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Lumpy Cartilage After Open Rhinoplasty

I had an open Rhinoplasty three months ago, and I now have quite a bit of lumpy cartilage up my nose. Is this normal/part of the healing process? Is this scar tissue, and will it go away in time? I'm also not seeing any results yet and my nose still looks wide at the base.

Doctor Answers 19

Bumps can be caused by different things

The nose can take 10-12 months to fully settle down. It is not unusual to feel mild asymmetries and contour irregularities for weeks after rhinoplasty. That being said, you should go see your surgeon and voice your issues so that he/she can examine you and help in the assessment.

Bumps can be caused by post-surgical swelling, scar tissue, cartilage asymmetries, and bone shavings or spicules. I usually let patients massage the areas of concern to see if they get better. Taping can help. The two methods only help swelling get better. Sometimes conservative steroid injections can be used to settle scar tissue down. Be careful with this method. Cartilage and bone problems may require revision surgery, but you should wait a full year post surgery to attempt any corrective surgery.

Even though you don't see huge changes at three months, your nose is still evolving and typically will make its greatest change between 8-12 months post surgery. If you have thick, oily skin you may never be able to see a ton of definition because the skin won't let it happen. In the end, see your surgeon a have them go over your list of concerns. If you don't like what they say, you should find a surgeon who specializes in revision rhinoplasty to help you if possible. Good luck.

Dr. Shah

Lumpy cartilage after rhinoplasty: Do you see it or feel it?

Cartilage grafts are very common during rhinoplasty.

When you say lumpy cartilage, do you mean that you can see it or feel it.

  • If you can see it, that may be a concern that you want to discsuss with your surgeon.
  • If you can feel it, I would not worry at this point but give it time for the swelling to resolve which as stated can take up to a year.

Did the surgeon attempt to narrow your nostrils and did you request this.?

  • If they narrowed the nose at the base, then it can be wide due to swelling and healing tissue and give this at least 8-12 months to improve.
  • If they did not narrow the nose, it can be an optical illusion which makes it seem more noticeable after removing a big hump. The other possibility is that it is swelling which is normal at this point in time.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 56 reviews

Cartilage Lumps and Swelling After Open Rhinoplasty

Believe it or not, swelling of the nose following rhinoplasty can take up to a full year to completely resolve.  It is at that point that most rhinoplasty surgeons consider the result to be final.  Cartilage 'lumps' that you feel may represent tiny remnants or shavings of cartilage that remained following the procedure.  These small bits of cartilage are usually resorbed over time.  They may also represent edges of the sculpted nasal cartilages which often smoothen over time.  Only your surgeon would know which of these situations applies to you and can best advise you as to the benefits of massaging these areas or patiently awaiting their spontaneous resolution.

Jeffrey Weinzweig, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 19 reviews

Lumps After Open Rhinoplasty

It's normal to have swelling in the tip and base of the nose for months after open Rhinoplasty.

Check with your surgeon to see if the irregularities you see and feel are normal post-op swelling, or require attention.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.5 out of 5 stars 14 reviews

Cartilage and lumps after nose surgery

Very good question.  The lumps may be a result of cartilage remnants or edges and it is uncertain whether these areas will resorb or stay longterm.  The uncertainty comes because only your surgeon knows the origin of those uneven areas.  In most cases, however, they resorb.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 61 reviews

Give Rhinoplasty results more time

Having small cartilage irregularities can potentially happen after Rhinoplasty. If you can feel them but not see them, then I wouldn't recommend doing anything about it. If however you can see them, there are two possibilities. One is it is scar tissue buildup, the other possibility is that it is the edge of a cartilage graft or cut that was made.

Unfortunately, swelling takes a long time to go away after Rhinoplasty surgery. So I would say that you would need to give it some more time to settle down. If however, if it's persistent after 6 months, it's unlikely that it will go away, and you would want to see your doctor again for a repeat examination.

With regards to your overall result, again, unfortunately swelling takes a long time to settle down and the full effect won't be evident for a year or more. Hope this helps.

Samson Lee, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 4 reviews

Scar tissue or cartilage misplaced?

Without an exam it is difficult to discern whether the area will resolve or not. What does our surgeon say? Most surgeons will not recommend any revision for at least six months. However, at three months the overall shape should be somewhat pleasing and symmetrical.

Talmage J. Raine, MD, FACS
Champaign Plastic Surgeon
4.5 out of 5 stars 8 reviews

Hard to tell

Lumpiness from a rhinoplasty is difficult to asses without examining you. It could be scar tissue but it is more likely cartilage grafts that may have shifted. A wide base may be becuase the base was not treated successfully, but with open rhinoplsaty, you should really give it a year before you fully assess it for revisional work..

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 19 reviews

Bumps 3 Months After Open Rhinoplasty

Hi MNM,

Your question is difficult to answer without examining you, and knowing what your rhinoplastic surgeon did. You should return to your surgeon for a check up.

Occaisionally after rhinoplasty patients may feel bumps inside of their nostrils where the incisions have been made. These usually lessen with time. There can also be cartilage edges in "new" places which usually will not go away unless excised. If your lumps are internal, my best advice is to keep your inquisitive fingers and anything else smaller than your elbow out of your nose; and please see your doctor.

If the lumps are noticeable externally, again you need to return for evaluation. Most likely these will need to be addressed with either camouflage with fillers, or excision. We recommend waiting at least 6 to 12 months following surgery before any revision surgery.

The wideness of the base will likely not change much if there is no difference at 3 months. When you see your surgeon, have post-op photographs taken, and compare the base to the pre-op photographs. Nasal base wideness can be corrected with excision of alar soft tissue (where the nostril meets the cheek laterally above the lip) if indicated.

Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
5.0 out of 5 stars 25 reviews

Maintain Contact With Your Surgeon.

Without an operative report, physical examination or pictures it’s virtually impossible to evaluate your clinical course. It’s not unusual for patients to experience anxiety about their nasal appearance following rhinoplasty for a variety of reasons.
It’s important to understand that wound healing is a dynamic process that can take 12 to 18 months to reach completion.During this period, it’s not unusual for patients to be anxious and in some cases unhappy with their result.It’s safe to say that the majority of these patients are ultimately happy with their result once swelling has resolved and wound healing is complete.For this reason, revision surgery shouldn’t be performed for at least a year following rhinoplasty.
If you’re concerned about the appearance of your nose, it’s important to maintain contact with your plastic surgeon.Your surgeon should be able to reassure you and alleviate your anxiety.

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.