Bony callous on one side of my nose bridge - 2.5 years post-primary rhinoplasty (Photo)

It is always worth obtaining a second opinion if you are not satisfied with the first one. I would recommend getting a CT scan to see the architecture of the nose. It is not uncommon to see some very bizarre bone deformities, especially if a bone/chisel was used (as opposed to ultrasonic instrumentation).

Thanks for your question. If your primary rhinoplasty was performed and osteotomies (breaking of the nasal bones) was performed, the right side, may not have broken evenly leaving behind a spicule of bone. At the beginning it may not have been obvious because of the swelling. As the swelling subsided, it became more pronounced. It may be rasped down. Good luck, Dr. PG

Hello and thank you for your question.

First off, it's important to recognize that complications happen to ALL surgeons, and any surgeon that does not have complications or any suboptimal results is either not operating enough or lying.

With that said, based on your photographs, your bump is at the junction of the top and middle third of your nose -- this is called the "keystone" area. This is where the bone transitions to cartilage, which means the prominence you have involves both bone and cartilage. This is important because rasping (aka shaving) addresses bone, not cartilage. You can't shave cartilage; you can only cut it out directly. I would recommend a formal revision rhinoplasty and not a small procedure under local anesthesia. Not only does this ensure better control, but the surgery to treat this would also likely involve undergoing bone grafting from rasped boney material and mastoid fascia used as an onlay graft (aka soft tissue "blanket") over the asymmetric area...

The next step for you is to pursue the right aesthetic plastic surgeon for your revision rhinoplasty. In your rhinoplasty consultation, be sure your surgeon addresses all your aesthetic goals and concerns specifically, IN PERSON, and discusses the surgery details including the position and size of the incisions used (with actual photographs and not just digital animations), the risks and benefits of the procedure, recovery time, and post-operative course. Also, be sure to see plenty of before-and-after pictures in women who have a similar nose appearance to yours, and preferably at different time frames (3 weeks out, 3 months out, etc) to more accurately predict your own surgical outcome.

After seeking out a board-certified plastic surgeon who specializes in aesthetic plastic surgery, I think the most important component of the consultation is to establish a good connection with your plastic surgeon. It’s the connection that allows you to clearly define your desired nose outcome goals, the first step of this whole process. If you don’t feel you have a good connection with your plastic surgeon after your consultation, he/she may not be the best surgeon for you.

For more information on rhinoplasty, please refer to my link below.

Good luck.

Mark K Markarian, MD, MSPH, FACS
Harvard-trained Board Certified Aesthetic Plastic Surgeon