Why does my nose look like this on the left? (photo)

Question

I had rhinoplasty (2017) and a minor revision in (2020) to make it a bit more symmetrical (straighter) and reduce bump on the left side! After surgery it looked exactly how I wanted and happy with the results but when time progressed the bump appeared! I think it wasn’t rasp enough and the swelling covered it! My surgeon has injected filler to camouflage it but that only last for a few months then starts to look weird again! What is needed to make it smooth on the left side like on the right!

Steven M. Denenberg, MD · Answer

Early postop swelling can certainly mask inadequacies after nose surgery. The photos to me don't show anything weird going on, other than the bridge wasn't modified perhaps as much as you needed. The way the photos are zoomed in on your nose, I can't tell whether there might be other areas to address as well if you were to have another revision, such as the length of the nose or the forward projection of the tip. These photos seem to hint at it but not really show it.
How *much* to further adjust the bridge, or make other changes? We figure that out with morphs, well before surgery. I'd love for you to see some excellent professionally-designed morphs of what could possibly be done with your nose. Morphs could also help you identify better just what's bothering you, and help you set a goal for the rhinoplasty that's accurate for your tastes. Profile and three-quarter views would be particularly important in morphing your nose. (Side note: in my opinion, morphs should really be done by the surgeon, or he should direct an assistant as she makes the morphs. Morphs should be made with a constant eye to what actually *can* be done in surgery, for that particular nose, and the surgeon has that information and judgment best.)

Finally, remember that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes that your nose needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. For most noses, it's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. And it also discusses how to take photos that are best for online evaluations.

And for those who have had previous surgery, it also discusses how to tell whether your first surgeon should be performing your revision.

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.In your case I would recommend you a last revision rhinoplasty (with most probably rib cartilage reconstruction). You still have a bump and that cannot be corrected with filler or injection.Your nose tip looks a little droopy.
Best regards!Prof. Dr. Selcuk Inanli

William Portuese, MD · Answer

The residual convexity on your nasal bridge can be related to many different healing issues which include residual cartilage and  bone left from the actual surgery itself. That convexity can also be related to hypertrophy of thick sebaceous skin. Thick skin is treated with steroid shots, while surgical intervention including a revision rhinoplasty  is required to shave down residual cartilage and bone.

Why does my nose look like this on the left? (photo)

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