Why do noses collapse after rhinoplasty? (Photos)

Question

I’m worried that my nose is in the process of collapsing after undergoing rhinoplasty in Turkey. When the plaster was taken off I had a bump and over time I’ve come to notice it looks like an inverted V shape and it is difficult to breathe out of one nostril. Can I expect my nose to fully collapse over the next few years? I really do not want to undergo revision as I’m worried I may have problems again and just aggrevate my nose.

Steven M. Denenberg, MD · Answer

There are some expected changes after surgery, as the swelling goes down. The bump gets smaller, the tip gets narrower, and the tip usually drops. But a real collapse is quite rare.
If you find yourself in the position of considering a revision, remember that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. Any revision requires advanced techniques, requiring skill that most plastic surgeons don't possess with expertise. For most noses, it's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. For those who have had previous surgery, it also discusses how to tell whether your first surgeon should be performing your revision.
Your nose is also a perfect example of why computer imaging is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish -- what features he thinks he can change, and by how much he thinks he can change them. I always email morphs to my online rhinoplasty consultations. When you see the surgeon's goals in the morphs, you'll know whether he has an eye for an attractive nose, and whether he shares your opinion of what constitutes an attractive nose. You'll also know whether the changes he proposes are large enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. How would you ever get that figured out without the morphs?! 
But remember, you're not the surgeon for his skills with the computer. The doctor must then show you his before and after photos to prove that he can actually accomplish what he draws on the computer.

Nirmal Nathan, MD · Answer

Dear Rhinoturkey2018,Thank you for your question. Collapse usually occurs in rhinoplasty when the cartilage is over-resected. This leads to instability in the support of the nose, which must counteract the force of the skin, which is exerting a shrinking and inward pressure on the nasal skeleton. At this point, just see what happens and if at 1 year after surgery you have an inverted V deformity or breathing problems you may need a revision.Good luck,Nirmal R. Nathan, M.D.Certified, American Board of Plastic SurgeryMember, American Society of Plastic Surgeons

Why do noses collapse after rhinoplasty? (Photos)

Answers (2)

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