Hump, Flatter Nose, Droopy Tip and Nose is Not Straight Post Septorhinoplasty

I had septorhinoplasty 2 weeks ago to straighten my nose as it had been broken. All my doctor was meant to do to the outside of my nose was to rebreak & realign it. He said he cut some bone off 1 side too. Now my nose looks more crooked than before from front on. Also the profile has changed but I liked my profile before- I now have a more obvious hump, the bottom half of my nose looks like its been pushed in towards my face and the tip is lower. How could this have happened? Will it fix itself?

Doctor Answers 5

Septal deviation can make a nose look more crooked after surgery

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Even though your nose is still swollen, your surgeon has apparently done more than move nasal bones in.  It appears that your bridge has been lowered, which has exposed the septal deviation. Your nose seems wider (though swelling is present) because of the lower bridge.

Often patients find that their noses are crooked after surgery when they weren't crooked before.  This unfortunate change usually occurs because of septal deviation.  When the bridge is lowered (as in removing a bump), the underlying septum, which is not in the center, becomes exposed, and the sides fall in toward it, one side more than another (because of the asymmetry). The bridge now looks crooked.

I look for this asymmetry during surgery so that I can take steps to correct it.  At this point, if the asymmetry does not disappear as the swelling resolves, your nose can still be corrected, probably by placing asymmetrically thick "spreader grafts" along the sides of septum and doing an osteotomy only on the right side.  This is an easy procedure, so don't worry.

The tip droop may be the result of a slight reduction in the alar cartilages.  See how it heals and then find a very experienced rhinoplasty surgeon who can show you noses like yours that he or she has corrected.

Nashua Plastic Surgeon

Dorsal lines

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It appears you do have a more prominent bony prominence on the lateral view.  Was a portion of the dorsum reduced?  Although waiting is always prudent due to swelling, 1 year may be too long.  Once you and your surgeon are satisfied that the deformity is not swelling, you can proceed with a simple solution to rasp the bony dorsum and bring it in line with the cartilaginous dorsum. 

Not Satisfied 2 Weeks after Septorhinoplasty

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You know that your nose will change as healing progresses, but I suggest you see your surgeon and share your concerns. Although we do recommend waiting a year before having revision surgery, it does appear that your right nasal bone has moved laterally - I would at least consider repositioning the bone with pressure.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Rhinoplasty Results Can Take A Lot Of Time To See

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It is virtually impossible to tell any long-term outcome from any rhinoplasty procedure at just two weeks out from surgery. The swelling and the changes in the overlying skin are so significant early on that what you see today will likely change in the next few months. While it can be difficult to not look at it, I would not draw any conclusions until at least 3 months after surgery. Even then it can be too early to tell. One important caveat about rhinoplasty is...the smaller the deformity is to start with, the longer it is going to take to see the final result. Most patients go into surgery thinking the opposite is true only to find out the reality afterwards. Be patients as no doubt your plastic surgeon has recommended.

Rhinoplasty postop question

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Hi there,

At 2 weeks postop there is a lot of swelling and its hard to gain a full picture of how the nose will look.  On your pictures, you have probably less swelling than average.  If there was more work done to one side of the nose that can swell more than the other, leadign to a look of asymmetry for a while.

However, I do see your concerns and suggest you see your surgeon in the next few days.  The reason for this is that if the nasal bone is not ideally positioned it will still be mobile at 2 weeks post op, and there is an opportunity to move it a little.  If you wait, it will heal into position and would need to be rebroken if it needed to be moved.

In summary, it might all be ok, but definitely worth having a checkup in the next few days.

Good luck.

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.