Is there hope for a good outcome? (Photo)

Question

After primary open rhino I developed a bump on the dorsum. Was given steriod & it made an indention. Also the tip didn't look good & was asymmetrical. Now 7 mo. postop closed revision rhino w/alloderm graft on dorsum w/same surgeon. Most of the swelling has gone except I think the septum because it is still tender. It is bulging on the left. Dorsum is bumpy & indents in a V. Surgeon will not see me for 6 more wks. Is this swelling? Will a steriod injection help? Is this botched?

Andrew Miller, MD · Answer

Looking at your photos, a couple things stand out. The end of the septum needs to be better centered, and you have an open roof deformity of your nasal bones. Fixing these two things will go a long way towards improving your nose. It also looks like the tip can be further refined and made more symmetrical. Be sure to see an experienced rhinoplasty surgeon that specializes in revision rhinoplasty for consultation.

Jonathan Kulbersh, MD · Answer

Thank you for submitting your question. Since you’re unhappy with the results of your previous nose surgery, you’re a likely candidate for revision rhinoplasty to address the concerns you have. However, these are not generally performed until one year following the previous surgery date. Under the care of an experienced surgeon, this procedure may correct bumps and indentations while providing a symmetrical and proportionate shape. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon who can assess your medical history and unsatisfactory results to suggest the best solution for your situation.

Thomas Trevisani, MD · Answer

Your nose can certainly be improved- in the right hands with Revision Rhinoplasty - through a closed technique. I suggest that you seek an experienced Board Certified PS to evaluate your options

David M. Kowalczyk, MD, MBA, FACS · Answer

Hi there! This certainly could be swelling if you notice any changes during parts of the day, temperature extremes, or changes in your diet. If you've had a robust response to the steroid, you need to be careful as it could cause further asymmetries. If the area feels firm like cartilage or bone, it's not likely to improve without revision. Closed procedures don't allow for exact visualization of portions of the nose which need delicate attention. I would suggest an open revision if you decide on one. Your skin near your bridge looks thin and may require camouflage grafts such as temporalis fascia. Hope this helps you!

Darryl J. Blinski, MD · Answer

Sorry for the very poor results following open rhinoplasty. You need a revision now for the residual cartilage/bone in hump, fix tip cartilage, correct scar in columella. Fee $10,000 ranges. 
Best to virtual consult with....

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