Bump on Bridge of Nose After Rhinoplasty

The type of contour irregularity that you describe is very common following rhinoplasty surgery.  During this procedure the nasal bones are filed and the nasal cartilage is shaved to reshape the nose.  It’s not unusual to have residual boney irregularity, cartilaginous irregularity, scarring and swelling following this procedure.  When these bumps occur, they can usually be felt, but not seen.  In some cases, they may be visible as well and this can be a major source of anxiety for patients.
                In the vast majority of cases this problem resolves without secondary surgery as the soft tissue swelling disappears and the underlying structures undergo remodeling.  In many cases this can be facilitated with gentle massage.  In some cases these deformities persist and secondary rhinoplasty is necessary.  It’s important to wait at least six to twelve months before proceeding with revisional surgery.  During this period scar tissue softens, swelling resolves and underlying structures remodel.  This situation stabilizes and the surgeon is no longer trying to hit a moving target.

                If you have concerns about contour irregularities following rhinoplasty surgery, good communication with your surgeon is essential.  Your surgeon has probably seen this before and should be able to reassure you regarding your ultimate result.

I read your concern and reviewed your photo. It's not clear how long ago you had your nose job. If the bump feels soft and compresses, sit tight and wait for the swelling to resolve.

If the bump is obvious due to an indentation below it, this may be improved by a well-performed Injectable Filler procedure. My personal preference is to use Silikon-1000, an off-label filler for permanent results.

I hope this is helpful for you.

Regards from NJ:

You need to wait 6-12 months to let the swelling go down. So be patient and I'm sure your surgeon will follow things along.

Are both photos after the surgery?  I see the bump you are talking about; this may be bone, but if it is bone, it wouldnt temporarily go away when you press on it.  Best to give it time to know for sure if it is just swelling, or if it is bone/callus or scar.  You may end up needing a revision, but should wait at least 6 months.

I agree with your surgeon: unfortunately we have to let things settle for a few months before we can judge more closely. Swelling lasts for a long time and sometimes occurs asymmetrically. A lot of these things will settle with time and not be visible or bothersome long term. This high in the nose, it is likely it was an area of bone. We normally rasp this down during surgery, and it's possible it looked good at the time of surgery. If it doesn't go back down in 6 months, then it's time to consider whether it was an area of bone that was not rasped down all the way or if there is anything else that can be done.
-Dr. David Mattos, New York Plastic Surgical Group

Dear Mel1087,Since your surgery was recent, it is very possible that some of this lump that
you see on your bridge is still residual swelling or a small piece of cartilage
or bone. I would advise that you wait
and let the swelling go away and have your surgeon reassess you at 3 months and
at 6 months. If it is still visible after
6-8 months then there is a chance that it needs to be revised to have this hump
addressed

The bump to which you refer appears to have been there prior to your rhinoplasty. That bump is largely bone and may have been rasped or filed down as part of your procedure. While it is likely that this small bump may persist as your nose heals, it is important to let the swelling go down and see how much remains. Once you are at 6 months after your surgery, then you can make a final determination. It is also at that time that any secondary revision of the bump can be done if it still remains a problem to you.

From the pictures you send in, it appears that the bump after surgery was there before surgery. A bump on that area is usually bone, so your surgeon should be able to tell by feeling it. Also the skin on that part of the nose is quite thin, so a bump on that area is not usually swelling.

Since your surgery was recent you will still have to wait for more of the swelling to resolve. I tend to stay away from Kenalog/steroid injections as they could thin your skin and create red blood vessels. If it is indeed swelling, then patience will be your best advocate. If it is bone you may need a small touch up procedure. 

Make sure you consult with your surgeon.

Best of luck,

 

Michel Siegel, MD

After the hump is removed in the course of a rhinoplasty, the bone and the cartilage are smoothed, though small imperfections can be present, and some callous will be present as the bones heal. Generally the bridge will just feel different and though your nose looks well the imperfections and healing tissue may be felt as a sore lump. The best thing to do is stop feeling, and give the skin and tissue rest and time.
Best of luck,
peterejohnsonmd

Small ireggularities after rhinioplasty surgery are very normal.  Thety reprsent the healing phase as tissues accomodate and heal.  I know that it is difficult to be patient and it is easy to be anxious.  The vast majority of such irregularities simply resolve.  Sometimes a small kenalog injection may help things heal quicker.  You might want to ask your surgeon about this.