What Are These Dark Lines/depressions Next to my Eyes Following Open Rhinoplasty/septoplasty? 5 Months Post-op (Photo)

Possibly from osteotomies? Could they resolve? The lines are very visible when I smile, extending into the tear trough region, making more of a shadow & really aging my eyes. The nose made a smooth transition prior to surgery, now it looks like it's stuck on my face. I also have a lumpy, wide middle 1/3 where the spreader graft was placed, which creates more unfavorable shadowing & asymmetric-looking eyes. I'm saddened by the negative impact that rhinoplasty has had on the rest of my face.

Doctor Answers 4

Rhinoplasty revision

It sounds and looks like some soft tissue under the skin was caught between the 2 edges of bone after the osteotomy. When the bones were then moved inward with the infracture this tissue was pulled as well creating a visible indent in the skin. Your surgeon should be able to discern this on physical examination because the indented line would be tethered i.e. not mobile. The solution may be as simple as inserting a needle to sever the connection.

If it is not tethered but there is a sharp palpable step off in the bone the solution would be to rasp the bone edge down.

Without a photo it is hard to make a comment about the spreader graft(s).

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Los Angeles Plastic Surgeon
5.0 out of 5 stars 2 reviews

Postrhinoplasty shadows

If you can feel a hard bony defect, then these are related to the osteotomies that were performed. The soft tissues can fill the gap and create a shadow effect. The region can be augmented with either fillers or fat to fill this space whether it is a result of surgery or aging.


Be healthy and be well,

James M. Ridgway, MD

James M. Ridgway, MD, FACS
Bellevue Facial Plastic Surgeon
5.0 out of 5 stars 92 reviews

Your post-rhinoplasty concerns are real.

I suspect you are correct about the dark line/depression at the junction of your nose with the maxilla and inner canthal area. It looks as if your soft tissues developed retracted/contracted scar into the osteotomy bone cuts. Now that the bones have healed, the attached soft tissues could possibly be freed up (surgically), reducing or eliminating this adherent, retracted scar depression.

Spreader grafts widening the nose--well, that's how they work to improve breathing, but IMHO, they almost never improve the appearance of the nose, since almost nobody comes in and asks for their too-narrow nose to be widened. Thus, this is a breathing-improvement surgical choice that should only be made if someone is absolutely not going to be bothered by increased nasal width. Otherwise, and again IMHO, better airway-enhancing options exist that do not widen the nose.

You need several consultations with experienced rhinoplasty surgeons of both plastic surgical and ENT/facial plastic surgical specialties. Help is out there; do not despair! Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

What Are These Dark Lines/depressions Next to my Eyes Following Open Rhinoplasty/septoplasty? 5 Months Post-op

I totally agree with Dr Tholen's posting. I might recommend trying a fillers to help in scar release, as for color changes use inlayer or bleaching agent. Last resort is a surgical intervention. The other issues you describe in the mid 1/3 of your result is not in the posted photo so very hard to expound on possible therapy. Best to seek in person second opinions. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

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.