8 months post rhinoplasty, what could have caused bump and crooked appearance? Are there options other than a revision? (photo)

Question

I had rhinoplasty in feb 2022 and I was happy with the results when I took my cast off. (Attached photos). I have a bump on the left side of my bridge that feels like bone, which wasn’t there before or maybe it was it was hidden under swelling ? It makes my nose bridge crooked and it’s not straight from the front view. I really don’t want revision surgery but I’m so unhappy with my nose. Is this swelling or did it heal wrong ? My surgeon said I could have a revision in feb 2023.

Oakley Smith, MD, FRCSC · Answer

Hello,
It appears that there is still minimal residual bony bump. This can be fixed with revision surgery limited to the dorsal of your nose. Another option is to have filler injection around the bump to make it look straighter.

George Bitar, MD · Answer

There can still be some swelling and scar tissue in the nose even at 8 months.  I would recommend waiting at least 1 year before making a final assessment of the nose and deciding if anything else needs to be done.  You have done all the right things so far.  You are keeping your surgeon in the loop with your concerns.  Your surgeon would know what was done in the operating room and your anatomy better than anyone else.  I would recommend being patient for a little while longer and continue with your follow-ups with your surgeon.

Eric M. Joseph, MD · Answer

Based on your photos, you may have a slight indentation along your left nasal sidewall that may cause a crooked appearance, and a small bump. Depending on your examination, microdroplet Silikon-1000 may be considered for permanently filling a bridge indentation for a straighter nasal appearance. Hope this helps. Dr Joseph

Ronald J. Edelson, MD · Answer

What you are seeing is where the bone meets the cartilage. It could be revised but I would wait. Overall your result is quite good.

Robert Ciardullo, MD · Answer

What is the bump on the left side of your bridge? The slight leftward protrusion on the left side of your bridge is your nasal bone. During surgery we in fracture the bones to make the bridge thinner after removing the dorsal hump. This also closes the “open roof“. However in a small percentage of patients one or both bones may drift back outward. If only one bone drifts outward it will make the nose look slightly crooked and your left three-quarter view will look like it has a small dorsal hump. I know of no other remedy for this than surgical revision.

Thomas Spalla, MD · Answer

As difficult as it can be right now, just be patient and see how you feel about your nose at the 1 year mark after surgery. The nose changes dramatically over the first couple months after rhinoplasty, but subtle changes continue to occur, even beyond 1 year. The 1 year mark is generally considered sufficient time to assess the long-term outcome and as scar remodeling is very minimal beyond this point, the 1 year mark is the earliest at which revision work is generally considered.
Check back at that time and let us know how you're feeling about your nose. You may be perfectly happy at that point and not desire anything else be done.

Jeffrey C. Hamm, MD - Account Suspended · Answer

Hi and welcome to our forum!
From your photos, I note slight displacement of the left nasal bone which appears to be responsible for the asymmetry. 15% of cosmetic surgeries require a secondary touch-up for optimal results. There are no viable non-surgical options. It is wise to wait a year from your last procedure to allow for further subsidence of swelling and the hypervascularity of healing which may otherwise increase the bleeding risk during / after revisional procedure. 
Best wishes...

8 months post rhinoplasty, what could have caused bump and crooked appearance? Are there options other than a revision? (photo)

Answers (7)

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