What could cause this firm bump on the tip of my nose 4 years after revision rhinoplasty? Could this be corrected? (Photos)

Very likely this is a suture rejection, some surgeons don't use dissolvable suturing when doing rhinoplasties, for reasons that are beyond me; then these late onset problems may happen.

Solution is easy: as office based procedure, a shot of local anesthesia and a tiny incision will allow its extraction (the problem suture).

Hello and thank you for your question. Based on your photographs, that is part of your lower lateral cartilage, which is showing prominence and asymmetry. You are a great candidate for a revision rhinoplasty. Maneuvers for your surgery would include nasal tip deprojection, placement of a mastoid fascia tip graft to provide a smoother contour, among other maneuvers. 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