18-year-old Caucasian woman, open rhinoplasty to lift tip 10 months ago, can you help with healing concerns (Photos)

Question

I am an 18-year-old Caucasian woman and had open rhinoplasty to lift my tip 10 months ago. I have thick sebaceous skin. My concern is that 10 months PO, the nose still changes appearance, looking fairly decent on rare occasions (image 1), but mostly resembling my old nose (image 2). In the past 2 weeks, after a kenalog shot, the squishy bump relocated itself on the lower part of the dorsum. Is this a normal occurrence in your experience?

Anil R. Shah, MD · Answer

You may need to discuss options for reshaping your nose and addressing the soft tissues. There are several effective approaches, including the use of medical-grade high-strength retinol, taping, and Kenalog injections. Additionally, it's important to ensure that your original rhinoplasty achieved the desired shape. If you are satisfied with the current appearance of your nose, it may not require further intervention.

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.
As far as I can understand from your question If you send a more detailed photo at a 95 degree angle, it will be possible to make an accurate evaluation, but it is useful to be examined by your surgeon immediately.
It would be better face to face consultation.
Best Regards!

Eric M. Joseph, MD · Answer

Even though you are 10 months after surgery, it is possible that you have some persistent swelling that will work its way out over the next several months. If you had a permanent change in your nasal appearance that did not fluctuate, that would be more of an indication of a permanent result. I hope this helps. Sincerely, Dr. Joseph

Gerald Minniti, MD, FACS · Answer

Your issue is that your tip complex is sitting too low relative to the level of the anterior septum, or bridge. This can be rectified by a limited revision of the tip with placement of a cartilage graft to support the tip complex. Your surgeon would know how much of your septal cartilage is available for harvest and grafting. If you have none, you will need either fresh frozen cadaver rib cartilage or your own rib cartilage; ear cartilage will not work.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. At 10 months postop, it is still very normal to have swelling. The final results take at least 1.5 years for the swelling to fully resolve. This can require lots of patience and waiting. Steroid injections performed by your surgeon can be extremely helpful. I usually start steroid injections around 1 to 2 months after surgery and continue as needed. I recommend that you maintain close follow up with your surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Zoran Potparic, MD · Answer

Postoperative swelling may last for one year and longer in thick skin person. Nightly taping (the way your nose was taped after surgery) may help to avoid buildup of the scar and create supratip deformity. Kenalog injection is one way to deal with it as well. In some cases, that has to be determined once result is mature and stable, revision of the dorsum or increased tip projection should be considered. Hope this helps.

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