I'm nearly 6 weeks post op and I am unhappy with the front profile of my nose. I had a rhinoplasty and septoplasty. (Photo)

I'm not happy with the front profile of my nose, it looks like I have a ditch on the bridge of my nose and its getting more and more noticeable. I am aware it takes a year for swelling to go down but I know different people that have had a rhinoplasty and there bridge is straigt with not lumps of ditches. Thank you

Doctor Answers 9

Rhinoplasty post op shape

Thank you for your photos and question.

It is difficult to fully assess what is going on with your post operative result without a full clinical evaluation, but as others have said, it is important to allow your face to fully heal.  6 weeks is quite early - often we quote 6 months to 1 year for rhinoplasty healing and swelling. 

I do agree that it appears you have some depression of the upper bridge of your nose, but that can be an artifact of the swelling on your nasal tip can distort the balance of your nose.  This would be easier to evaluate on a profile view and on clinical exam. 

Make sure you are being seen regularly by your surgeon and he/she can evaluate and decide if there is something that can be done to make the contour look better while the nose continues to heal.  Whether the goal is to reduce swelling by prescribing anti-inflammatories or steroids, or alternatively, to mask the transition zone with a temporary filler, you should ask your surgeon if either of these strategies are reasonable and feasible in their opinion.


Best wishes,

Christopher C. Chang, MD

Washington DC, Maryland, and Virginia

Rhinoplasty results

I am sorry to hear about your rhinoplasty results.  While I do not have a before photo to compare to, I suspect that what you have is something called "inverted V deformity" which is related to how the upper later cartilages are managed.  You have several options going forward including:

-non-surgical rhinoplasty by placing filler to smooth out the irregularities

-surgical rhinoplasty with spreader grafts

-surgical rhinoplasty with rib cartilage to raise the bridge and reset the upper later cartilages

Good luck with your rhinoplasty shaping revision.

All the best,

Dr. Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 154 reviews

Some indentations along the nasal bridge after rhinoplasty surgery may be corrected with injectable filler treatments

If you have an indentation above your nasal tip, depending on your exam, it may be amenable to correction with microdroplet Silikon-1000 injections, an off-label filler for permanent results. Hope this helps. Dr Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 397 reviews

Inverted V?

It looks like you have an inverted V deformity developing. Best to give it time to heal at this point. Good luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Rhinoplasty

You would require a revision to correct the contour of your dorsum. Cartilage grafts would be needed to ensure you get a nice even contour.  Your tip can also be improved with reduction and suturing of nasal tip cartilages.  Best wishes, Dr. T. 

Nose

It is still early in your healing process. It takes almost a year for the swelling to subside in the nasal tip area.

Deborah Sillins, MD
Cincinnati Plastic Surgeon
5.0 out of 5 stars 10 reviews

Rhinoplasty

Thank you for your question and photographs.

It is important to understand that every person heals slightly differently and that you are still quite early in your recovery period and your appearance will continue to refine.  It may take up to a year for all swelling to resolve and for your nasal appearance to settle to a final outcome. Your doctor may prescribe you a Medrol dose pack (steroid) to help reduce the swelling. Healing is often unpredictable and one side may heal quicker than the other and sometimes even nasal bones may shift in healing.  The outcomes may not be as expected.  In some cases a revision may be recommended to refine your outcomes, but I would wait at least 12-18 months so you are fully healed before considering a revision. 
Best of luck in your recovery!
Sincerely,

James Fernau, MD, FACS
Board Certified ENT
Board Certified Plastic Surgery
Member of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science

James Fernau, MD, FACS
Pittsburgh Plastic Surgeon
4.9 out of 5 stars 68 reviews

6 weeks post op, some advices:

Thank you very much for enquire.

Swelling after a rhinoplasty depends of the surgery complexity. In this regard, the nasal swelling Post-op It can last from two weeks to two months. To reduce this swelling, I recommend you perform delicates daily lymphatic drainage massage therapy over the face (around the nose) avoid sun exposure, and take pain/inflamation pills, as your surgeron precribe you. Kind regards,  Dr. Emmanuel Mallol Cotes.-  

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 178 reviews

Nasal "ditch"

Thanks for your post. What you are noticing is the transition zone between your nasal bones and the upper lateral cartilages. Based on your photos, it looks like there was some visibility of that issue pre-operatively, too, though now it is more apparent.

You are correct in noting that you still have a lot of healing to do; however, should that depression persist, you may need a revision surgery where more structure is added to that area. This may involve spreader grafts, dorsal onlay grafts, and/or osteotomies. Be sure to communicate your concerns to your surgeon. Good luck!

Mark Been, MD
Barrington Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.