What can be done to fix it? Hump removed and trimming back of the columella. What is the bump that protrudes up on my bridge? Will it go away? What is causing this? The right side of my nose bridge and nasal tip is fuller than the left and looks unbalanced and not right. Will this even out and look symmetrical? Could it still be swollen? Will I need revision, & how can this be corrected? Can this be performed earlier than 12 months as I am not pleased? Thanks
What has caused my nose to look like this? Open septo-rhinoplasty + spreader grafts, 5mths post-op. (photo)
Doctor Answers (3)
Nasal bridge asymmetry after rhinoplasty
You seem to have a middle vault collapse. This occurs when there is a difference in width between your upper third and middle third. At five months, there is still swelling, but I honestly believe that this will not improve. If you would like to have this corrected, it should take place after one year and would involve a slight reduction of the bony upper third and spreader grafts to augment the width of the middle third.
Bumps after rhinoplasty
There are many kinds of bumps that can develop around the middle part of the nose after rhinoplasty. In your case, what looks like a bump is a combination of slight excess of bone, but more importantly an inner collapse of the upper lateral cartilages (the cartilage sidewalls of the nose). Usually, spreader grafts are placed in order to prevent this from happening. However, it is likely that in your case the spreader grafts were either insufficiently thick, or placed too far inferiorly to provide adequate support. This may not be a technical error by your surgeon, since often the anatomy in this area is very complex and may simply not have allowed your surgeon to place the grafts where they belonged.
Treatment for this can be either surgical or non-surgical. If they appearance bothers you a lot and you don't want to wait for one year for correction, then consider having Restylane filler placed in the area by someone skilled at that. Restylane is a hyaluronic acid filler than works well in this area. Best of all, it can be dissolved if you decide you want surgery closer to one year.
Revision surgery in this area should be delayed until you have fully healed. This may be as little as 9 months, but probably never before that. The skin is very thin in this area, so all the swelling and scar tissue should be gone before revision is performed, otherwise you will still have an unsatisfactory outcome after the revision.
What has caused my nose to look like this? Open septo-rhinoplasty + spreader grafts, 5mths post-op.
The nasal bridge asymmetry can be addressed at 12 months, sometimes sooner.
Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties and rhinoplasty revisions each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.
Kenneth Hughes, MD
Los Angeles, CA