Nasal Bone or Swelling After Rhinoplasty Revision? (photo)

I have a bump on the side of my nose that feels like bone after my second time of having Rhinoplasty. Could this be swelling, or did my doctor miss this? It is my second time having it done for the same spot.

First time I had it done was October 2008 and I just recently had it done again Feb 2009. My plastic surgeon said I just need to massage it, but it really feels like bone to me, and looks the same as the first time I had it done that he had to go in and re-do! How can I tell if this is swelling or bone? It's making my nose look crooked which I never had before. I am the person in the middle and you can see the bump on the left hand (would be my right in person).

Doctor Answers (9)

Bump after revision rhinoplasty

+2

Without examining you, it is impossible to tell for sure.  However, if firm,  it is likely that there is a residual bone or bony overgrowth (callous formation).  

In some cases, this does go down, but not usually.  After waiting one year or so, it may be possible to take care of this.

Hope this helps,

Dr. Sam Most


Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 32 reviews

Time will tell if it's swelling or bone

+2
The original bump should have been filed down and addressed with both primary and secondary revision nasal surgery. If the bump is still there three to six months after the secondary revision rhinoplasty, it will probably stay. Massaging will not help this go away and it needs to be addressed by narrowing the nasal bones or filing the bump down. Any crookedness to the nasal bones will have to be addressed through osteotomies and resetting of the nasal bone.

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 58 reviews

Residual bump after rhinoplasty

+1
If you have a residual bump on the nose after a second rhinoplasty and its been over a year then its probably not going to change :(.  There may be another reason why the bone isn't moving if it has been moved twice and filed down twice.  Visiting with a revision rhinoplasty surgeon for a second opinion may be a good option. 

Mike Majmundar, MD
Atlanta Facial Plastic Surgeon
5.0 out of 5 stars 27 reviews

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Persistent Swelling Along Nose Bones

+1
While the nose tip swelling may last a year and sometimes longer, this swelling along the nose bones usually goes away faster. After the hump is removed a nose that looked narrow, normal or only minimally wide on the bridge becomes significantly wider which requires osteotomy (mobilizing and moving the nose bones) and moving the nose bones in to make the width of the bridge of the nose more pleasing. Sometimes the bones would not move in so easily and requires removal of a block of bone between the septum and the nose bones to allow them to be repositioned inwards. Otherwise this excess piece of bone will either resist narrowing the nose or the nose may look narrower during the surgery and widen while it is healing. It appears to me that you will need another surgery to remove a segment to allow for narrowing the bones that are still sitting away from the center of the nose. I suggest that you discuss this with your surgeon.

Bahman Guyuron, MD
Cleveland Plastic Surgeon
4.5 out of 5 stars 8 reviews

Persistent Nasal Bone Issues

+1
Thank you for the questions and the photo. It seems that the nasal bone on the right side stayed wide or flared after the surgery.  In some cases, swelling makes this look more prominent than it will end up. Often, though, this requires repeating the osteotomy. Generally, it is good to wait 9-12 months to allow for appropriate healing before doing this.

Evan Ransom, MD
Bay Area Facial Plastic Surgeon
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Revision rhinoplasty for swelling

+1

You need to wait a minimum of six months before undergoing another revision. From your photograph, it appears that you have not had a very skillful rhinoplasty performed and would benefit from another operation. I suggest you find a different plastic surgeon to perform the procedure.

Howard T. Bellin, MD
Manhattan Plastic Surgeon
2.5 out of 5 stars 2 reviews

Nasal Bone Swelling

+1

Time will answer your question. It will be quite clear in a couple months. There is nothing wrong with getting a second opinion; it may alleviate some of your anxiety. If necessary, this should not be a difficult problem to correct. 

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 15 reviews

Too soon after Rhinoplasty to make any judgement

+1

Be patient. It will take at least 6 months for this to resolve. If it doesn't you should seek a second opinion with an experienced revision rhinoplasty specialist.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 15 reviews

Seems like multiple surgeries in a short period of time

+1

Sounds like you have ahad a lot of surgery in a short period of time. Whether or not you have a twist and some residual bone, at the current time you should relax and allow for the swelling to go down!

Robert M. Freund, MD
New York Plastic Surgeon
4.5 out of 5 stars 18 reviews

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.