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

Question

There's a bony callous that is on one side of nose bridge that's causing my nose to look lopsided. It's been 2.5 years since my primary rhinoplasty, and more than a year since I had minimal rasping done on top of my nose bridge to remove a small bump, but it wasn't near this area at all. Most of my swelling has subsided but this hasn't gone away and it feels hard like bone. My surgeon isn't taking my concern seriously. Worth getting a 2nd opinion to get it rasped down?

Gianfranco Frojo, MD · Answer

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).

Jose Perez-Gurri, MD, FACS · Answer

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

Mark K. Markarian, MD, MSPH, FACS · Answer

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

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. I don’t recommend having rasping performed under local anesthesia. This will usually make the nose look better for 1-2 months and then it will actually get much worse long-term afterwards, with contour irregularities developing. This is because the skin of the dorsum is extremely thin. A much better approach is to do a formal revision with rasping and placement of a dorsal onlay fascial graft to help smooth the dorsum. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Eric M. Joseph, MD · Answer

The reason you are seeing this small irregularity is because the skin at the top of the nose is very thin. Depending on your examination, microdroplet Silikon-1000 nasal injections may be considered for camouflaging that bony bulge, and for providing a straighter and less lopsided nasal appearance. I hope this helps! Sincerely, Dr Joseph

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

Answers (8)

Answer: Revision rhinoplasty

Answer: Revision rhinoplasty

Answer: Permanent non-surgical nose job may be a better option.

Answer: Permanent non-surgical nose job may be a better option.

Recommended reading

Everything you need to know about Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.

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

Answers (8)

Answer: Revision rhinoplasty

Answer: Revision rhinoplasty

Answer: Permanent non-surgical nose job may be a better option.

Answer: Permanent non-surgical nose job may be a better option.

Browse related questions

Recommended reading

Everything you need to know about Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.