2 Months Post-Op Rhinoplasty - Nose is Now Crooked and Longer Than Before

Question

with hanging columella.My surgeon said its swelling and scar tissue because it's a revision,but x rays and new doctor showed hump on left bridge is bone.I realised he had done a poor job.I asked what procedure,if bones were broken,if he sutured tip,no answers. He said he only removed cartilage, but i feel something poking on the right side of tip, and on middle tip of left side. If i have cartilage removed (if he did add)will that distort my nose?

Umang Mehta, MD · Answer

Hello Paola,

	First of all, I absolutely agree with the other surgeons who have responded to your question, in that at 2 months after rhinoplasty, there is still a great deal of healing to go. Ideally, one would wait until around 12 months following prior nasal surgery before considering a revision rhinoplasty, though there are exceptions to this rule.

	All that being said, there are a few issues that are identifiable in your photos. Obviously, a physical examination of your nose would provide the best opportunity to assess your nose fully. First of all, the bump along the left side of the nose gives me the impression that the left nasal bone has lateralized or moved to the side. At this point swelling over the entire nose is probably accentuating this particular issue but if it persists, that nasal bone can be refractured and pushed towards the middle of the nose.

	Secondly, the "bumps" you are describing at the tip may be the result of changes in the shape of the tip cartilages, or lower lateral cartilages. Bumps visible in the nose, sometimes called bossae or knuckles, can be the result of underlying cartilage poking irregularly underneath the overlying skin. This could be the result of cartilage grafts or simply the way in which the underlying cartilage was reshaped. These are not very well visualized in the photos you uploaded but again, an in-person examination would be helpful. In some cases, these bossae can become more prominent as the swelling in the tip decreases. In other cases, the bumps may simply be swelling-related and may improve with time. 

	The third issue I am noticing on your front-view is that the middle portion of your nose appears narrower than your nasal bones and nasal tip, what we call the inverted-V deformity. This can happen if the upper lateral cartilages fall towards the middle of the nose. If this persists, it can be corrected with placement of spreader grafts, which are long, thin pieces of cartilage taken from the septum to repair this internal valve of the nose. This technique may improve your ability to breathe as well and may therefore be covered by your insurance. 

	My advice would be to address these issues with your primary surgeon but if you feel you would like a second opinion, seek the advice of a rhinoplasty specialist.

	Best wishes,

	Dr. Mehta

Sam Naficy, MD, FACS · Answer

even though you have some concerns about the early appearance of the nose it is better to wait before seeking a revision - 2 months is still very early in the course of healing.  The problems you see now may very well not get better with time (sometimes they will get worse)

Thomas A. Lamperti, MD · Answer

You are still early i the healing phase so I would recommend waiting at least a year to see how your nose healsbefore considering a revision procedure. Asymmetric swelling can contribute to crookedness as the nose heals.

	If the persistent bump you see is still present that can certainly be address as well. It's hard to comment on the tip bumps without an examination. Cartilage grafts are commonly used in rhinoplasty and are usually not palpable. The cartilage can be removed or revised if needed, though.

Tania Medina de Garcia, MD · Answer

Hello dear!!
Thanks for the question and provided information as well.
You are still early in the healing process, it can take up to six months to see your final results, so please be patient. At the stage you are in, inflammation, discomfort and irregularities are normal.
If you have any concerns, please follow up close with your plastic surgeon.
Good luck :)

Peter E. Johnson, MD · Answer

Nasal revision is more difficult than rhinoplasty the first time around, and it pays to select a surgeon carefully. If you nose is still crooked and appear longer than you did before, chances are it will not improve much over time. Unfortunately you must wait out full healing, and if the result is one you cannot live with find a surgeon with experience to see you through.
	Best of luck,
	peterejohnsonmd

2 Months Post-Op Rhinoplasty - Nose is Now Crooked and Longer Than Before

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2 Months Post-Op Rhinoplasty - Nose is Now Crooked and Longer Than Before

Answers (7)

Answer: 2 Months Post-Op Rhinoplasty - Nose is Now Crooked and Longer Than Before

Answer: 2 Months Post-Op Rhinoplasty - Nose is Now Crooked and Longer Than Before

Answer: Nose still crooked afer revision of rhinoplasty

Answer: Nose still crooked afer revision of rhinoplasty

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Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.