'm still looking for the best possible results, as is anyone!!

The maximum number of nose jobs I will schedule for a morning is three. As long as your surgeon is expert at rhinoplasty, you should be fine if your case is within the first three of the day. 

Rhinoplasty may take around two hours, and after 6 hours of intense concentration (3 cases), I'm ready to leave the surgicenter. Other surgeons may have different levels of mental stamina: this commentary is based on my personal preference.

Hope this helps.

Dr. Joseph

Eric M. Joseph, MD

West Orange Facial Plastic Surgeon