How soon can I have a second nose bump rasp procedure done? (Photo)

Question

I had a full open rhino performed in sept. 2015 to repair deviated septum, nasal valve and turbinates repairs. I had to have rasp procedure to remove a boney dorsal hump this April 2016 which made the bump smaller but another rasp procedure will be needed...how long do I have to wait? The rasp was simple easy procedure - can I have it sooner rather than later?

John Michael Thomassen, MD · Answer

A second rasp procedure can be undertaken to soften the residual dorsal hump you have.  However, you may consider a revision to reduce both your cartilage and bony dorsum slightly further for a nicer overall result.

Philip S. Schoenfeld, MD, FACS · Answer

Your photos are helpful and demonstrate the areas of your nose that you are still concerned about.  On examination of the photos it appears that a simple bony rasping procedure would be all that is needed to help correct the issue that you are confronted with.  Palpation of the nose can often times reveal other issues.  You should feel comfortable having your revision procedure performed as soon as you are able to.

Shlomo Widder, MD · Answer

Dear K,   Thanks for submitting your pictures.  If you are interested in only bump reduction, it can be done, the earliest, 3 months after your last procedure, though ideally it should be done after 1 year due to scar maturation . However, this issue is very personal and not every person can tolerate the deformity for long time, hence earlier date is possible.  If you are interested in more than just bump removal and obtaining a nicer,  more feminine nose , I would recommend the followings:   1. Small cartilage graft to fill up the depression on the left upper nasal slope.  2. Reduction of the pre tip dorsal cartilage , for more tip definition.  3. Cartilage graft to the columella and naso-labial angle , for more feminine upturn angle of the nose.  Not all rhinoplasty results are the same, because experience, skills and aesthetic eye are critical for good outcome.   Always, consult with experience board certified plastic surgeons who do lots of rhinoplasty surgery in an accredited surgery center for your safety. Most importantly, check the before and after pictures (usually in the office, because most patients do not feel comfortable having their face picture on the internet), to make sure that they are numerous, consistent and attractive .                           Best of luck,                                              Dr Widder

Emmanuel Mallol Cotes, MD · Answer

Thank you very much for sharing your concerns about your Rhinoplasty with us.Congratulations for having patience and wait more than six months PO, which is the recommended time allowed to make judgments of value and be precise and accurate.After having analyzed all the info and photos provided to us, i recommend to perform a Secondary Rhinoplasty (not a tip revision) this means (basically) treat the nasal bones and the nasal cartilages.Therefore i would perform a narrowing of the nasal base (nose osteotomy) and alar and triangular cartilage shaping.Respectfully,Dr. Emmanuel Mallol Cotes.-

Eric M. Joseph, MD · Answer

The bump appears to be at the bony-cartilaginous junction of your nasal bridge, and cartilage does not lower with a rasp. An examination would be necessary to determine what might be best for you, but if your issue could be improved with microdroplet Silikon-1000, that might be worth considering rather than a third nasal surgery.Hope this helps, and wishing you well moving forward.Dr Joseph

Paul S. Nassif, MD · Answer

Hello, and thank you for the question. In general, it can take 18-24 months for the final result of surgery to be evident. It is best to wait one year before any revision work is performed, as any residual swelling that is present from the prior procedure can affect your surgeon's ability to perform his or her best work. I would recommend following up with your surgeon, as he/she knows the details of your procedure and will be able to advise accordingly. I hope this helps, and I wish you the best of luck.

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. I suggest you wait 12 months after your rasp procedure to ensure you are completely healed. You should also consult with the board certified facial plastic surgeon who performed your surgery as they are familiar to your healing process and surgery results.Best wishes,

Sumit Bapna, MD · Answer

Depending on what your surgeon is comfortable with, you could have rasping on the dorsum of nose as early as six months after your rhinoplasty. But in my opinion, you should wait about a year if you can.

Steven Wallach, MD · Answer

Yup, the bump is still there.  If you want it softened,. then a revision may be necessary. Best of luck.

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