Crooked Nose 17 Days After Rhinoplasty (photo)

Question

I had a Septo-Rhinoplasty 17 days ago and 5 days ago my surgeon took off the band-aids and my nose is slightly crooked to the left side.Before surgery my nose was completely straight on the outside.The septum was deviated on the right side and this was corrected by an ENT, in the same surgery, before the plastic surgeon.My surgeon said that we might have to have a revision in 3 months. I'm still a little swollen (mostly right side). Is 3 months enough or should I be worried about his opinion?

Amy T. Bandy, DO, FACS · Answer

I agree that your nose appears to deviate to one side.  From the pictures, it is difficult to tell if this is because of the underlying deviated septum, because you do not have a pre-op "birds eye view" photo, but you do have the post op one.  The deviation may be from the septum, not the rhinoplasty.  Although most surgeons would recommend waiting 6 months to a year before re-operation on a nose, I agree that as long as most of the swelling is down in 3 months, there is no reason to wait to correct a deviated nose as this is unlikely to change for the better over the course of the year.

David C. Pearson, MD · Answer

I suspect the nose will remain crooked until it is revised. I can imagine the following scenario: pre-operatively the interlocked tensions on the deviated septum and upper lateral cartilages were keeping it from deviating the cartilaginous bridge of the nose, but once the plastic surgeon detached the upper lateral cartilages from the dorsal septum, those tensions were released (despite correction of the lower parts of the septum). At that point, the typical maneuver would be to address this "new" deviation of the septum and correct it, but by that time it sounds like the ENT surgeon was done and gone and the plastic surgeon (who, by requiring the ENT, was obviously unfamiliar with septal surgery) was unable to address this situation.

	Now, it's also quite possible that this asymmetry is simply a complication of rhinoplasty that could happen in any surgeon's hands. It does happen even without any septal issues. However, it's my opinion that anyone performing rhinoplasty should also be facile with septal surgery since the two are often interlinked problems.

	In a particularly severe case, it still might be preferable to wait 6 months before a revision, though. Consider carefully, though, who will do the revision.

	Good luck,

	--DCP

Matthew Bridges, MD, FACS · Answer

I agree that it does look somewhat deviated, but I also agree with others who have noted that 17 days is still very early to make any real assessment.  I find it interesting that you had a two-surgeon team operate on your nose.  My personal bias is that surgeons who cannot operate on the septum should not be doing rhinoplasty.  The septum is the foundation of support for the nose.  It is a fundamental part of most rhinoplasties I perform.  Have you followed up with the ENT to check the septum?

Christopher Tolan, MD · Answer

It appears that the lower 2/3 of your nose are deviated to your right and in nearly all cases this is related to a deformity of the underlying  septum.  While the likelihood of improving the the external deformity by placing finger or digital pressure to your left is very low I think it may be reasonable if you decide to wait before proceeding with revision surgery.  Although most surgeons including myself prefer to wait 6-9  months before revising the nose, in your case I think early intervention is likely to correct the problem and minimize your frustration with the appearence.

Daniel Reichner, MD, FACS · Answer

Your nose seems to have a deviation.  Traditionally, plastic surgeons have recommended waiting 6 to 12 months for revision.  However, it cases like yours with a clear deformity, I would recommending returning to the operating room right away.

Crooked Nose 17 Days After Rhinoplasty (photo)

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Crooked Nose 17 Days After Rhinoplasty (photo)

Answers (9)

Answer: Post Rhinoplasty Deformity

Answer: Post Rhinoplasty Deformity

Answer: Crooked Nose After Rhinoplasty

Answer: Crooked Nose After Rhinoplasty

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Everything you need to know about Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.