One Monet After Osteotomy/Rhinoplasty, A Hard Bump Appeared On Right Side? (photo)

Question

osteotomy-rhinoplasty after nose surgery on the right side appeared hard bones My doctor says that it is bone ossification whether the bones disappear with time? because at that point that the bone was not before

Ali Sajjadian, MD, FACS · Answer

Dear Diana,

	 

	I am sorry that you are not satisfied with the results of your osteotomy.

	 

	Your photo shows the deformity more on the right side of your nose and I encourage you to consider a revision with well experienced surgeon only if you are close or already fully recovered.

	 

	Thank you for your question and the best of luck to you.

	Dr. Sajjadian

Mario J. Imola, MD, DDS · Answer

There are several possible causes to explain bumps, irregularities or asymmetry following nasal surgery.  In your particular situation, I would guess that the bone segments in the region of the right lateral osteotomy are displaced.  As discussed below this was either not noted at the time of surgery or shifting occurred shortly afterwards.  It is unlikely at 4 weeks following surgery  that excessive bone growth (hypertrophic bone formation) or soft tissue scarring are at the root of the problem.  See below for a more complete discussion.  Up until now, swelling has camouflaged the problem.  In all likelihood you will require a revision surgery.

	Early in the postop course following rhinoplasty (first 1 to 2 months) the most common causes of bumps, asymmetry or irregularities are:

	
		They were left there during surgery.  During the first 2or 3 weeks following rhinoplasty, the swelling camouflages these problems.  As the swelling resolves, these issues will start to 'appear' or 'grow' but in fact it is more likely that they have been there from the time surgery was finished. 
	
		On occasion, the facial bones or cartilages can shift early on following surgery, but this is usually associated with some form of trauma.   


	Later on in the postoperative course, generally after 4 to 6months bumps, irregularities or asymmetries can develop as the result of one or more of the following:

	
		Structural instability and collapse of the under supported segments
	
		Cartilage warpage
	
		Bone overgrowth (hyperostosis) or soft tissue scarring.


	Mario J. Imola, MD, DDS, FRCSC.

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi,

	It looks like you have an inverted V deformity from osteotomies. The right is worse than the left. This can be corrected with a revision rhinoplasty. It may require medial osteotomies and possible some soft tissue grafts.

	Best,

	Dr.S.

One Monet After Osteotomy/Rhinoplasty, A Hard Bump Appeared On Right Side? (photo)

Answers (3)