9 days post-op. Have I got soft triangle notching? What is the cause and cure? Do you believe this will resolve? (photo)

Question

The past few days I have been growing very concerned about the dent/notch in my right nostril. I am happy with the overall surgery result (potentially) but this notch is causing assymetry and makes the right nostril a rather unnatractive shape. After reading lots of stuff I've come to the conclusion that this is probably soft triangle notching. Would you agree on this? If so, is there a chance this can resolve on its own or will I definately need a graft? Could it be something else entirely?

Emmanuel Mallol Cotes, MD · Answer

Thank you very much for enquire.It's too early to make value judgments with only nine days after a rhinoplasty.Swelling after a rhinoplasty depends of the surgery complexity.In this regard, the nasal swelling Post-op It can last from two weeks to two months.To reduce this swelling, I recommend you perform delicates daily lymphatic drainage massage therapy over the face (around the nose) avoid sun exposure, and take pain/inflamation pills, as your surgeron precribe you.Kind regards, Dr. Emmanuel Mallol Cotes.-

John Michael Thomassen, MD · Answer

It appears the cartilage that extends from the dome to the ala on that side has buckled or separated.  An excellent option to repair this is an alar graft.  This is probably the best option, although it does involve a trip to the OR.

David Gilpin, MD · Answer

Thank you for your question.  At this point, you are still very close to your surgery date, and still have quite a bit of swelling.  I would not worry too much about nasal 'notching' at this point.  As you continue to heal, the soft tissues of the nose will relax and soften.  However, it can take anywhere from 6 months to 1 year for all swelling to resolve.  Be sure to discuss your concerns with your surgeon, as he/she is the only one who know what was performed during your surgery. I hope that this helps!-David Gilpin

Robert H. Hunsaker, MD · Answer

It is not really the soft triangle, it is the ala itself. If this persists, AT AN APPROPRIATE TIME, this can be predictably improved with a small cartilage graft to the ala. In many people, this can even be done under local anesthesia though most seem to want to be sedated or asleep.

Darryl J. Blinski, MD · Answer

To early to consider a non surgical rhinoplasty filler injection to the notch. After a few months than I would offer. Fee $1,000 for Restylane injection to nose...

Fred J. Bressler, MD, FACS · Answer

Based on your posted photos, your asymmetry appears to the be result of alar base reduction and it's subsequent effects on the right lower lateral cartilage of your nostril. Sometimes this occurs when your cartilage is weak and by moving the alar base inward, the alar rim and soft tissue are not able to support the natural shape and curve. If this does not improve, you may need to have an alar batten and/or alar rim cartilage graft placed into your nose via a revision. I would discuss your concerns with your surgeon and seek his/ her advice on this. Fortunately, I do not believe that this is a classic soft triangle notch, which can be far more difficult to correct. Hope this answer helps.

9 days post-op. Have I got soft triangle notching? What is the cause and cure? Do you believe this will resolve? (photo)

Answers (6)

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