Palpable bump on left cartilage followed by a dip? One year post op. Do I need a full blown revision? (Photo)

Hello and thank you for your question. After rhinoplasty (nasal surgery), the nose can become REALLY swollen, particularly around the tip, and this swelling can take a LONG TIME to resolve (up to 2 years to fully resolve). Unfortunately without being in the operating room at the time of your surgery, it is impossible for me to say how much of what you're observing regarding the asymmetry is due to the underlying structural framework vs due to soft tissue swelling. You are still only 12 months post-op, so ultimately you should still wait to see what your final results will be. I agree with your surgeon that if something as minimally invasive as an alar rim graft under local can help address the focal asymmetry that is concerning you, it is certainly worth trying. If it fixes the problem, fantastic! If not, it wouldn't make a future revision procedure any more difficult or any less successful. I wouldn't consider a full revision procedure, if needed, until everything has fully healed though. I constantly remind all my rhinoplasty patients how important it is to be patient after rhinoplasty surgery as it can take up to 2 years to see what the final nose will look like. I hope this helps!
Best,
Dr. Donald Groves
Plastic Surgeon

It appears the tip is leaning towards the left side in your photographs. You may need your midline straightened to correct this deformity.

Best Wishes,

Gary Horndeski, M.D.