I had rhinoplasty surgery on June 1st 2011 so remove a hump on the bridge of my nose. About 4 months into the healing a bump formed on the bridge. I am going in for a minor revision which he says should just be some rasping. he also says there's a 20% chance he has to break the bone again. I am very nervous,I don't want to go in for an improvement and have something terrible happen. What are the risks involved here? I have the worst luck, I just want to better myself not make anything worse.
Bump 2 Years After Closed Rhinoplasty?
Doctor Answers (8)
Bump 2 years after closed Rhinoplasty?
When removing a nasal hump, it may be necessary to perform osteotomies (fracturing of the nasal bones). An open roof deformity can occur if a nasal hump is reduced and osteotomies are not performed, or not performed properly. During a nasal hump reduction, the tops of the nasal bones are shaved down to decrease the appearance of the hump. This can make an opening in the top of what is referred to as the “roof.” Performing osteotomies can help to move the bones inward and reduce the open roof. I would recommend communicating any concerns to your surgeon prior to having your revision procedure. I hope this helps, and I wish you the best of luck.
Hump Removed, Bump Appears. What to do?
During rhinoplasty, humps are removed, tips are refined, twists are made straight. As with all cosmetic surgery, however, there is no perfection. In America, an estimated 10-15% of individuals undergoing rhinoplasty will undergo a revision to fix a problem with the first operation (or to make additional changes). Sounds like you are in this category.
But try not to worry- usually your situation has a straightforward fix.
Modifications to the bridge of the nose to reduce or eliminate a hump can occasionally result in the appearance of an "irregularity" in either the bone or the cartilage. A bump- so to speak. They often are not visible right away, but appear in the months of healing after a rhinoplasty. They are visualized in certain angles and detract from the overall result of the rhinoplasty.
As your surgeon indicates, removal of theses bumps typically requires a minor revision to shave or rasp the irregularity, thereby making it invisible. This is typically done in a closed fashion (no external incisions) and takes less than an hour. (If the bump is cartilage only, these can often be treated in the office under local with needle subcision.) And unless the bump is large, you probably will NOT require additional osteotomies... usually less is more in these instances so as not to introduce some other uncertain variable in healing. The only other thing I'd add? Be realistic in your expectations BEFORE your procedure. There is no perfection. At the end of the day, take the improvements you've gotten and be happy. Good luck! - Dr. Capone
Bump 2 Years after Rhinoplasty
In the hands of an experienced rhinoplasty surgeon there is minimal risk when removing a small hump on the nasal bridge.
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Minor revision closed rhinoplasty
Filing down a small bump after close rhinoplasty is a minor procedure. Depending upon the size of the bump, osteotomies may or may not need to be performed. The reason of osteotomies may need to be performed his to prevent an open roof deformity.
Look at the big picture when it comes to a nose job
Perfection may be the goal but not the reality. Improvement is always what you should hope for and expect. The nose is not made of plastic or metal or stone. Edges of previously rasped bone and shaved cartilage will heal and scar tissue always forms and results change with time. If you have a big improvement achieved already and the new bump is minor then you can just leave it alone because each and every surgery has risk. There is no risk-free rhinoplasty. But if your plastic surgeon did a good job and you didnt heal well and a minor touch up is needed then trusting him to do a good job again is reasonable. Too many patients lose faith too quickly without the proper information that is often fueled by misinformed friends and relatives as well as other plastic surgeons seeking to gain more business. But if your surgeon truly didnt do a good job the first time then you are certainly correct to hesitate and question your decision to go back to him. Just understand that even in the best hands there are risks and healing is unpredictable and if it is good enough then leave it alone but if its not good enough then you need to weigh the risks vs rewards of another surgery. Good luck
the risks of a secondary rhinoplasty are the greater than the risks of a primary rhinoplasty. with that said it is important to choose someone with experience and someone with whom who you feel confident.
Minor endonasal revision rhinoplasty
It's unlikely that "something terrible" will happen with a minor revision such as the one you are describing. In experienced hands, I would say in the worst case scenario, the hump would persist after the revision. If you are otherwise happy with your nose make it clear to your surgeon, so that he/she does not alter anything else during surgery.
Bump following rhinoplasty
Most likely the bump was not taken down enough. If it a small bump or ridge, then rasping or filing it down is the correct method. You surgeon should know before the surgery day.
If the bump is too big, he or she will have to use a chisel to shave off hump and may be to more bone cuts.
Ask your surgeon
Dr David Ellis, Toronto
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.