I had an open rhinoplasty, I'm wondering what the probable causes of the asymmetry of the tip of my nose.
18 yr old female, 3 months post-op, rhinoplasty. My tip is objectively uneven, what's the probable cause? (photo)
Doctor Answers 7
When your nasal tip swelling resolves after rhinoplasty, persistent asymmetry may be addressed non-surgically.
Your left nostril margin appears higher than your right, and at three months postoperative, this may be from swelling. You appear to have thin skin, so your tip swelling will continue to diminish relatively quickly over the next three months. If you have persistent tip asymmetry when your swelling has diminished, you may consider a nonsurgical rhinoplastic procedure to lower your left nostril and replace volume to your left tip. We may prefer using Silikon-1000, an off-label filler for permanent results. Wishing you well. Dr Joseph
Causes of tip asymmetry after rhinoplasty.
After rhinoplasty, there is always swelling of the nasal tip and this is more after an open rhinoplasty. As the swelling resolves and the tissues heal the scarring under the skin may distort the shape some. This is why it's important to allow full resolution of these issue before deciding to revise. Your photos do show a fair degree of unevenness. You should follow up with your surgeon to express your concerns. If you wish to seek another opinion, see a board certified plastic surgeon with experience in revision rhinoplasty. Best wishes.
Deciding on a revision rhinoplasty.
Your pictures do show a good amount of asymmetry, even for postop swelling. However, you really need to wait one year before deciding on whether you need a revision procedure or not. During the healing process, the normal process of scar formation will still produce some changes to the nose - so you will not know what revisions (if any) are needed until one year out. At one year, if you think you still need a revision, make sure to find a board-certified surgeon who performs a good number of revision procedures.
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If you look at you preop photo, you tip was asymmetric to begin with. It looked asymmetric post-op. At this point, you have to give it more time to heal before considering a revision if necessary.
Tip Problems after Rhinoplasty
After your open rhinoplasty, your tip was asymmetrically immediately after surgery and continues to do so now that 3 months have passed. Your tip will continue to change as swelling goes down further but your tip will not be symmetrically. Its the underlying cartilage structure that provides for the shape and support of the tip; so, its asymmetries in the cartilage framework that creates the problems you are observing. Before planning surgical (or non-surgical) revision procedures after open rhinoplasty, you should allow for a full year of healing to occur.
Thank you for your question. You are in your early stages of healing. As such, it is best that you remain patient until the 12 month post op mark at which point you can evaluate your results and hold a realistic understanding of your new nose. Always consult with a board certified facial plastic surgeon and please discuss your expectations and best practices for recovery with your 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.