Can Scar Tissue from Rhinoplasty Develop 15 Years Later?

Is it possible to develop scar tissue 15 years later after a Rhinoplasty? It must have been happening slowly, but this year, I've really noticed 4 bumps on my nose. I have had no trauma to the nose other than 1 surgery, 15 years ago. What can be done to treat this? If it is scar tissue, can I avoid surgery? Thanks.

Doctor Answers 8

Changes Long After Rhinoplasty

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It is possible to see changes, even 15 years after Rhinoplasty. It is less likely due to growth of scar than it is to thinning of the skin of the nose, with aging.  It is possible that the bumps you are now seeing have been there, but are more apparent now because of thinning of the tissues.

If the bumps are visible and bothersome, consult with a Rhinoplasty surgeon to see if a touch-up is advisable.

Denver Plastic Surgeon
4.7 out of 5 stars 45 reviews

Probably not scar, but your nasal cartilages showing as you age.

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As we age the skin thins and we can see the cartilages "suddenly". They were always there. This look can be modified with further surgery, but usually we can soften this with fillers that last up to a year and a half.

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

Bumps are likely cartilage instead of scar

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Bumps on the tip of the nose can appear years after rhinoplasty, as the skin of the nose gets progressively thinner with age. These bumps (often called bossae) can be quite firm and are due to sharp bends on the nasal tip cartilages. This condition can be corrected with revision rhinoplasty. For pictures and more information see:

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Nasal cartilage causing bumps after rhinoplasty

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Most likely this is a “bossa”, or an area where the nasal cartilages have folded or contracted on themselves, resulting in a bump. If along the nasal bridge, then most likely this represents some overgrowth of bone. While not typically first happening so many years after surgery, this is still possible. To treat this, sometimes injections of steroids can help, but usually surgery with reinforcing and sculpting of the cartilages can be performed, by an experienced surgeon who understands the structural issues of the nose.

Jeffrey Epstein, MD, FACS
Miami Facial Plastic Surgeon
4.7 out of 5 stars 145 reviews

Nasal Changes Years After Rhinoplasty

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We (surgeons) always say it takes a year or more for swelling to go away.  The truth is, it probably takes decades for 100% of swelling to go away and for the tissues to assume their final shape.  Add to that  the natural thinning that occurs in some people's skin with age and further changes are evident.  Odds are that there were some very subtle irregularities in your initial rhinoplasty that were obscured by the swelling and thicker skin of years past.  You may consider a rhinoplasty touch-up to smooth this or you could use fillers like Restylane, Juvederm, and Radiesse to "re-obscure" the irregularities.

Louis W. Apostolakis, MD
Austin Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Its not new scar tissue

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Whats happening is your nasal structure is shifting and altering under the skin. Even without an obvious trauma, all the small movements that a nose undergoes from touching rubbing itching, along with the effect of gravity and aging, cause slow subtle changes to occur. Sometimes they appear to be sudden. This can be due to the 'straw that broke the camel's back' explanation. You need an assessment by a knowledgeable and experienced rhinoplasty surgery to resolve all this.

Small irregularities are possible

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Small irregularities can appear on the bridge of the nose many years after the procedure. These are related to both settling and thinning of the actual dermis and epidermis of the skin over time. Small bone and cartilage regrowths can also occur and are easily fixed through a touch-up rhinoplasty.

Touch up rhinoplasties can be done as an outpatient procedure but under a general anesthetic. This is not typically scar tissue itself forming; it is just a thinning of the skin and regrowth of cartilage, which tends to make the bumps appear.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Bumps on the Nose 15 Years After Rhinoplasty

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Hi Artsy Gal,

The skin of the nose actually thins for years following rhinoplasty, sometimes revealing underlying irregularities. What you are feeling in the upper third of your nose may be tiny boney spicules. In the middle third of the nose you may feel catilage irregularities, and in the lower third you may have bending of the lower lateral nasal cartilages causing "bossae". Lastly, there is the possibility of a cyst forming years after rhinoplasty. Most importantly, consult with your rhinoplasty surgeon, or an expert in nasal surgery to make an accurate diagnosis. The diagnosis will determine what the treatment will be. There are both non-surgical as well as surgical corrections available depending on what is causing your nasal bumps. Good luck and be well.

Dr. P

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

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.