Lumpy bridge after revision rhinoplasty - Can this be corrected? (photos)

Question

Female, 50 years old, thin Caucasian skin. I have had two revision rhinoplasties (2007 and 2021) after a skiing accident in 2003. The 2021 surgery was done to create a smoother bridge due to a dent in the bridge that was expanding over time. Prior to 2021 surgery I was getting the bridge dent filled with filler. The surgeon used ear cartilage to create a substance meant to fill the dent and avoid ongoing filler. During healing three lumps developed on my bridge. Can this be fixed?

Jonathan Kulbersh, MD · Answer

Thank you for your question and for providing photos. The lumps on the bridge you’re referring to may be caused by protruding grafts, which can be addressed through another revision rhinoplasty procedure. This might require adjustments to the cartilage grafts or replacement to produce a smoother result. 
Please keep in mind that each subsequent nose surgery becomes more complex due to the loss of structural support and scar tissue. The importance of experience, expertise, and artistry cannot be overstated. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon with expertise in rhinoplasty techniques. They will be able to review your surgical history and conduct a thorough physical examination to determine the best approach for you.

Man Koon Suh, MD · Answer

Thank you for your question. Good news is your case can be definitely fixed but using rib cartilage might be required. For the correction of irregular lumpy nasal dorsal surface, the ear cartilage graft must be removed and the dented area filled with new cartilage graft. Whether the new cartilage is transplanted in the form of diced cartilage or block cartilage requires detailed physical examination and X-ray examination. It may also have to be determined during the operation. New cartilage is likely to require the use of rib cartilage.And since dorsal skin seems thin, new cartilage graft needs to be covered in temporal fascia or allograft dermis.

Hong Ryul Jin, MD · Answer

It seems that cartilage grafts are showing through your thin dorsal skin. Revision should focus on finely tuned cartilage graft with reinforcement of your thin skin by your own fascia or dermis graft.

David M. Kowalczyk, MD, MBA, FACS · Answer

Hi Diana! Yes, the bumps can be fixed. It'll be important to determine if it's filler, cartilage, scar, or bone causing the problem. The skin may be damaged from the multiple procedures used to fill the defect. Care should be taken removing what's under the surface. Sometimes, fascia is added for camouflage and to protect the skin from problems with healing from disrupted blood supply. Nanofat is useful as well to provide stem cells and growth factors ideal for skin repair. Seek consultation with a surgeon who specializes in revision rhinoplasty and delicate nasal skin. Hope that helps!

Lumpy bridge after revision rhinoplasty - Can this be corrected? (photos)

Answers (4)

Answer: Lumps on Bridge

Answer: Lumps on Bridge

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Everything you need to know about Revision Rhinoplasty

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Lumpy bridge after revision rhinoplasty - Can this be corrected? (photos)

Answers (4)

Answer: Lumps on Bridge

Answer: Lumps on Bridge

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Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.