How Was This Nose Job Deformity Caused and What Will Fix It?

I am planning for a revision rhinoplasty since there are many thing I do not like about my new nose. It has been 6 months since my first surgery. It seems like I have an an "open roof," as I've seen it called here and a "retracted columella." Additionally, on top of the open roof plateau there is a very noticeable bump that developed over time. What caused this bump and what can make my nose more attractive, since I am just completely distraught over the look of my new nose.

Doctor Answers (8)

How to address a "bump" or other deformity on the nose after rhinoplasty surgery

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The deformity after your nose surgery, whether open roof, scar tissue, or cartilage remnant needs to be addressed with revision rhinoplasty. The timing depends on you and your surgeon.  The revision should address  your bony cartilaginous complex and also the retracted columella, and cartilage grafting will be necessary to correct both deformities.  If your surgeon is experienced with injectable fillers (radiesse, restylane) in the nose, then that could provide a tempory solution.   

 

Ramtin Kassir, MD


New York Facial Plastic Surgeon
4.5 out of 5 stars 27 reviews

The bump on the bridge of your nose appears to be a small remanent of bone after your prior Rhinoplasty Surgery.

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The bump is in the same location as your pre-operative hump. When it was removed during your Rhinoplasty Surgery, it appears that a remanent of cartilage or bone was inadvertently left behind. Sometimes irregularities like this can be effectively camouflaged with an Injectable Filler treatment. If you have a open-roof, as you describe, then a revision rhinoplasty may be necessary.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
5.0 out of 5 stars 276 reviews

Handling Nose Surgery Complications

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Regarding: " I am planning for a revision rhinoplasty since there are many thing I do not like about my new nose. It has been 6 months since my first surgery. It seems like I have an an "open roof," as I've seen it called here and a "retracted columella." Additionally, on top of the open roof plateau there is a very noticeable bump that developed over time. What caused this bump and what can make my nose more attractive, since I am just completely distraught over the look of my new nose."

The changes you are referring to are correctable. The question on your mind - surgeon's inexperience or act of nature cannot be fairly answered based on your photographs.

I would ask your surgeon how he/she suggests these can best be corrected and what would be your financial obligation. If you want to learn more seek another or more second opinions from reputable surgeons in your city. That would give you enough information to take the right path and choice in surgeons.

Good Luck.

Dr. Peter Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 60 reviews

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Rhinoplasty Open Roof Deformity and Revision Rhinoplasty

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Hi Jers,

Sorry about your rhinoplasty results, but it is correctable.  Discuss your concerns with your rhinoplasty surgeon.  If you still trust his/her work, plan on having a revision rhinoplasty.  If you are not going to have your revision for at least 6 to 12 more months, you can have a small volume of hyaluronic acid injected to help camouflage your deformity.  Surgical correction can best be performed through an open approach revision rhinoplasty.  Crushed cartilage grafts and/or fascia can be used to repair your dorsal deformity.  Columellar struct graft to repair your retracted columella.  Good luck and be well.  If you decide to consult with other surgeons, choose your revision surgeon most carefully.

Dr. P

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 23 reviews

If you are planning a revision rhinoplasty please wait one year

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It can take a year for the nose to fully heal. Changes you see at 6 months rarely go away but they may change and/or you may see more things to address at a year. Bumps come from either scar tissue, regrowth of bone or cartilage or residual cartilage that might have not been seen at the time of the original surgery. The first place I suggest you go is to discuss your concerns with your surgeon. If you are not satisfied with the answers then seek a revision rhinoplasty specialist, but again, most will not and should not touch you for a year.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 39 reviews

Revision Rhinoplasty and Surgical Options

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Rhinoplasty is the most challenging cosmetic surgery, and as a result has one of the highest revision rates. It appears that you have either a bump or a depression causing an irregularity along the bridge.  The "retracted columella" cannot be fully assessed in the photo.  If this is a simple depression, you might be able to fill it with a soft tissue filler such as Radiesse, however if there is additional areas that need to be addressed - or bone that needs to be reduced - you might need a revision procedure.  In most surgeons hands, you would wait until you are 1 year from your original surgery prior to embarking on a revision.

Best of luck

Vincent Marin, MD, FACS

La Jolla Plastic Surgeon

Vincent P. Marin, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 26 reviews

Open Roof Deformity

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Hi,

If you truly have a open roof deformity and it bothers you, you should get it fixed. Open roof deformities are usually caused by poor osteotomies (infracture of the nasal bones). The columella can be fixed with cartilage grafts taken from the ear or septum.

Best,

Dr.S.

Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
5.0 out of 5 stars 211 reviews

After rhinoplasty complications.

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Besides what you mention the bump may be a small piece of bone or cartilage the needs to be removed. This can happen rarely to all surgeons. Return to your surgeon for an evaluation and/or get a second opinion.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 14 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.