Kristina Zakhary, MD, MSc, FRCSC

It is good that you’re overall pleased with your rhinoplasty results since the result looks beautiful and natural. Here are some points to consider regarding the bump on your nose:

• Swelling Assessment: It can be challenging to distinguish between residual swelling and scar tissue without an in-person evaluation. At 7 months post-op, some swelling may still be present, particularly in certain areas, though it should be largely resolved by 7 months.
• Scar Tissue: If the bump is due to scar tissue, (the nasal bones heal with scar tissue called callous) there options for reducing it. Steroid injections are sometimes used to minimize scar tissue, depending on the assessment.
• Residual Bump: If your initial bump was not entirely removed, this could be the cause. An evaluation would be necessary to confirm this. If this is the case, it looks natural.
• Nasal Rasping: This is a procedure that can refine the contour of the nasal bridge. It may be an option depending on the underlying cause of the bump, but it’s important to assess suitability on a case-by-case basis.

It is recommended to follow up with your primary surgeon if you have any concerns and your surgeon will most likely be happy to assess you and offer you management options.

Thank you for outlining your goals. Based on your desire for a smaller and narrower nose while preserving your side profile, I would consider a combination of approaches to achieve the results you’re seeking.

1. Nasal Bridge Reduction: To narrow the width of the bridge possibly with osteotomies (bone cuts) and provide a more refined shape, reducing the nasal bridge can contribute to a slimmer and more proportionate front view.
2. Nostril Reduction: Alar base reduction can help narrow wide or flared nostrils, which would enhance the streamlined appearance of your nose from the front.
3. Cartilage Grafts: To achieve a balanced and defined look, cartilage grafts could be utilized to raise the dorsum (bridge) to make it look narrower, and cartilage grafts can also be used to enhance tip definition. These grafts help create a more contoured and structured appearance, which can improve overall harmony while ensuring the changes complement your natural features. Cartilage grafts are particularly useful in refining the tip and providing a natural, well-supported nasal bridge.

This combination of techniques can help create a smaller and narrower nose with the refinement and definition that align with your goals. During a consultation, your surgeon would assess your unique facial anatomy and discuss how these options could work together to achieve the desired outcome.

Thank you for reaching out with your questions regarding your rhinoplasty recovery.

It is not uncommon to consider steroid injections as an option to address swelling or certain irregularities post-rhinoplasty, such as a scar tissue “pollybeak” appearance. The timing of steroid injections can vary based on individual healing and any skin conditions that might affect the procedure, like the presence of active pimples. Delaying the injections until a later stage can be a part of the plan to ensure your skin is in optimal condition for treatment.

In terms of timing, there is no strict deadline for steroid injections, though they are generally most effective within the first year post-surgery. Your surgeon’s suggestion to wait until your 7-month follow-up is likely based on assessing the stability of your results and ensuring the best conditions for the treatment.

While steroid injections can help reduce localized scar tissue and help to improve the contour of the nose, it’s important to note that they are not guaranteed to completely resolve the issue in every case. The effectiveness can depend on individual healing responses and the specific characteristics of the swelling. Your surgeon will be able to evaluate the likely outcomes based on your progress and provide tailored advice.

While it is normal to experience a runny or leaky nose for a few weeks following rhinoplasty, persistent leakage beyond the initial recovery period could indicate other underlying factors. One possible cause is vasomotor rhinitis, a condition where the nasal passages become overly reactive to various triggers, such as temperature changes, humidity, or even changes in body position, which can lead to excessive nasal drainage. Unlike allergic rhinitis, vasomotor rhinitis is not triggered by allergens but rather by abnormal nerve responses in the nasal passages.

If vasomotor rhinitis is suspected, treatment options may include nasal sprays (such as anticholinergic or corticosteroid sprays), which can help reduce nasal secretions, or other medications that help manage the symptoms.

Other potential causes of leaky nose may include residual inflammation, changes in the nasal mucosa, or disruptions in the normal nasal drainage pathways. In some cases, conditions such as non-allergic rhinitis or sinus-related issues can also contribute to prolonged nasal drainage.

It would be advisable to consult with your surgeon or an ENT specialist to assess your symptoms thoroughly. They can evaluate your nasal anatomy and function, perform any necessary diagnostic tests, and recommend appropriate treatments based on your specific condition. Management options may range from medical treatments, such as nasal sprays, to surgical interventions if structural issues are identified.

I hope this information helps clarify the potential causes and encourages you to seek a comprehensive evaluation for the best course of action.

Thank you for your question regarding options for correcting a C-shaped or crooked nasal dorsum in rhinoplasty. While spreader grafts are commonly used to address such deformities, other surgical techniques may also be effective, depending on the specific anatomy and needs of the patient.

Alternative methods include the use of cartilage grafting techniques, such as onlay grafts or structural grafts, to reinforce and reshape the nasal framework. Additionally, techniques like osteotomies (controlled bone cuts) can help realign the nasal bones to create a straighter appearance. Suturing techniques may also be employed to adjust and stabilize the nasal cartilage without the need for spreader grafts.

The appropriate approach depends on a detailed evaluation of the nasal structure and the desired outcome. I recommend consulting with a facial plastic surgeon who can assess your individual case and advise on the most suitable method for achieving a balanced and natural result.

I hope this information is helpful, and I encourage you to discuss these options with your surgeon for further guidance.