My Bridge After Rhinoplasty... Why is It Worse? (photo)

I just am so angry and so upset... How come reducing my hump made me end up with a weird bridge? Can you explain to me what happened to my bridge ??? I just am in so much pain and i really would appreciate detailed and honest answers. ps: saying that photos arent enough is not an answer. it is somewhat visible, my problem.

Doctor Answers 7

Hump reduction typically alters the shape of the nasal bridge.

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Hello germangirl1990,

Thanks for your question.  A profile picture of before and after would be very helpful.  But in the absence of those photos, I will try to help give a possible explanation for your current outcome.  When a dorsal hump, or elevated bridge, is reduced the nasal bones become more prominent and a small spacing can be felt on the top of the bridge.  This is known as an "open roof deformity."  When you have an open roof deformity, your surgeon has to create controlled fractures in the nasal bones to re-narrow the nose and close the "open roof."  This is especially important in thin skinned individuals as the open roof can be felt and often see as 3 lines in parallel where the hump used to be.  Any surgery to the bridge can result in contour deformities and asymmetries.  There are ways to camouflage these issues.  Acellular dermal matricies (ADM) like Alloderm, Strattice, etc. can be laid on to smooth out contours.  Cartilage grafts and diced cartilage/fascia (DCF) grafts can be used to create a more even shape to the bridge.  You did not mention how far out you are after rhinoplasty.  You also did not mention if you had any tip surgery.  If you are early in your recovery and you also had tip surgery, you could have a fair bit of swelling near the nasal tip.  This would make the tip appear wider, but with time and swelling reduction this asymmetry could correct.  

My advice is to discuss your concerns with your plastic surgeon and see what can be done to try and satisfy your concerns.

Good luck,

Dr. Shah

Denver Plastic Surgeon
4.8 out of 5 stars 69 reviews

You may be a candidate for a non-surgical rhinoplasty procedure to improve the appearance of your nasal bridge after Rhinoplasty

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I read your concerns and reviewed your up-close photos which are limited for evaluation.

You may have a slight indentation along the left side of your bridge. If that is the case, an injectable filler treatment may be helpful for restoring symmetry, depending on your examination. My personal preference is to use Silikon-1000, an off-label filler for permanent results.

Hope this helps you.

Dr. Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

My Bridge After Rhinoplasty... Why is It Worse?

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Best to seek IN PERSON consults than over the internet opinions without focused posted photos. My guess is there is more narrowing of your mid/upper bridge than you anticipated. But this is a standard appearance after hump removal and lateral nasal bone osteotomies. Again very hard to advise via the internet.  

My Bridge After Rhinoplasty... Why is It Worse?

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           If the profile view shows that the hump has been reduced adequately, then the surgeon may have done better than you think.  Healing is not entirely predictable, and sometimes maneuvers performed to correct one thing during rhinoplasty can unmask other asymmetries.                                                                                                                                                                                                                                                        Kenneth Hughes, MD
Los Angeles, CA

Why is bridge worse after rhinoplasty

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The bridge can be the more difficult part of rhinoplasty even though most are more concerned with the tip. However, a twist can be unmasked as the bridge is reduced, an upper cartilage can collapse, irregularity can appear, an inverted V can become visible. There are techniques to avoid most problems, and revisions can correct such problems. We can only guess as to the whys, but an experienced surgeon should be able to sort things out.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Postoperative issues might be the result of swelling.

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I see the issue with the wide nasal dorsum based on the provided photographs. Depending on when the operation was performed this could be the product of swelling. If not I would have to know what was done in the operating room that could widen that area.

My Bridge after rhinoplasty

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If a dorsal hump deformity was removed to go from a larger nose to a smaller nose then inherent assymetry is possible.  Palpable deformities and visible ones can be exaggerated if you have thinner skin to begin with.  One option for concealing any and all defects is either A)temporalis fascia onlay grafts or B)Crushed cartilage grafts.  If neither was done then this is likely the reason for what you are seeing.   Initially, I would suggest discussing and visiting with your surgeon.  Secondarily, wait at least a 6-9 month window for everything to settle.  Ultimately, if either of these options are not another opinion.

Shepherd G. Pryor, MD
Scottsdale Facial Plastic Surgeon
4.6 out of 5 stars 23 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.