Bony dorsal hump after rhinoplasty, when can I get a revision? (Photo)

Question

Good morning, this is M. MEHTA here.I live in Mumbai. Actually I had a rhinoplasty done two months back for correcting my deviated septum and shaving down the dorsal hump in the upper half of the nose.However i can clear still see the dorsal hump in the upper half and it doesn't appear to be swelling, in fact looks and feels like a bone. My plastic surgeon seems to completely avoid the situation. Henceforth, i just wanted to know when can I get a revision rhinoplasty .

Jacob Tower, MD · Answer

Hello, hope you are well. Most rhinoplasty surgeons would advise waiting a year or so before proceeding with revision nasal surgery, but it depends somewhat on the exact issue. For hump revision going earlier would be reasonable (6-9 months). If you are really bothered by the appearance in the interim you can consider non-surgical rhinoplasty with dermal filler placed at the radix to smooth out your dorsum. Then either allow it to dissipate or dissolve the material with hyaluronidase prior to revision. 
Best,Dr. Tower

Ali Sajjadian, MD, FACS · Answer

Thanks Manthan Mehta for your question! If two months after rhinoplasty, you still see a dorsal hump, it's reasonable to be concerned. Even while some bruising and swelling may last for several months, it's crucial to speak with your surgeon to find out why the hump continues to show up. Generally, we recommend waiting at least a year after the initial surgery before considering a revision. This enables full healing and the reduction of swelling, giving a better view of the final result.
To choose the best time for a revision, your surgeon will consider a number of criteria, including:
-The degree of swelling : Waiting for the swelling to go down further would be wise if there is still a lot of it.
-Healing Process: Prior to undergoing any additional surgery, it is crucial to guarantee that the nasal tissues have fully healed.
-Character of the Problem: A longer delay may be advised if the problem is mostly cosmetic. On the other hand, earlier intervention could be considered if it's functional, like recurrent breathing issues. 
Setting up a consultation with your surgeon is the best line of action. They can talk about your worries, inspect your nose, and evaluate the healing progress. If required, they could advise a revision surgery, further waiting time, or non-surgical therapies like massage or injections.
Hope this was helpful!
Best wishes,
Dr Ali Sajjadian 
TRIPLE Board Certified Plastic Surgeon

Oakley Smith, MD, FRCSC · Answer

Hi, It is better for you to consult with your facial plastic surgeon who can examine you and give you opinion based on examination.

Eric M. Joseph, MD · Answer

The best advice is to take a deep breath and to sit tight for another 4 months. The rationale for waiting 6 to 12 months for revision surgery is to allow all swelling to resolve. You appear to have a masculine nasal profile appearance, and if there's still swelling, it may Improve on its own. I hope this helps! Sincerely, Dr Joseph

Arturo Valdez, MD · Answer

Virtually 100% of all rhinoplasties performed in the world, approximately 20% require a revision rhinoplasty, which means that this is very common. In your specific case, this residual hump or dorsal hump, should be carefully evaluated by a surgeon to determine whether or not it is untreated bone or if it is a bone callus( callus osseous). The ideal time frame to undergo a revision rhinoplasty surgery is approximately six months after the initial surgery. The reason for waiting,  is that during  those six months the healing process creates scar tissue which  becomes very fibrous and it is very likely there  will be some need of fine tuning so,  it is of the most importance to wait a minimum of 6 months. If you  operate too soon after the initial surgery, it will only result in a much more complex surgery and may cause complications and unsatisfactory end results. Be patient with yourself and give your nose the time it needs to heal  first before going back under the knife.  I hope this helps, and I wish you the best.

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.From the photo you provided it is evident that you still have a hump on the top of your nose. It needs to be shaved. You can get a revision surgery once you are 6 months post-op (the earliest). Of course we first need to make a consultation.
Best regards!Prof. Dr. Selcuk Inanli

Cenk Teker, MD · Answer

It’s a bit early to say that it is a wrong operation. The healing is still continuing. You may be surprised after a while because the healing tissue can act as bone. However, if you are still worrying after a year, then revision surgery can be an option for you.

Mustafa Bagli, MD · Answer

Hello Firstly, I am sorry that your first surgery didn't go as you wished. To decide for revision surgery we want the nose to be fully healed since when swellings subside that may change your decision and Swellings can also cover some problems that can be overlooked.In my practice, I wait at least 1 year for patients who are looking for revision surgery

Mehmet Dogru, MD · Answer

Hello. The crucial point to note here is to wait for at least 10-12 months to clearly see the results of the initial surgery. The time to get rid of internal swelling and crusts inside the nose will take at least 6 months. It's important to be aware that the ideal waiting period for a revision surgery after the first rhinoplasty is between 10 to 12 months.

Dean Toriumi, MD · Answer

Hi Manthan. Great question. The time between rhinoplasty procedures is largely dependent on the extent of the recent surgery and the surgeon's preference. Generally, it is important to wait for the nose to heal for approximately 8-9 months before discussing the need for a revision because there can still be significant swelling that far out which is liable to change. Hope this helps and good luck in your journey.

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