Augmented Nose Bridge Still Off-center After Revision (9 Days Post Op)

Oct '08, I got an L-shaped silicone implant in my nose. Closed Rhino. The implant shifted to the right over time. I got a revision rhino on 11-28-10. Went to a rhinoplasty specialist. He used my own tissue this time instead of an implant. I love how he narrowed the base, but the graft looks diagonal on my nose at this point. I asked the doc and he says it will even out. Not sure if I should trust that. Sleeping on my left to try to get bridge graft to fall to the center. Any thoughts?

Doctor Answers 7

Deviated Nose Needing Rhinoplasty Revision

While it is real early, you would benefit from tailored massaging. I am not sure if sleeping on one side will do it. Rather, you can place your thumb on the opposite side to the deviation and with the same hand use your index finger to smaooth out and massage the bridge towards the side it needs to go to.

Taping also helps.  Depending on what "tissue" your surgeon used, this may or may not fix itself with time or at least be more acceptable to you and your aesthetics.  Revisiing this is a fairly simple procedure and may somteimes be done without general anesthesia in a doctor's office.

Good luck and make sure you always select a board certified specialist for your nose procedures and do your research. 

Beverly Hills Plastic Surgeon
4.1 out of 5 stars 105 reviews

Dorsal asymmetry

It is possible that you have pre-existing deviation of your nose which makes implants and grafts shift to one side - it is unlikely that asymmetry seen at a few months will correct over time

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Nasal bridge augmentation graft off center

This early after surgery it isn't uncommon to see some asymmetry due to the swelling. I would have this followed by your surgeon to see that it resolves normally.

I wouldn't do any manual nasal exercises unless directed to do so by your surgeon.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 21 reviews

Infected nasal implants

Dear rhinoplasty patient from Bulgaria,
The appropriate approach is to treat the infection with oral antibiotics first. If the redness and swelling subsides, your surgeon must monitor you closely to ensure correct healing process. However, persistent redness will leave no choice but removal of the synthetic implant. Good luck and good healing

Kevin Sadati, DO
Orange County Facial Plastic Surgeon
4.9 out of 5 stars 204 reviews

Uncentered graft will probably not straighten with time.

I think the advice of your surgeon is good.  The apparent asymmetry of the graft might be due to swelling.  Usually, the graft is off a bit and will need repositioning.  It would be wise to wait a few months before doing that.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

Revision rhinoplasty

Rhinoplasty, especially revision rhinoplasty is one of those procedures that requires a lot of patients.  The nose takes time to heal and for the swelling to go down - so I understand you may be worried, you may just need to be patient.

If you're only 9 days post operative, the nasal tissues are still slightly mobile.  If your surgeon feels that there is a little residual deviation, he can show you where to press on your nose to bring it into a straighter position.  In general this means putting gentle pressure for ten seconds on the point that is deviated to help guide it into the correct position.  I would advise you not to do this unless instructed by your surgeon.

Catherine Huang-Begovic, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 32 reviews

Rhinoplasty Results Take Patience

One of the points that I make with my patients is that for the first few months after surgery, every morning when they wake up, the nose will look different.  Today it looks like it is off to the right, tomorrow it will look like it is off to the left and the day after it will be straight.  This is all normal.

It sounds like you did your homework and went to someone that specializes in revision rhinoplasty.  You have also been up front about what your concerns are. You should be commended for this.  Now, however, comes the hardest point, being patient.  If you really have a high quality surgeon, they will be upfront and honest about the result.  If your surgeon states that the result is what they expected, I would put faith in them.

Joseph Campanelli, MD
Portland Facial Plastic Surgeon
4.5 out of 5 stars 8 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.