Revision Augmentation Rhinoploasty Problems

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.

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

Chicago Facial Plastic Surgeon
4.5 out of 5 stars 17 reviews

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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

Pat Pazmino, MD
Miami Plastic Surgeon
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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.

David W. Kim, MD
Bay Area Facial Plastic Surgeon
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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.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
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Nasal augmentation with a bone graft


Your nose feels hard because there is now bone where there was only softer cartilage prior to your surgery. Rib grafts can resorb over time, but if they were properly placed, the result might be permanent.

Howard T. Bellin, MD
Manhattan Plastic Surgeon
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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.