Can Nose Tip Move to One Side After Rhinoplasty?

I am on 3,5 month after rhinoplasty (with straightening of nasal septum). Lately, the tip (started apx. from center of the nose) visibly moved to one side. Since sweelling still remains, I'm hopining that it's just asymmetrical come downs of it. Is there any possibility that it's a complication, and how often such things are observed in practice? I am going to visit the sergeon, but for some reasons your opinion is very important to me! Thank you very much in advnce.

Doctor Answers 11

It is rare but possible

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It is possible for a nose tip to move to one side after rhinoplasty.
It may happen if the surgeon performed unbalanced reshaping on right vs left side or less commonly due to scarring. A patient need to make sure that the surgeon performs rhinoplasty frequently and see his good and bad before and after pictures.

Los Angeles Plastic Surgeon
4.5 out of 5 stars 337 reviews

Nasal Tip Crooked After Rhinoplasty

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Hi Jen,

Without examining your nose, seeing photographs, and knowing what your surgeon did to the tip of your nose, it is very difficult to answer your question accurately. You should revisit your surgeon for examination and explanation. You need to wait at least 6 to 12 months before having a revision surgery. Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Nasal tip deviation can happen

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This can certainly happen after surgery, and it may be due to a number of factors, including swelling, the surgical technique, or even how you healed after surgery. My advice would be to see how it looks after all of the swelling has resolved, and this may take a year or more. If you need to have a revision surgery, it can be done, but you need to wait a minimum of a year after your procedure before considering having any more surgery.

Shahram Salemy, MD, FACS
Seattle Plastic Surgeon
4.9 out of 5 stars 155 reviews

Some Shifting is Possible

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It is possible to see some shifting of the tip of the nose during the healing after Rhinoplasty.

It is also important to allow swelling to go down and enough healing to occur before considering any revisions.

Depending upon the surgery techniques and the amount of swelling, your surgeon can best determine if it is best to wait or do something in the near future.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.7 out of 5 stars 45 reviews

Nasal tip re-correction depends on prior Rhinoplasty

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The key element of this discussion depends on the type of surgery you had performed during your rhinoplasty. There are many dedicated and expert rhinoplasty surgeons in Armenia and the type of surgery performed will determine the most common reasons for your postoperative nasal tip deviation.

If you had septal reset or a significantly deviated septum preoperatively, you may have experienced a condition known as septal memory or septal rebound, where the deviated septum resumes its preoperative deviation and contour after surgery.

If a graft was placed onto the nasal tip, the graft may have migrated.

If the nasal dome was manipulated, there is a small chance that the nasal tip may have succumbed to normal scarring to cause mild unilateral deviation.

In any case, experienced nasal surgeons, especially those in Beverly Hills and Santa Monica, wait about one year before undertaking revisional work.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Patience is still a virtue

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Three months after a rhinoplasty is very early to critically evaluate your results regardless of the cause of your tip deviation. As you yourself mentioned, it may be differential swelling causing the appearance. At any rate, you really need to wait a full year for all of the scarring and swelling to subside before a revisionary procedure can be done.

Nasal tip deviation may be related to the septal deviation

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The nasal tip can indeed move slowly after surgery, especially if a very deviated septum is fixed at the same time. Even with the attempts made to straighten the midline septal cartilage of the nose, sometimes the bone that the caudal (or lower) part of the septum sits in remains crooked or the cartilage itself can shift. This area,called the anterior nasal spine needs to be straightened along with the caudal septum during septoplasty. There are other things that can lead to the tip looking asymmetric such as a shifted strut graft, but by your description I wouldn't be surprised if you had a persistent deviation at the base of the nose where I described.

Swelling or scar contracture can cause this

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It is too early to tell whether this is due to swelling or scar contracture to one side. Time will tell, but sometimes as the nose heals scarring can cause the nasal tip to go to one side or the other. Your doctor should be able to evaluate this at 1 year.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Moving the nose tip is possible

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Being that you are in the early postop phase, it would be difficult to tell if the asymmetry was from swelling or created anatomically at the time of surgery. For any asymmetries related to swelling I usually recommend a regimen of taping.

If you are less than 4 weeks postop, asymmetries related to bone position may be able to be gently changed. You will have to see after one year what your nose looks like. Small, fixed deviations can be camouflaged with injectible filler if necessary.

Good luck. Dr. Shah

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
4.8 out of 5 stars 69 reviews

Swelling changes after Rhinoplasty

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Hi Jen-

Without seeing your before and after photos and not knowing exactly what procedure and techniques were used during your rhinoplasty, it is difficult to give you objective information about your particular recovery. However, I would recommend seeing your surgeon to have him/her re-evaluate your recovery. Theoretically, the tiny sculpturing sutures that are placed in the small cartilages at the tip of the nose can loosen or even break on one side causing asymmetry...but typically it is due to normal post-operative swelling changes which subside generally at 10-12 months.

See your surgeon before jumping to any conclusions.

I hope this helps and I wish you well in your recovery!

Dr. C

John Philip Connors III, MD, FACS
Atlanta Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.