Do I need revision after septorhinoplasty, 1 side of looks really bad & nose doesn’t seem straight

Question

I’m south Asian, I think my nose is still swollen, what I don’t understand is why one side looks so much better then the other. Also, do you also think the nose is still bent on one side? Do you think a revision could give better results?

Randal Haworth, MD, FACS · Answer

We all heal asymmetrically, and it's possible that one side of your nose needs more time to settle, depending on when your rhinoplasty was performed. I would recommend scheduling a post-op appointment with your plastic surgeon. They can assess your progress and provide specific guidance based on your individual case. If the problem persists or you have concerns, it would be a good idea to seek a second opinion from another reputable, board-certified plastic surgeon. Best of luck with your recovery!

Timothy Osborn, MD · Answer

Depending on when your surgery was, you could definitely still have swelling. It appears you have some left, especially at the tip. Asymmetrical swelling is also common. You would have to wait for all the inflammation to be gone before any addition work or revision is done. That being said, it does seem to be slightly leaning to one side. Many factors go into a revision, especially your ability to breathe. How is breathing through your nose? Do you have difficulty breathing through one side vs. the other? Does the tip of your nose feel more soft, or is it hard? Our office offers in-person or virtual consults if you would like to discuss things further!

John Michael Thomassen, MD · Answer

You still have significant asymmetry on some views.  You may be a candidate for a revision to help address these asymmetries.  First however you need to allow enough time for soft tissue swelling to resolve and then have a careful analysis with your surgeon as to how to correct them.

Zoran Potparic, MD · Answer

It takes an average of 1 year after surgery for nose result to settle and mature. So, you can expect further changes, in particular regarding swelling and tip size, projection, contour. Postoperative tapeing over night may help to eliminate swelling. Once your result is mature and stable you should address your concerns with your surgon. Hope this helps.

Jonathan Kulbersh, MD · Answer

Thank you for your question and photos. It’s difficult to make accurate suggestions without knowing how long ago your initial surgery took place. Your nose will continue to be in a state of recovery for at least one year following septorhinoplasty. Depending on how long ago your procedure was, you may still be experiencing some swelling that can inhibit your ability to assess your final results. Asymmetrical swelling is not uncommon during this phase. Once six months have passed, you may consider dermal fillers to temporarily alter your nose’s appearance, if desired, and can inquire about revision rhinoplasty after one year.

When considering a revision, it’s important to note that each subsequent nose surgery becomes more complex due to the loss of structural support, scar tissue, and other factors. 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 oversee your recovery, review your medical history, and determine the treatment plan that may be right for you.

Jacob Tower, MD · Answer

Hello, hope you are well. It is hard to answer your questions with precision without some more information. The most important factor is how long ago your primary rhinoplasty surgery was. (I.e. did rhinoplasty take place 1 week ago or 1 year ago?) Swelling can take a long time to resolve completely, especially in the tip. It can also cause some asymmetry (for example, if you favor sleeping with the left side of your face down). Features like a persistent nasal hump and overall curvature are less likely to be temporary. Once swelling has resolved completely, you will see the 'final' structure of your nose and can decide whether the imperfections are bothersome enough to pursue with further intervention. Having said that, your first move should be to follow-up with your surgeon to discuss your concerns and for some immediate guidance. Perhaps a revision will be necessary if the asymmetry and tip bulbosity persist, but this is not usually performed until at least a year after recovery from the initial procedure. 
Best.Dr. Tower

Thomas J. Walker, MD, FACS · Answer

Hard to tell and don't know how far out you are from surgery. Looks like you have a C-shape deformity. Best to follow-up with your surgeon and follow his or her advice. If still present after 6-9 months, unlikely due to swelling and a revision surgery can then be considered although we generally like waiting a whole year before considering a revision rhinoplasty.

Best wishes,
Thomas Walker, MD, FACS
470-900-3223
@drthomaswalker

Best wishes,
Thomas Walker, MD, FACS
470-900-3223
@drthomaswalker

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.I don't know when you had a rhinoplasty but I recommend you a revision rhinoplasty surgery. Your nose has a S shape and the tip looks very deviated. The tip is very bulbous and your nostrils look too close. If you want to get a revision surgery please keep in mind that you will most probably need a cartilage reconstruction (from the Rib).
Best regards!

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