Is my nose still collapsing? Can this be repaired? (Photos)

Question

I had a closed rhino almost 14 ago, and i have thin skin. Recently it looks like my ULC on the left is sinking in more, i can feel the LLC on that side with a break and then the ULC, while on the other side i cant feel the junction between the cartilage.. I also still have something inside and im not sure if its swollen or turbinates or it also has somerhing to do with the possible collapse?

Eric M. Joseph, MD · Answer

Based on your photos, I agree that you do have thin nasal skin and since you are 14 months post-operative, you are seeing the underlying nasal skeleton of your nose. Depending on your examination, microdroplet silicone 1000 injections may be considered for adding permanent volume to your nose for a less operated and straighter nasal appearance. This would not address any breathing issues that you may have, however, this may address many of your cosmetic concerns. I hope this is helpful! Sincerely, Dr Joseph

Ruslan Zhuravsky, DO · Answer

It appears to be a very thin bridge overall, so less likely that spreader grafts were used. The area of indentation can likely be fixed with some grafting, most likely a spreader grafts. If the septum wasn't touched it can be taken from there, otherwise ear might be an option, or rib. This definitely requires an in person evaluation with physical exam and palpation for a more definitive answer. I have also taken on cases like this based on virtual consultations, explaining that I anticipate using cadaveric rib cartilage if I find necessary during the case. If you're not ready to dive into a revision, filler can serve as a temporary solution.

Zoran Potparic, MD · Answer

It would be difficult to give you sound advice without an in-person evaluation. It appears that cartilage grafts for airway expansion and internal valve support should be considered. Good luck.

Gary M. Horndeski, MD · Answer

Yes, it is still collapsing.  You will need a cartilage graft and will be harvested from the septum or possible cadaver graft.

Best Wishes,

Gary Horndeski, M.D.

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