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.
How Was This Nose Job Deformity Caused and What Will Fix It?
Doctor Answers 8
How to address a "bump" or other deformity on the nose after rhinoplasty surgery
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
The bump on the bridge of your nose appears to be a small remanent of bone after your prior Rhinoplasty Surgery.
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.
Handling Nose Surgery Complications
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.
Dr. Peter Aldea
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Rhinoplasty Open Roof Deformity and Revision Rhinoplasty
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.
If you are planning a revision rhinoplasty please wait one year
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.
Revision Rhinoplasty and Surgical Options
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
Open Roof Deformity
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.