I've read that a revision to reposition the bones should be done ASAP, before they heal. Is this true?

Dear darkok,

It is not uncommon to have mobile nasal bone fragments. These can be small fragments or larger trap
door fragment. If it is very early
post-operatively the nasal bones can’t be manipulated until there is some
relative bony union and stability. Early
on following removal of the cast I have patients very gently but assertively
mold the nasal bones while they are healing which often assists in any small
nasal fragments being reduced and repositioned appropriately prior to the bony
union.

However, on analyzing the photo that you sent it does appear
that you have an inverted V middle third deformity, which is usually a result
of the collapse of the upper lateral cartilages. It is only 6 weeks in to your surgery so
there may be further changes of soft tissue swelling and edema subsides. Inverted V’s are generally best addressed at
one year and usually corrected with spread or graphs to the middle third
of nose with or without repeat osteotomies and infracturing of the lateral
nasal sidewalls.

In the interim, although this is controversial, in the rare
instances that this has occurred in my nasal practice or when patients are referred
to me following the surgery, I camouflage the irregularity and soft tissue
injectable fillers. Using appropriate
techniques this can be done quite safely and can camouflage the irregularity
until revision surgery is possible.

I hope this information has been of some assistance and best
of luck.

For more information, please review the link below.

R. Stephen Mulholland, M.D.

Certified Plastic Surgeon

Yorkville, Toronto

At this point the nasal bones are solidified in place so to mobilize them would require osteotomies. They won't shift on their own and sink any further. To me it looks like the bones are more lateral with inverted V caused by over resection of the upper lateral cartilages. There is still swelling so it is best to wait at least 6 months, preferably a year. Good luck