New Bump 8 Years after Rhinoplasty - how can I treat this? (Photos)

This late onset of a granuloma cyst and likely an abscess is due to something your tissues try to expell out due to being "non living stuff", this can be 3 options:
-late devascularization of your rib grafting, for whatsoever reasons
-some internal stitches were non dissolvable (beyond me why still this practice persists) and now they are being rejected
-there is something else that was undisclosed or unware of, a piece of syntethic material is trying to find its way out (this is my bet, either the surgeon "forgot" some alloplastic piece there or he used synthetic structure to support your nose)

In any case this has to be immediately treated with antibiotics and drained, probably office procedure to begin with.

Go back to your surgeon and seek his help; do NOT accept esteroids injections under any circumstances, that'd be a calamity.

Over time, when foreign materials or cartilage are placed inside the nose, the pressure on the nose can increase. This may cause the skin to thin, which can make the underlying cartilage more visible.
In your case, the area appearing at the nasal tip seems to be part of the cartilage. If left untreated, there is a risk that it could eventually pierce through the skin. By undergoing revision surgery beforehand, we hope to prevent this from happening and maintain healthy nasal skin.
Along with reinforcing the internal nasal skin, there may also be a need to slightly lower the height of the nose.

Based on your photo, you appear to have relatively thin skin, and we are seeing a severe edge of white cartilage poking through your nasal tip skin. In general, we have had excellent success in camouflaging these irregularities, when they occur, utilizing microdroplet Silikon-1000 injections to put a cushion in between this edge of cartilage, and your thin skin. I hope this helps! Sincerely, Dr Joseph

Unfortunately in some cases, small amounts of cartilage or bone may remain after rhinoplasty, leading to the appearance of bumps or unevenness even after many years. These structures might be more noticeable as swelling subsides. Fortunately, it’s an easy fix most of the time. Your surgeon can file it at the clinic under local anesthesia.

Of course, I haven't had the chance to examine you in person, but that bump looks very very much like the "dome" of your left tip cartilage. It's got a couple of unusual and sharp bends in it, so we can see it's outline, and it stands out against the somewhat thin skin covering the tip of your nose.

Now what to do about it? It depends on whether there's anything else that you might want different about your nose. For example, if your profile shows that the tip is strong in its forward projection away from your face, or if you would prefer that the tip be elevated some to make the nose shorter, then the surgical techniques that allow those changes would involve work on those tip cartilages, and it could be dovetailed into some modification of the bump part to make it less conspicuous. If you love your nose exactly as it is but just want the bump not to show so obviously, it's still possible to design an operation, but it's just more difficult. The surgeon would have to see you in person to try to map out what's going on as accurately as possible so a good procedure can be planned. Sorry for being so vague-ish!

Your photographs show what appears to be cartilage that is very prominent and poking out. This will require an open incision to correct the cartilage displacement. This could be from the graft you had or it could be from your other cartilage that has broken and has sharp edges.

Best Wishes,

Gary Horndeski, M.D.

Hello and thank you for your question. Based on your photographs, you are a great candidate for revision rhinoplasty. Maneuvers for your surgery would include nasal tip deprojection, placement of mastoid fascia tip graft, among other maneuvers. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Answer from Dr. Sean Hill, Board-Certified Plastic Surgeon at Lone Star Plastic Surgery in Frisco, TX:
Thank you for your question and for sharing your photos — they’re very helpful in understanding your concern.
At 8 years post-rhinoplasty, the healing process is long complete, so when patients notice a “new bump” this far out, it’s often something that’s been present but has become more noticeable over time. Based on your photos, it looks like the area in question may be a cartilage tip graft — a common structure placed during surgery to shape and support the nasal tip.
These grafts can become more visible over the years, especially if: • The skin has thinned, which can happen naturally with age • There’s been minor trauma or pressure to the nose • There’s a gradual shift or resorption of surrounding tissue, making the graft more prominent
If the bump is firm and doesn’t move, and you can feel its outline clearly, it’s very likely the underlying cartilage graft and not a new growth or swelling. That said, if it’s bothering you aesthetically or feels uncomfortable, revision rhinoplasty or minor contouring may be an option.
At Lone Star Plastic Surgery, I see many patients for secondary rhinoplasty and always recommend a conservative, personalized approach — especially when tip grafts are involved. And if you’re seeking further treatment, be sure to consult with a board-certified surgeon who is also a member of The Rhinoplasty Society, as these cases require advanced experience and a nuanced understanding of nasal anatomy.
Warmly,Dr. Sean HillBoard-Certified Plastic SurgeonLone Star Plastic Surgery – Frisco, TX

Based on the nicely posted series of photos, still a virtual consult would be in order. It appears that some type of cartilage displacement or growth that needs to be addressed by a rhinoplasty technique usually open rhinoplasty for this situation expect fees to range from $10,000-$20,000. Again, best to virtual consult with.

I think your new bump is unrelated to your previous surgery.
You can consult with a plastic surgeon or dermatologist to get evaluated and possibly treated.
I think you have developed a nevus (raised mole)
Best,
Mats Hagstrom MD