Dorsal hump after rhino surgery: Is this just swelling or will I need a revision/in-office touch up? 1 week post op. (photos)

Hello,Although selfie photos taken with cellphones can be deceiving, and swelling can contribute to the allusion of persistent unwanted features, it appears that more reduction of the bridge could be warranted. You are correct, swelling is much more an issue with the tip, but practitioners use this excuse to mollify patients with the hopes that they will eventually be happy with their result (which happens less often than they realize, as this sort of dishonesty just leads many never to come back for follow up).  You may want to get a second opinion from  ABPS certified/ASAPS member surgeons (or AAFPRS equivalent) who specialize in revision rhinoplasty. Although rare, re-operation within two weeks of surgery is acceptable; after that, waiting is warranted for the requisite 9 to 12 months. Best of luck!

It's still too soon to tell what your final results will be. You need to have patience with your body as it begins to heal. The skin, bone and cartilage are all traumatized during surgery. Inflammation (swelling) is the normal response and will help your nose to heal and look beautiful in the end. If, one year from now, you are unhappy with your nose, then that is the time to think about a revision procedure. Right now, concentrate on other things you like to do and let your nose and under eyes take the time to heal. I hope this helps.

You are early in your healing and it is possible this is swelling of the soft tissue and bony lining (periosteum). Patience is indicated here. Most surgeons would wait a few months before considering a touchup as swelling goes through a lot of evolution in the initial several weeks. One of the respondents here is correct that swelling as a justification is only part of the answer in many cases, but since none of us did your surgery, we would be speculating without actually examining you. Some additional reduction of the dorsum may be indicated but you need to have a collegial discussion with your surgeon as your result takes further shape. The good news is that even if you need a revision, it is usually a smaller procedure and recovery can often be quicker.

Thank you for the question. At one week post-op, swelling will be present. As you mentioned in many cases the swelling may be greater in the tip, but in some patients the dorsum may have noticeable swelling. Only time will tell if the dorsal profile will improve to meet your goals. If it does not, then a revision would generally not be performed for about one year. Try to be patient, and best of luck.

It is difficult to adequately evaluate your pictures with the surgical tape still on. Furthermore, you said it :) its way to early to make any determinations regarding your final result. Even if something needed revised I would consider doing it until 9-12mo after your primary surgery as tips and nasal dorsums can be swollen for a long time. Communicate your concerns with your doctor and follow up as scheduled. Good luck

Dear Sasa, You are correct the majority of the swelling that requires the longest time to resolve is generally in the tip however you still have some swelling in the dorsum. You will need to wait a few months to see if you are happy with your results and if not then discuss with your surgeon a possible revision to reduce the dorsal hump. Likely you will be advised to wait an entire year so that all of the swelling has fully dissipated. Best regards, Michael V. Elam, M.D.