Dents and Bumps. Revision? (photo)

I had rhinoplasty 14 months ago. Just the nasal hump reduced. Initially I was happy with the results but as the swelling went down, I saw many imperfections. The surgeon has told me to come in so that he can "file" the imperfections down and use a filler for the dents. Based on the photo I've provided, do you think this is something that could be fixed with small in-office procedure or should I consider a revision with another surgeon all together.

Doctor Answers 12


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Filling can be a reasonable option to correct mild imperfections.
I would generally consider that before going back to surgery.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 53 reviews

Rhinoplasty Dorsum Refinement

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    If this is a bony and cartilaginous excess issue, further removal in a closed rhinoplasty is a reasonable option.  Fillers could also be considered.  Kenneth Hughes, MD Los Angeles, CA

Bumps/dents following rhinoplasty

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“Filing” may be a bit more than an in-office procedure, so you want that explained more before doing it. Filler is a useful adjunct and can be done in the office. The photo provided is somewhat inadequate and out of focus. Therefore, based on it alone, it is difficult to determine if a complete surgical revision is warranted. You may want to get a second opinion from a board-certified plastic surgeon.

Use of a filler sometimes works

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Dear Victoria
It is possible to correct some of these subtle deformities with fillers, realize you may need to repeat it yearly. 

However if it works it may buy" you some time, and then you cn make a more educated decision. It is vey hard to see in this picture if its "subtle". When in doubt there is nothing wrong with getting a second opinion.

Andres G. Sarraga, MD, FACS
Aventura Plastic Surgeon

Bumps and Dents in Nose #nosejob

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I partially agree with my colleagues. After 14 months you won't see much change. You certainly could entertain filler as a non surgical option. This would need to be redone every 6 months or so depending on how fast the filler dissipates. If you have multiple areas of concern then revision may be cheaper in the long run once you spend years putting filler in the nose. I can't see clearly if that dent in the nose is at the junction of the cartilage and bone part of the nose or not. If so it is unfortunately all to common that I see over resected bumps in this area that leads to an abnormality. With large hump reductions I will often place cartilage grafts called spreader grafts that extend up into that region to maintain the proper nasal structure there. I can not tell you with any accuracy what is going on without laying my hands on the nose. I can tell you even the best of surgeons will have things like this happen to their patients so if you like and trust your surgeon then stick with them. If you are not happy then seek as many opinions as it takes until you find the most qualified board certified surgeon that you trust. You are now a revision nasal surgeon patient and you should seek a surgeon that specializes in revision surgery.

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 54 reviews

Bumps and dents in nose

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It sounds like a reasonable plan to have the bumps filed down and the irregularities or dents perhaps filled.  

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Minor correction after rhinoplasty

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The small dent can be corrected as a minor procedure by a filler injection which is an office procedure.

Filing of any bony irregularity is better done in an operating theatre either under local anaesthesia (numbing injections) or general anaesthesia.

The photo you have posted does not show the whole nose and has only the front view. Based on this it does not look like you need a full revision rhinoplasty - but please post more photos including side and basal views if you need further advice.

Anindya Lahiri, FRCS (Plast)
Birmingham Plastic Surgeon

Revision of Prior Bridge Work Done

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The photo is a bit blurry so an accurate assessment is difficult. That being said, there are some cases where minor refinements done in the office setting can help further improve your rhinoplasty results. This includes small filing procedures to smooth out the bridge as well as use of fillers to contour minor depressions. Wishing you the best of luck.

John M. Hilinski, MD
San Diego Facial Plastic Surgeon
4.7 out of 5 stars 44 reviews

"Dents and Bumps" after Rhinoplasty

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You describe "many imperfections"  which implies more than a minor procedure. I would need to see more than the one picture you submitted. If you have any doubts a second opinion may help you decide what to do.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Non-surgical Rhinoplasty is great for small revisions after surgery

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Your nose could be treated very well with fillers!  An experienced injector could contour your nose very well.  I find that fillers are actually better at fine-tuning contouring than surgery.   You'll find that over time, the concavities will be less and less with each injection.  It is important, to have someone who also performs surgical rhinoplasty and is familiar with the anatomy to contour your nose.

I have attached an example of a non-surgical revision rhinoplasty patient, take a look.

David C. Mabrie, MD
Bay Area Facial Plastic Surgeon
4.7 out of 5 stars 156 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.