If you felt your nose prior to your surgery, you might feel some irregularities in the underlying bony-cartilaginous skeleton which are not necessarily visible. The same is true here....if indeed there is no external deformity, there may be no need for revision. You may find that over time (things can change well past 1 year) this may become visible. If so, depending on the severity, something as simple as an injection may be possible, or a minor surgical revision.
Hope this helps,
Dr. Sam Most
After rhinoplasty, even in the best of hands, there can occasionally be palpable dents or bumps present in the underlying cartilage or bone. From your description, it seems as though this dent is palpable but not visible. If this is the case, I would wait it out and see if over the next several months, the indentation becomes visible. If so, it can be addressed with the placement of a small camouflage cartilage graft or possibly injectable fillers such as Restylane, Juvederm, or Radiesse. If the dent never becomes visible, I would leave well enough alone. Usually insurance would only cover some or all of the cost of the surgery if there were a medical issue, such as difficulty breathing. All the best, Dr. Mehta
The assymetry in your dorsum may be due to swelling or malposition or absence of your cartilage. I would have to examine a patient before making this determination.
Even in the most experienced hands, an approximately 5% revision rate for rhinoplasty exists. You can do a perfect surgery and can sometimes get a slightly imperfect result. It looks like all you would need is a minor revision with a small camouflage graft in this area. Insurance will not cover this since it is a cosmetic issue. You should be able to talk to your original surgeon who would probably cut a great deal for you. remember he wants you to look as good as possible too!
Injectable fillers are a very simple way of correcting dents in the nose. Temporary fillers at first, then permanent filler is a choice between that + revisional surgery.
There is still lots of swelling remaining. Perhaps even half the swelling is still there. That isnt to say you may need further work. In Fact sometimes even this early an experienced eye can tell that the final result wont unfortunately be satisfactory. But even then you will need to wait a year before any further surgery should be attempted.
In general, I like to wait one year before considering a revision procedure. It is generally accepted that in the best of hands a 5-10% revision rate occurs. So if any surgeon states they do not have to perform revision procedures you should question this. See your surgeon and express your concerns, that is the best initial strategy.
After a patient has had a rhinoplasty, a small percentage of patients may choose to further modify their nose or correct in area that they feel was not impressed with the first surgery by receiving a revision rhinoplasty. It is important to only consider the surgery once your nose has fully healed from the first procedure. For this reason, we recommend that patients wait at least 10 months after their surgery before considering a revision. This will allow the swelling to go down and will allow your surgeon to modify your nose and produce a lasting optimal result.
If you are overall pleased with the results of your rhinoplasty but have a few areas of concern such as a mild curvature or some minor depressions, several options include the judicious use of fillers versus morselized or softened cartilage or other similar types of implants. Sometimes these areas can be easily camoflauged with minor procedures as noted above. I would ask your rhinoplasty surgeon about options and then decide which way you would like to go. I hope this information helps.
If you see a depression after a year, it may be something that could be improved. Sometimes, just a filler may be added to smooth the depression. Other times, a revision surgery may be beneficial. Irregularities may frequently be felt after surgery, since the underlying structures have been modified, but they do not need to be treated unless they are visible. As to why - sometimes things just do not heal as planned and additional tweaking may have to be done. Talk to your surgeon about your concerns and discuss options with him.