Crooked columella, uneven nostrils 12wks post rhino/septo w/ tip graft & nasal base reduction. Swelling or need revision?(photo)

Eaz81,I do see the concerns which you are mentioning. However, 12 weeks post op is still early and there is still a significant amount of swelling in the area. Healing time for a rhinoplasty ranges up to 1 year, meaning the swelling in your nose will not completely subside for another 7 months. I recommend being patient until this time, and if you still feel as though the problem persists speak to your plastic surgeon for possible revision.Hope this helps!Dr. Ali Sajjadian

Great question and thanks for sharing your photos.The first most important message is to stay in close contact with your doctor.  He or she can really be your best source for information and probably knows your anatomy better than anyone at this point.Next, I do think this is very early in your course to be too concerned.  I agree- give it time.  Massage may be helpful.  Time will probably be even more important.  Try to relax.Having said this, it does appear that the end of the septum has shifted moving the footplates out into the nostril.  Essentially, the base of the septum may have shifted slightly to the side moving the footplates of the medial cartilage into the nostril.  Hopefully this is just swelling and things will relax.I generally will not operate on a nose for one year after surgery.  It places the patient in the best shape for a great outcome.  Try to get a hold of your operative notes and any drawings or schematics from your surgery.  A very important consideration in the future if you do require additional surgeries will relate to the availability of additional septum for harvest that will be needed.Best of luck in your recovery.Dr. Hobgood

12 weeks is still way too early before any consideration be given to a revision rhinoplasty.  From the looks of the picture, it is the medial crural footplates, or portions of the lower lateral cartilage that are causing the asymmetry.  Allow for swelling resolution and at one year's time reassess.

Swelling after surgery can be variable as you have described. Tell your surgeon your concerns and he may be able to place steroids to help speed recovery. Probably after that you just need to be patient for at least a few months more.