Dent on left side of nose plus sharp bridge two years post op - how can I fix this? (Photos)

Question

I had a septo and rhinoplasty done almost 2 years ago Since the surgery i can only breath from one side at a time About 6 months ago i started to notice a dent on the side of my nose I wonder why this happened and if it will heal over time Doctor has confirmed inflammation on the nasal lining Any ideas on cause and fix please I really dont want another surgery

Semih Yildiz, MD, FEBOPRAS · Answer

The frontal photos suggest a narrow, sharp dorsal line with an asymmetric depression along one mid-nasal sidewall, although lighting and a photograph cannot show whether cartilage support is actually weakened. At almost two years, a new or persistent contour dent is unlikely to fill in through normal healing alone. Possibilities include scar contraction, an irregular bony edge, loss of upper lateral cartilage support, or internal nasal valve narrowing. Inflamed lining can worsen congestion but would not by itself explain every external contour change. Alternating airflow can partly reflect the normal nasal cycle, yet consistent blockage on one side deserves examination with nasal endoscopy and dynamic valve testing by your operating surgeon or a revision rhinoplasty specialist. Medical treatment for rhinitis or inflammation may improve breathing if swelling is important. Filler can sometimes camouflage a small depression, but in a previously operated nose it has meaningful vascular risk and does not repair an airway collapse. If a true structural defect is found, cartilage grafting or another targeted revision may be the durable option; you can still obtain the diagnosis and discuss nonsurgical measures before deciding on surgery.

Eric M. Joseph, MD · Answer

Based on what I see, you appear to have a small indentation along your left nasal sidewall. Microdroplet Silikon-1000 injections maybe an excellent alternative to revision rhinoplasty surgery, for permanently filling this indentation, and for achieving a less distracting and less operated looking nasal appearance. I hope this helps! Sincerely, Dr Joseph

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you may benefit from a revision rhinoplasty. If you end up getting a revision, I would make sure to place a fascial  dorsal onlay graft  or moreselized bone dorsal
Onlay graft  to provide a smooth long-term contour of the dorsum. Make sure you are going to a surgeon with hundreds of long-term before and after pictures on their website with standardized lighting and standardized backgrounds. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Dent on left side of nose plus sharp bridge two years post op - how can I fix this? (Photos)

Answers (3)

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