Dip in nose after rhinoplasty. Permanent solution? (Photo)

Question

I am 6 months after surgery. My surgeon has told me I will take 2 years to heal as I have thick skin. He said that this is common and suggested a steroid injection to speed up my healing. He said I cannot get this injection in London. However, I am skeptical about this. Can perichondrium and fascia alone be used to augment the dip? Is there any risk of uneven resorption with this in the future? Can I be certain that it will provide a stable, long term result for my lifetime?

Eric M. Joseph, MD · Answer

For over 25 years, we have been using microdroplet Silikon-1000 to augment the nasal dorsum several millimeters for indentations just like yours. If the area of skin is bound down to the underlying nasal skeleton, results can be limited. Silikon-1000 is never associated with biofilm formation, embolus, blindness, or stroke. I hope this is helpful! Sincerely, Dr Joseph

Bora Ok, MD · Answer

Hi from Istanbul! It is still too early to see the final results of the procedure. But right now, rather than a steroid injection, a small amount of filler application may be sufficient to augment the dip in the middle. Best of luck to you!

Zoran Potparic, MD · Answer

Soft tissue filler rather than steroid injection (which will have the opposite effect) could be used as a temporary solution to see how augmentation of the area may affect the overall presentation of the nose; it usually stays there for over a year. A permanent solution would be the placement of the fascia, perichondrium, or crashed ear cartilage. Good luck.

Ronald J. Edelson, MD · Answer

At this point it is a waiting game. You could try fillers in the meantime . A revision may be necessary but too soon to know

Mats Hagstrom, MD (license on probation) · Answer

To make an accurate assessment regarding the outcome of a plastic surgery procedure we generally need to see a complete set of proper before and after pictures.
Ultimately your surgeon is responsible for the outcome of the procedure and you are responsible for choosing the surgeon.
There are no guarantees For any surgical outcome, including the placement of tissue grafts. 
Rhinoplasty results are typically final at 12 months and it is unlikely you’re going to see a difference by waiting longer.
In reality results are basically final by a few months, though there may be very very small amounts of swelling that can make minuscule differences when making assessments.
 Typically the face heals very quickly. 
I see no indications for having steroid injections.
Follow up with your provider or schedule in person second opinion consultations with other plastic surgeons in your community.
For second opinion consultations I suggest coming, prepared to bring with you and complete set of proper before and after pictures and a copy of your operative report.
Best,
Mats Hagstrom, MD

Dip in nose after rhinoplasty. Permanent solution? (Photo)

Answers (5)