What happened to my nose?! 5 months post rhinoplasty, is this hump normal? (photos)

Question

I had rhino 5 months ago and initially loved the results but after 3 weeks I developed a large hump, which went down a lot after a week but has now stayed put. It is hard like bone and doesn't hurt. There is no asymmetry from the front but the profile is awful, it looks like a bird beak. I understand I have to wait the standard 12 months for revision but do these types of bumps ever go away on their own? I'll need to budget for a revision if I need one and I'll be finding a new surgeon too.

Gerald Minniti, MD, FACS · Answer

Hello,You've documented very well how the tip of the nose can de-rotate and de-project after a surgery that only removes tissue but doesn't re-support the remaining structures, leading to a polybeak deformity. The hard, bone like structure is the septum that is now exposed, because the tip complex has receded from its tenuous and temporary position. Although many structural grafts can be utilized in a close rhinoplasty, it is rarely done, or done correctly due to difficulty. Go visit a few ABPS certified/ASAPS member surgeons (or AAFPRS equivalent) who specializes in revision rhinoplasty. Best of luck!

Andre Panossian, MD · Answer

There may have been a dorsal graft that was used at the time of your surgery that absorbed. When that happens, it may unmask a pollybeak deformity. You will likely need a proper hump reduction of the cartilage portion of the hump. I typically perform closed rhinoplasty, which may offer some advantages to visualize the amount of dorsal reduction needed.

Arian Mowlavi, MD, FACS (license on probation) · Answer

Now that your swelling is all gone, it looks like you have a residual lower nasal dorsal hump. The lower nasal dorsum is cartilagenous and will require resection of the dorsal cartilagenous septum.

Michael Elam, MD (retired) · Answer

Dear Nosey.14, It appears that you have a slight polly beak deformity that requires resection of the dorsal cartilagenous septum. Discuss your concerns with your surgeon or seek secondary consultations. During secondary opinions it is always helpful if you have your original pre-operative photographs and a copy of your operative report. I would advise that you wait a full year for the swelling to dissipate before you move forward with any revision procedures. Best regards, Michael V. Elam, M.D.

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