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Hard Bumps on Nose After Rhinoplasty

I am five weeks post open rhinoplasty. I had a tension nose with a pronounced hump and droopy tip. Everything has gone very well, and I was extremely pleased upon removal of the cast, splints, etc... At that time, my hump was gone, the front and sides of my nose were very smooth, and my tip no longer drooped.

However, over the last couple of weeks I have developed bumps on both sides of my nose - on the right side just next to my eye, and on the left side a little lower than my eye. The bump on the left is fairly significant and hard. It makes my nose look crooked - similar to Owen Wilson's nose. I realize that it can take up to a year to achieve final results.

My surgeon has been great, but his response to my bumps is 'we will just wait and see'. However, I need to know if this is common and how likely these bumps are to go away. People are even starting to comment that my nose looks crooked.

Please share your experiences with me, so that I have some idea of what I am dealing with. Is this likely part of the healing process, or should I be concerned?

Thank you,

Nancy

Doctor Answers (18)

Massage May Help Bumps On Side of Nose After Rhinoplasty

+4

Thank you for your question. It is very common to feel irregularities on the side of the nose near the eyes after Rhinoplasty. As others have explained this is where the bones were cut.

Usually this swelling is a combination of tissue swelling and blood and will resolve. I find that massage often helps speed their resolution. Keep in touch with your surgeon and follow his/her advice.


Boston Plastic Surgeon
4.5 out of 5 stars 31 reviews

Rhinoplasty results can test your patience

+4

The bumps you describe sound like swelling in the area where the bones are broken to achieve the desired result. The swelling in a rhinoplasty can be slow in resolving.

My advice is to ignore your friends and relax.

Robert M. Freund, MD
New York Plastic Surgeon
4.5 out of 5 stars 18 reviews

Bumps on side of nose

+3

Many times a rhinoplasty will look best when there is still a little operative swelling to hide any imperfections.It now appears you are seeing slight remnants and imperfections of the osteotomy sites.  I tell patients it only matters if the problem is visible and not what you can feel. However if you can see a problem it may be necessary to go back in and clean up the osteotomy sites so that they are smooth and straight.  This problem arises more often if the osteotomies were not done low down and close to the face bones as sometimes happens. The problem may actually get worse as more swelling abates, any bony imperfections are unlikely to change or dissappear and may eventually need to be dealt with but not before 9 months

Richard Galitz, MD, FACS
Miami Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

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Bumps on the Nose Five Weeks After Rhinoplasty

+3

Hi Nancy,

Only your surgeon knows for sure.

It sounds as if there is a "step-off" in the area of the upper osteotomies, higher on your right than left. When the nasal bones are incised to narrow the upper third of the nose, there is sometimes a palpable and noticeable area of swelling. This usually resolves with time as the bones heal.

If grafts were placed in the areas of concern, then address the issue with your surgeon at your next post-operative visit. There is nothing to do at this point, and for the next few months. Don't worry about your friends "Owen Wilson's nose" comments; they're probably just jealous of your new nose.

Be patient and most likely all will be well. Happy and healthy New Year.

Dr. P

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

Recovery after Rhinoplasty: Swelling, Edema, Bruising, Assymetry

+3

Rhinoplasty requires aesthetic and technical prowess to acheive perfect results. In the early postoperative period, edema sets in the nasal skin and subcutaneous tissue and can obscure the actual results of the soft tissue. It is customary to wait one year after rhinoplasty, when the swelling has reached a nadir, to contemplate additional corrective surgery.

In some cases, the assymetry is caused by the nasal bones. If this is the case, the assymetry may persist after one year. On your next consultation with your surgeon, discuss whether the pattern of assymetry is due to a bony prominence, cartilage, or merely soft tissue edema.

Your surgeon appears to have given you correct advice and he/she is the only person who really understands the specifics of your rhinoplasty as he/she performed it.

Raffy Karamanoukian, MD Kare Plastic Surgery & Skin Health Clinic

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 47 reviews

Bumps after rhinoplasty at the nose-cheek junction

+2
You are correct that it typically takes about 1 year to see the final results following rhinoplasty. At this stage of your recovery, the bumps that you are describing may very well be swelling created by osteotomies (the controlled breaks that are made to reshape the nasal bones). It is common for patients to feel a small 'pea-sized' bump on each side of the nose in the locations that you are describing especially after percutaneous lateral nasal osteotomies (using a very small and sharp instrument that is actually passed through the nose/cheek skin instead of internally to make the osteotomies). The bumps are the result of swelling in the skin where the instrument was passed through. If your bumps are secondary to the osteotomies, gentle massage of this area will help these bumps to resolve in a few weeks and this is normal following rhinoplasty. Alternatively, an irregularity in the location you described could be the bones themselves. You should discuss this again with your surgeon.

Jamil Ahmad, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 6 reviews

Hard Bumps after Rhinoplasty

+2
 The hard bumps after a rhinoplasty procedure could be related to the bony/cartilaginous junction where the hump was filed down or where the bones were broken. Bone and cartilage are living tissue and sometimes a callous formation can occur in the area where the bone was in cartilage was cut. If the hard bumps are still present after one year,a minor touch-up revision procedure can file down the bumps.

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 57 reviews

Hard Bumps After Rhinoplasty

+2

Hard bumps after rhinoplasty can be from a variety of causes:

-Swelling- Early swelling can sometimes feel hard. This can be hard to distinguish from a remnant bump. Waiting for an appropriate amount of time to see if they resolve can be helpful.

-Residual bone- Bone may not have been filed completely and can create an edge

-Stepoff- Sometimes there is a stepoff between the nose which can be addressed

-Callous formation- The perisoteum of the nose can form a hard callous which may need to be filed down or could resolve on its own with time.

-Cartilage graft- If any cartilage grafting was performed it can translate into a bump

Speak with your surgeon about your concerns and possible remedies for the bumps.

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 69 reviews

Rhinoplasty recovery

+2

Post-Rhinoplasty is a waiting game. Once the splint is removed, swelling ensues and may change the appearance of the nose. Be patient and you have to give it some time.  I would wait 6-12 months before making a decision about doing anything else.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

If it is not swelling, it can usually be improved...

+1
When any bone in the body is broken, it can heal with some callous formation. For example, if you break your arm, let it heal, and then take an X-ray, you will not simply see a straight line where the fracture was. Instead you may see a collection of extra bone growth around the healed break called a callous. The same thing can happen in the nasal bone area, especially if there was a big hump that was taken down. Now it is certainly possible that it is simple swelling and will improve over the next month or two. A regular massage of the area can definitely help. But if it is a little extra bony growth then it is very easy to go back in under local anesthesia and file the bone down some. Be sure to keep in constant discussion with your surgeon about your concerns.

Andrew Miller, MD
Edison Facial Plastic Surgeon
4.5 out of 5 stars 40 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.