Rhinoplasty: Q&A

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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.

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25 Doctor Answers | Asked 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

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

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

Crooked Nose or Uneven Swelling After Rhinoplasty?

The circumstances that you described are reason for concern. There is a chance however, that surgical technique needed to straighten your nose required more intense manuvers on one side than the other and hence you may have uneven swelling. You will know better if the surgery was fully successful after 4 weeks and definetely after 6 months

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

21 reviews

Los Angeles Facial Plastic Surgeon

drpersky.com

Nose still crooked

A number of things could be going on.. Yes, swelling could be making it looks still crooked The bones may need to be helped along to heal straight. We have our patients do gentle compressions for a week. The coating over the bone (called the periosteum) on the shorter side, the side to which the nose deviated, may be pulling the bones to that side. Again gentle compressions, as shown by your doctor, may help. Your nose will take about 18... more

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

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

32 reviews

Chicago Plastic Surgeon

Crooked Nose Surgery

Before and After Photographs would be helpful to give you more specific advice. That being said, swelling can make your nose look crooked. Especially if you had osteotomies - where the nasal bones are broken. Take serial photographs of your nose and you will probably see your nose getting "straighter" with time. I also recommend "taping" to help control post-operative swelling.

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

Jonathan Berman, MD

Palm Beach Plastic Surgeon

www.drberman.com

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

9 reviews

Bay Area Facial Plastic Surgeon

www.dwkimmd.com

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

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

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

5 reviews

Chicago 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.

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

12 reviews

Manhattan Plastic Surgeon

Swelling After Rhinoplasty

Right after the cast comes off, it is very tempting to judge a rhinoplasty result. This is a natural tendency, but really should be avoided. There is significant swelling after nasal surgery, and this can make the nose seem crooked or asymmetric. It's best to wait a few weeks before trying to make any judgements in this regrad. Please stay in touch with your surgeon throughout the healing process. Best of luck!

In the Vast Majority of Patients Who Have Noticeable Residual Deformities Following Splint Removal, the Cause is Swelling

In the immediate post-operative period, it can be difficult to differentiate residual swelling from residual deformities. If a deformity is present, it may be obvious. In most cases, residual deformities are subtle and cannot be differentiated from swelling. When this situation arises, it’s important to allow the swelling to resolve before making decisions regarding revisional surgery. In the vast majority of patients who have noticeable residual deformities following splint removal, the... more

Crooked nose after rhinoplasty

Uneven swelling is common after rhinoplasty and may be responsible for what you are seeing. In noses that are crooked, the skin has been pushed out in this position for a long time and takes on a particular shape. When the bone and cartilage underneath is straightened, it can sometimes take some time for the skin to contract and flatten to the new level and allow the nose to appear straighter. Swelling can also appear asymmetric and this is true when there are two sides to anything in the... more

Crooked Nose or Uneven Swelling After Rhinoplasty

After a rhinoplasty and removal of the splint there may be some uneven areas or crookedness. This is normal and may be due to asymmetric swelling or other factors. These early results can change daily. The most important rule to follow is to have your Plastic Surgeon reevaluate as you go through the post-operative period.

Uneven Swelling After Rhinoplasty

It is entirely normal to have a nose look uneven or more swollen on one side. The swelling will usually subside within 12-15 months.

Rod J. Rohrich, MD

10 reviews

Dallas Plastic Surgeon

Crooked Nose after Rhinoplasty

Yes, there can be uneven swelling after a rhinoplasty. I tell patients that it takes 4-6 weeks for most of the swelling to go away. The remaining swelling after this period slowly goes away over the next 6-12 weeks. I would recommend that you remain patient and hang in there and allow the swelling to resolve so that you can begin to see the longterm result. see video

Crookedness Because of Differential Swelling

There is almost always crookedness after the cast comes off because of differential swelling and because no nose is ever completely straight. It is completely normal to be anxious about your results, but you must try to be patient. While your nose might look crooked immediately after removing the cast, it does not mean that the nose will be crooked when the swelling is gone. It is actually impossible to tell right after you take your cast off. I advise all of my patients to wait 24... more

Babak Azizzadeh, MD

4 reviews

Beverly Hills Facial Plastic Surgeon

www.facialplastics.info

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.