Indents and crooked nose 7 months after rhinoplasty. Do I need a revision? (Photo)

Question

I’ve gotten a rhinoplasty back in May and noticed my nose is still crooked. A couple months later I noticed indents on the sides of my nose and that I still have a slight bump. I spoke to my doctor about it and he says I have to wait a year before making any judgements. I completely understand that as the nose takes a year to heal. I’m just worried about needing a revision rhinoplasty because I don’t think I could afford that. I would love to hear other opinions. Thank you.

Daniel Barrett, MD · Answer

Dear Gentle440429,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Jonathan Kulbersh, MD · Answer

Thank you for your question and I appreciate your concern. However, the nose can go through many changes during that first year, due to swelling that may take many months to subside. During the healing process, you might see some less than desirable changes to your nose, but it is possible those changes may correct themselves in time. If you are still unhappy at your one-year mark, that would be the time to meet with your surgeon to discuss a revision option. Always work with a very experienced, board-certified facial plastic surgeon when seeking rhinoplasty or revision rhinoplasty as these are the most complex plastic surgeries performed.

Mark G. Albert, MD, FACS · Answer

Hello,
Thank you for your question. I can appreciate the depressions/asymmetry in your photos. Without seeing you in person, it is difficult to determine the best treatment since this can result from a number of things. It's possible it's from where cartilage is routinely removed during the procedure. 
A revision rhinoplasty can be done using the closed / scarless approach, and a surgeon may perform it while waiving the procedure fee in some cases depending on the circumstances. If you do elect to undergo a revision, I would suggest you find a surgeon who performs a lot of revision rhinoplasty. I wish you all the best.
Mark G. Albert, M.D., F.A.C.S.New York, NY & Boston, MA

Behrad Elmiyeh, MBBS, MRCS, FRCS (ORL HNS) · Answer

Many thanks for your questions and for sharing your photographs.
During the healing process your nose will go through changes which may result in formation of some irregularities. It is paramount to wait for 12 months after a primary rhinoplasty surgery to assess the final result. I appreciate that you feel anxious and wish to avoid any further risks and cost implications associated with a revision surgery, but I am afraid you need to remain patient. Only then, you and your surgeon can fully assess the outcome and weight the benefits vs risks of revision surgery if indicated.
Wishing you all the best.

Jeffrey C. Hamm, MD - Account Suspended · Answer

Hi and welcome to our forum!
From your photos, I note slight irregularity the the bridge at the bone / cartilage junction, the bridge is slightly high, and there is minimal displacement of the nasion from midline. However, the patient is only 7 months after surgery...
The procedure of rhinoplasty involves separation of the nasal bones and cartilages from overlying and underlying tissues, fracturing and reshaping of bone, trimming and reshaping of cartilage. The tissue trauma resulting from this "insult" is significant, resulting in the inflammation of healing, swelling (which may be asymmetric), firmness and a slight degree of warmth which may persist for a year or longer. This phenomenon will gradually subside. Some surgeons advocate the use of nasal tapes to control the swelling in the early postoperative period.
It is still too early to ascertain the result of your surgery. One must wait at least one year to determine the result. Swelling can masquerade as bone and cartilage displacement early on. 
Continue follow up with your plastic surgeon. 15% of cosmetic surgeries benefit from a secondary touch up.
Best wishes...

Indents and crooked nose 7 months after rhinoplasty. Do I need a revision? (Photo)

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