Had a revision with rib graft in bridge and columella 5 months ago. Nose is very hard and looks almost triangle shape. It looks big and high for my face (this is a change than on first reveal). I hope the bone will shrink some, do i still have swelling? Also I have alar base scars like stitch holes. How can i resolve this. It is upsetting.
Revision Augmentation Rhinoploasty Problems
Doctor Answers (7)
Revision rhinoplasty healing takes time but their are options
Following revision rhinoplasty the healing period can be long and ardous especially if a rib graft was used. It is not uncommon to still have swelling at 5 months. But be assured your nose will continue to shrink and soften with time. Ask your physician if he or she thinks a steroid injection would help. Occassionally this can accelerate the shrinkage of the nose especially if paper tape is applied after wards and kept on at night specifically. The alar base scars should also become better camouflaged with time. You may want to consider a fractionated laser treatment to reduce their appearance. I know this can be difficult time period but try your best to not get too anxious. If after a year you are not still satisfied you can consider another revision. Although going through another procedure is not ideal an overbuilt nose can be shaved down and made smaller through a closed approach. Good luck
Revision rhinoplasty with rib graft
The swelling after a revision rhinoplasty and especially after using rib cartilage can still be quite evident 5 months after surgery. Rest assured that the swelling and stiffness should continue to improve. There is a bit of a trade off with using rib cartilage in that it can make your nose stiffer, but the benefit is that there is much more stability to the tip structure. Your surgeon should be able to give you an idea of how much stiffness improvement to expect.
Regarding the alar base scars: the skin in this area is often quite oily and prone to thickened scars. Some patients benefit from either a steroid injection or dermabrasion to the scar during the healing phase.
Recovery process after a revision rhinoplasty
The recovery process after a revision rhinoplasty, especially in a surgery that uses rib graft is more prolonged than that of the initial surgery. The rib graft tends to be stiffer and more firm than cartilage from your septum or the back of your ear. You should anticipate any longer period where this area is firm or stiff. Be sure that you follow closely with your plastic surgeon as they will want to know how you are healing and that your cartilage is settling in a straight fashion
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Rib grafts will soften and shrink over time
Be patient. Rib cartilage grafts start out being firm, especially near the tip and nostril areas but they will soften over time. it is doubtful that your surgeon used rib bone in your nose (although it may feel like it).
Stiffness in the nose is normal with a rib graft
Rib cartilage is often used during rhinoplasty when large changes need to be made to the nose.
The hardness is pretty typical and for many an acceptable trade-off to having a better shape to the nose. But if you think the graft has made your nose too large, it may be correctable with a revision surgery to reduce the volume of the graft.
I think by 5 months, enough swelling will have resolved to get a sense of this.
Healing after Revision Rhinoplasty
Healing always takes longer after a revision procedure, especially when augmentation is necessary. Ii is likely your appearance will chage significantly over the next six months. For your information, if the graft was taken from the rib it is probably cartilage, not bone.