Why are my nasal sidewalls still prominent 3 surgeries later? (photos)

The nasal sidewall fullness that appears in photos and lighting one month after a tertiary rhinoplasty may be from residual swelling and/or incomplete osteotimies especially in the upper radix region which can make the fracture incomplete. If it feels soft in the area then it is likely swelling. If it feels like bone it may be incomplete in fracture. 

Your osteotomies appear to have been performed too high--in other words half way up the dorsum rather than very low on the maxilla and up to the corner of your eye. If your 3 surgeries were performed by the same surgeon, you should find someone else.  This is an easy fix. I have corrected this problem using an external approach with a small 2mm osteotome thus avoiding another complete Rhinoplasty.

Dear mys9,Usually it is because the osteotomies are incompleteFor the most narrow dorsum, you need lateral, medial and transverse ostetomiesI have found that most surgeons do not perform the transverse osteotomy which goes from the inner corner of the eye to the center of the nose, right where the nose starts.  This combined with the other 2 types of osteotomies will reduce the bonesMost surgeons typically perform a lateral ostetomy and try to crack the bone into place, but it does not work very wellBest regards,

Dr. Nima

Member, American Academy of Facial Plastic and Reconstructive Surgery

Board Certified Facial Plastic Surgeon

Board Certified in Head and Neck Surgery