Septum cut during pituitary surgery - nose appears much more bulbous now. Can I expect for it to return to normal? (photos)

Question

I underwent sublabial transsphenoidal surgery for a pituitary tumor about 2.5 months ago. I've noticed that since I've had my surgery my nose appears wider, my columella seems to have retracted slightly, and the tip has grown more bulbous (one of my nostrils is a much different shape than before). I see now in my notes that my ENT cut away some of my septum bone during surgery - is this what has caused this dramatic change? Can I ever expect for my nose to look normal again?

Ali Sajjadian, MD, FACS · Answer

Thank you for your question!First, I hope that your surgery and your recovery were optimal.

Second, it is understandable that you are
concerned especially with the bulbous tip shown in the pictures you have provided. However, without profile view pictures and the inability to perform a physical exam it is not possible to
provide you with a definitive medical answer.That being said, to provide you with a raw and a simple answer to whether or not your nose will return to its original shape, I would have to tell you that it is highly unlikely. Nevertheless, a corrective septoplasty can benefit you greatly.

My best recommendation at the moment is
to be patient hence allowing nature to take its course and edema subsiding for better
results. There is no doubt that once the swelling resolves, more definition and
shape will be achieved.It is important to mention that the
finest cosmetic results in any particular case are based on a variety of
factors, including: the unique anatomy of the patient, realistic expectations,
a well-informed and detailed discussion with your plastic surgeon concerning
the best options for you especially covering a deep understanding of the pros
and cons of any given choice you will adopt.

Please keep in mind that following the
advice from a surgeon online who offers to tell you what to do without a
physical examination covering the nature and the status of the tissue,
assessing your desired outcome, taking a full medical history, and discussing
the pros and cons of each operative solution would not be in your best
interest. With that in mind, it is the safest and for your best interest to
find a plastic surgeon with solid experience and certified by the American
Board of Plastic Surgery who is ideally a member of the American Society of
Plastic Surgeons that you will trust and be comfortable with. You should
discuss your concerns with that surgeon in person.

Good luck!!!

Ali Sajjadian, MD FACS

Amy K Hsu, MD, FACS · Answer

Dear A12BG~

The bone that was removed from your septum was most likely removed from the posterior (back/inside) portion of your septum and is probably not what is causing the changes that you see.

If would be helpful to see your nose from the profile views to give a more specific answer.  It is possible that disruption of either the medial crural cartilages or the anterior (front) part of the cartilaginous septum occurred during the surgery. Any weakening of these areas can affect the support to your nasal tip and result in a change to the shape of your tip and nostrils.

I’m sorry to hear that you had unexpected changes to the appearance of your nose.  Unfortunately it’s unlikely that your nose will return to its original appearance on its own, but all of the things you have mentioned should be able to be improved with a rhinoplasty.  I hope your surgery and recovery went well otherwise.

Best wishes,
Amy Hsu

Garrett H. Bennett, MD · Answer

An incision in the front of the nose along the septum can weaken a major tip support. If the nose drops downward then the tip can look more bulbous. You can demonstrate this on yourself by pulling the skin under your tip towards your teeth. The shape of your nostrils seems changed as well. The treatment to this would have been repositioning the tip higher on the septum and then allowing the tip to heal downwards into its previous position. You should wait to see where the tip ends up at least 4 to 6 months before deciding to do anything. Keep in mind that you had brain surgery and curing your pituitary problem was the most important thing.

Septum cut during pituitary surgery - nose appears much more bulbous now. Can I expect for it to return to normal? (photos)

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Septum cut during pituitary surgery - nose appears much more bulbous now. Can I expect for it to return to normal? (photos)

Answers (3)

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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.