Why do I have bumps on both nose sides & why the revision did not fix the issue? (Photos)

Question

I had a revision Rhinoplasty to get rid of the bumps on my both nose sides but unfortunately, that did not help. I am very disappointed and not able to do a third surgery and it is not guaranteed anyway. The revision was to fix the tip as well (dropped from the first surgery) but it did not go well. I had the revision Oct 2022. First surgery was 10/21 What is the reason that happened to me and why the revision did not fix the issue?

Ruslan Zhuravsky, DO · Answer

Hi, Sorry to see that you went down this road and still do not have the results that make you happy. Although it's hard to say for sure why your results came out this way, there are some potential explanations. For the tip droop, it seems like there is little to no support of the tip at the columella. The bottom of the columella where it meet the upper lip seems to be a little receded. This in itself can give the appearance of a more drooped tip (relative proportions), plus it is where the main tip support resides. Press on your nasal tip, if it drops easily, there is probably inadequate support. The bumps on the sides are likely from a higher osteotomy or incomplete osteotomy, but this is very difficult to say from pictures only. The bump on the bridge is your nasal bones being slightly higher at the "rhinion" compared to the cartilage below. It can be either from not enough reduction of bone, or too much reduction of cartilage. Check out the video on nasal anatomy, which might help make more sense out of this explanation. In the end, a formal consolation with someone who specializes in rhinoplasty, including revisions, is the best way to get the most accurate answers. ... and even with this, we do not always know the exact reasons or issues until we go into the nose for surgery. If you rule out surgery completely, these issues can be mitigated with filler via liquid rhinoplasty. Some filler at the columella base can rotate the tip and some filler below the bridge bump can help smooth out the dorsum. Hope this helps. Good luck!

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you may benefit from a a Revision Rhinoplasty in order to address these issues and others. Spreader grafts can be placed in order to address the asymmetric dorsal aesthetic lines which you are describing. Additionally, slight tip elevation, Nasal Tip Deprojection, tip refinement, among other maneuvers could be performed for improvements. 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

Best wishes and good luck.

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

Why do I have bumps on both nose sides & why the revision did not fix the issue? (Photos)

Answers (2)

More Revision Rhinoplasty Questions

What can be done to correct my crooked nose, droopy tip and uneven flared nostrils 1 year after my revision? (photos)

1 year post op and nostrils look unnatural when smiling - is it too early for a revision? (photos)

In the revision can you see where my nose length & projection previously was based on where the graft is?

Hard bump inside nostril after rhinoplasty, has anyone seen something similar? (Photos)

Appears to have some kind of asymmetry/wrong placement of implant? (Photos)

Concavity above right hand nasal tip - what are my options? (Photo)

WE SEND PRETTY
EMAILS