Dorsal Hump Swelling or Callus After Rhinoplasty?

Question

Three months ago, I had a surgery to correct my nose. It is now smaller and narrower in overall size. However, the dorsal hump area is still pronounced. It is no longer as big as before but the dfifference is minimal. My doctor assured me that he had smoothed my dorsal hump down. Is it possible that the swelling hasn't subsided yet? The tip of my nose is still very bulbous. Could I just be a slow healer? Or could it be I have developed a callus? Thank you.

Brock Ridenour, MD · Answer

Patients are often surprised that their nasal hump is not immediately "gone" after surgery.  After all, if the bone and cartilage were removed it should look immediately better.  Right? Oddly that is not the case as it can take many months for the bridge of the nose to reach its final appearance. Often, swelling will go down more quickly in one area of the nasal bridge and take longer to go down in another. Three months seems like an eternity to the patient, but it is the minimal time required to see a significant change. Regrowth of bone or scar (callus) does occur in some patients, but it is not particularly common.  You should see some real improvement in the coming weeks and months. The nasal tip will likely take longer to refine, especially if you skin is thick or inelastic.

Richard J. Bruneteau, MD · Answer

It’s not unusual for patients to experience significant
swelling in the post-operative period.This swelling may be present for up to a year following surgery.It can often cause the nasal tip to be hard,
stiff and bulbous.It can also cause the
nasal dorsum to be prominent even though cartilage and bone have been removed
from the area.In rare
cases, a persistent nasal bump may be related to callous formation.This phenomena occurs when excess scarring
occurs in the area of the previous dorsal hump.This type of scarring doesn’t always respond to massage and may require
more aggressive surgical maneuvers including steroid injections and in some
cases surgical intervention.The
vast majority of persistent dorsal humps are related to prolonged swelling and
resolve with the passage of time.Never
the less, they can be the source of significant anxiety.For this reason, it’s important to contact your
plastic surgeon as soon as possible.Your surgeon should be able to address your concerns and alleviate your
anxiety.

Bao L. Phan, MD · Answer

It usually takes up to a year for your nose to completely heal and look it's best following rhinoplasty.  If you had osteotomies (fracturing of the nasal bones to make it more narrow) along with the dorsal hump reduction, this will definitely cause more bleeding, bruising and swelling and will require more time for all the swelling and scar tissue to subside.  The tip of the nose tends to remain swollen longer than the rest of your nose and can take many months before enough of the swelling to go down before you can see all of the refinement that was accomplished. If your nose had more bleeding during and after surgery, this can cause more swelling and scar formation (callus) that will take longer to heal and could potentially compromise your results.  At this point I think it would be too early to tell what your final outcome would be but as long as it is showing consistent (even modest) improvement each month then it's a good sign.  I would just follow up with your PS so he/ she can continue to track your progress to let you know how it's healing.  Best wishes.

C. Spencer Cochran, MD · Answer

Following a hump removal during rhinoplasty, it is very common for there to be excessive swelling overlying the area where the boney hump was removed.
If the bone was adequately reduced, that bump should disappear as the swelling subsides over the first 3-4 months. If the hump persists beyond then, it may indicate that the hump was not entirely reduced during the surgery. Reduction of the residual hump can easily be performed with further rasping (filing down) of the hump through intranasal incisions. There is usually minimal downtime and minimal bruising and swelling.
Most surgeons recommend waiting a full year after a rhinoplasty before making any determinations as to whether a revision is needed. In some cases it can take the full 12 months for all of the swelling to subside.

Gary Motykie, MD · Answer

You nose will continue to improve and change significantly for up to a year after your rhinoplasty. You are healing normally and the dorsal hump area and tip of the nose generally take a while to heal completely. In general, the hump will heal first followed by the tip of the nose several months later. I always advise waiting for at least a year after your surgery before evaluating your final results.

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Dorsal Hump Swelling or Callus After Rhinoplasty?

Answers (8)

Answer: Rhinoplasty Recovery: Final Results Can Take Time

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Answer: Swelling after Rhinoplasty

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