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Crooked Nose or Uneven Swelling After Rhinoplasty?

I had Rhinoplasty to "straighten" my nose. I just got my cast off and it is clearly not straight. If a nose looks crooked when the cast is removed one week after rhinoplasty, does that necessarily mean that the nose will be crooked when the swelling is gone? Or could it just mean that the swelling is uneven? I just pray that when the swelling finally goes away that it will reveal a straighter nose than what I am seeing now.

Asked 36 months ago by Tigerfan7777 in Baton Rouge, LA

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Rhinoplasty Recovery: Post-Operative Swelling

In the first several weeks following a rhinoplasty, the swelling of the nose can be asymmetric. This can give the illusion that the nose is crooked or asymmetric. Post-operative swelling can also fluctuate from day to day on different parts of the nose for the first several weeks. If your nose looks crooked after the cast removal, you should revisit your surgeon so that he or she can reassure you that what you are seeing is transient. There are often things that can be done in the office... more

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C. Spencer Cochran, MD

Dallas Facial Plastic Surgeon

Patients are often suprised when the Rhinoplasty cast comes off

I have a large number of patients that were not happy when they saw the results after the cast came off. Usually it may be because of swelling or they may not be used to seeing their new, different nose. Or possibly some cartilage grafts were used on one side of the nose in an attempt to straighten it, and the grafts are causing temporary swelling. However, about 99% of the time after another week or two, they are extremely happy because the swelling comes down and the nice shape starts... more

Andrew Miller, MD

Edison Facial Plastic Surgeon

Nose crooked externally immediately after Septo-Rhinoplasty

Hi Tiger, It is too soon after your surgery and splint removal to make any judgments about the final shape of your nose. Give it another week, and hopefully as the swelling resolves, your nose will appear straighter. It actually takes a few months for everything to settle, and revision is not recommended until at least 6 to 12 months if it remains crooked. An alternative is having filler such as Radiesse injected to even out any asymmetries. Good luck, be well, and keep us updated on how... more

Michael A. Persky, MD

Los Angeles Facial Plastic Surgeon

Nasal swelling can take a while

Dear Tigerfan, A crooked nose can be the result of crooked bones in the upper 1/3 of the nose(easy to fix), crooked cartilage in the middle 1/3 of your nose (moderate difficulty to fix) and distorted cartilage in the lower 1/3 of your nose (most difficult to fix). The bones can be fractured and realigned to appear straight and the risk of them returning to the crooked position is not high. The cartilage in the middle 1/3 of your nose include the septum and the upper lateral cartilage. These... more

Robert M. Freund, MD

New York Plastic Surgeon

ASPS

Crooked Nose Immediately post Rhinoplasty

Patients are excited after having had their surgery. They understand that there is post-operative swelling. How much swelling and how much patience a patient has with their healing varies. Most feel that once the cast is removed, much like a wrapped present, they will have the gift of a new nose. Unfortunately, removing a cast is not like unwrapping a present, there is often black and blue discoloration, sometimes yellowish skin color changes and swelling that may... more

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Jonathan Berman, MD

Palm Beach Plastic Surgeon

ASAPS ASPS

It could be swelling or structure

Swelling can occur unevenly through the nose, but it would not account for large discrepencies. You can get an idea by pushing (gently) on the areas of fullness to see if they are spongy like soft tissue swelling or hard like cartilage and bone. I would wait several months to re-assess. If the uneveness does not resolve, a revision can help in most cases.

David W. Kim, MD

Bay Area Facial Plastic Surgeon

Need to wait 6 months to a year

Even though it has only been one week since your rhinoplasty surgery, and if it appears crooked, one needs to wait until the swelling has subsided. This could certainly be related to uneven swelling in the nose. One needs to wait at least six months to a year to give any final judgment as to whether the nose is truly crooked or not prior to making any decisions about a revision.

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William Portuese, MD

Seattle Facial Plastic Surgeon

Swelling and nose shape after Rhinoplasty

When the splint comes off, there is often quite a bit of swelling. Usually, the nose appears straighter at this point, but not always. You have to give it some time.

Steven Wallach, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Deviated Nose Correction and Swelling

One of the hardest things to do in plastic surgery is correct a deviated or crooked nose. The problem, in many cases, is complex in nature and involves asymmetry of multiple cartilages, asymmetry of the underlying facial skeleton, and deviation of the nasal septum. While correcting all elements in a single surgery is not always possible, significant improvement can be achieved in the vast majority of cases. Because correcting the deviated nose is, by definition, a more elaborate and... more

Richard W. Westreich, MD

Manhattan Facial Plastic Surgeon

Swelling is very common after rhinoplasty

I would not be overly concerned at this point. If it gives you any consolation, we generally do not take our nasal photographs for typically 6 months after surgery, due to the selling and distortion that occurs during this period. In some instances surgeons may slightly overcorrect a deformity anticipating a slight recurrence. In any event, I would discuss your concerns with your surgeon but give it time to allow the surgical results to settle.

Otto Joseph Placik, MD

Chicago Plastic Surgeon

ASAPS ASPS

If there is any asymmetric swelling, or even "crookedness”, may often be adjusted after cast removed

While you will get some sense of what the nose is going to look like immediately after the “cast” is removed, you are certainly not seeing the final result at this early stage. If there is any asymmetric swelling, or even persistent “crookedness” this may often be adjusted, if necessary, at this early stage. Uneven swelling may represent greater attention paid to the swollen area during surgery, which will resolve soon. The contour and symmetry will likely... more

Michael R. Macdonald, MD

Bay Area Facial Plastic Surgeon

Crooked nose after Rhinoplasty

Assuming your nose was 'crooked' before surgery then the surgeon would have had to address several issues. One of the most important is the position of the nasal septum which separates the nasal passages in the midline. Untreated septal deformities can cause post surgical twisting or deviation of the nose. Proper placement of the splint is also important as too much or too little pressure can cause an apparent deviation of the nose. Ask your surgeon how everything went and if... more

Jon F. Harrell, DO

Miami Plastic Surgeon

ASPS

Crooked nose correction

Correcting a crooked nose involves changing the underlying bone and cartilage to align all of the elements of the nose. It can be quite difficult and may require an open rhinoplasty. You need to let everything settle down to really assess the final result .Patience, however difficult, is essential to see your result and not get overly upset or react and demand more surgery too soon. Best, Talmage J. Raine MD FACS

Talmage J. Raine, MD

Chicago Plastic Surgeon

ASAPS ASPS

After Rhinoplasty, crooked nose after cast comes off not uncommon

After rhinoplasty the nose will swell asymmetrically and heal at different rates that make the nose appear as if it is crooked when It likely is not. It will take up to 6 months to a year to see the final result so it will take a lot of patience.