Crooked Nose 17 Days After Rhinoplasty (photo)

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. 

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

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? 

Hi Judia in Lisbon, Portugal,

The nose is typically still very swollen after rhinoplasty. Nasal swelling may also contribute to asymmetric appearance or "firm" skin texture. It's possibly still too early to determine final results. Traditionally, plastic surgeons recommend waiting 6 to 12 months before considering revision surgery.

However, speak with your surgeons now, as parts of the nose may shift in the early postop period. Only after a comprehensive evaluation can your surgeons help determine appropriate options for you. Best of luck.

Dr. Chaboki

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.

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.

Sorry for your post operative issues. Yes you need revision but after at least 6 months of healing. From MIAMI Dr. Darryl J. Blinski

Yes, it does look like it is off to one side more so than preop, but this also may be a result of the septum being curved in that position as the dorsum was taken down.  Talk to you surgeon.

Your nose does appear to be crooked, but normal swelling this soon after surgery make it difficult to evaluate. If a revision is necessary, I would wait at least another 6-9 months.