Needle or closed procedure to shave cartilage irregularities on the bridge? (Photo)

Hello! Thank you for your question. As far as I can see from your photos you had a little bump due the damage and relocated cartilage might be the reason of this image. Closed technique and operation room will be much more safe and hygenic. It would be more convenient to decide with face-to-face consultation. Best Regards!

Shaving down the dorsum to achieve a smoother result, seems like the right solution discussion with your primary surgeon as to their methods Is entirely up to you. It seems reasonable to try the less invasive modality first and go from there.

Hello, this is a relatively common situation that there can be dorsally regularities I'm all of which, can we do to a multitude of different scenarios. The main issue is that I do not think you will need an open approach. I believe this could be very easily accessed via endonasal approach and taken down in a conventional manner. I think it would be a more direct address of the irregularity however requires a little bit of incision inside the nose, elevation of the skin and then gently taking that area down. It appears to be the dorsal septum so I think it may be a bit much for just a needle.

I would be careful of simple solutions to complex problems. If this provider claims to have experience shaving Cartlidge, using a needle, then ask them to show you some before and after pictures. It may be possible to cut tissue using the sharp edge of a large needle, but how is the cartilage going to be removed? Simply slicing through the Cartlidge using a procedure that does not have good control sounds unpredictable and I don’t think you’ll be happy with the outcome. I think you need to ask yourself if this warrants, a revision rhinoplasty or not. You may be able to get some improvements using fillers. Each time someone has had previous surgery things become more difficult and complex. The threshold for surgical intervention should be higher based on having multiple previous procedures. Sometimes it’s better to leave good enough alone. Being in the hands of the most experienced and talented providers is probably the most important variable. Focus on choosing the most experienced provider and follow their guidelines. I generally always encourage people to have multiple in person consultations before scheduling any procedure and this is more true for complex operations like revision rhinoplasty. During each consultation, ask each provider to open up their portfolio and show you the entire collection of previous patients who’ve had similar procedures. An experience plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. Highly experienced surgeons should have access to 100s or preferably thousands of before and after pictures. Seeing a handful of pre-selected images, representing only the best results of a providers career is insufficient to get a clear understanding of what average results look like, what your results are likely to look like or how many of these procedures anyone surgeon has actually done. You may very well be in the hands of a very talented provider, but Getting confirmation and vetting providers and comparing is always a good idea before committing to having surgery.
I would err on the side of caution, considering the complexity of your previous surgery.
Best,
Mats Hagstrom, MD