My fat grafted nose now looks disfigured and swollen. Am I a candidate for a Revision Rhinoplasty? (photos)

Question

My doc suggested I get AFT around the tip of my nose. He warned me that my nose would be swollen. But now it looks disfigured--crooked, lumpy, and extremely bulbous. It doesn't resemble anything aesthetically pleasing. I would rather have had a small amt. injected and need a touch up later, than be stuck with this swollen atrocity. Is there anything I can do now--like ice or steroid shots? And, am I a candidate for revision rhinoplasty or must I wait 3-6 months for the swelling to go down?

Jennifer Parker Porter, MD, FACS · Answer

Your nose looks to have recently been operated.  Time will help to resolve some of the irregularities that you see; I usually have patients wait at least 6 months to a year prior to embarking on revision rhinoplasty.  Additionally, fat sometimes resorbs, so it may not be so lumpy as time progresses.  Perhaps discuss with your surgeon options for minimizing the swelling.

David Shifrin, MD · Answer

It typically takes 3 months for fat graft % take to be known. You would be best served waiting a minimum of 3 months before having a revision. Foundational changes such as cartilige or bone manipulation may be a better idea to shape your nose. Good Luck!

Steven Wallach, MD · Answer

I think that at this point you have to let the swelling subside. This can take several weeks to months. Then you can re-evaluate your concerns.  Best of luck.

Vincent P. Marin, MD, FACS · Answer

From your photos, you are clearly not very far out from your procedure. There is nothing to do at the moment and time will help to clarify the remaining issues. You may need a surgical procedure to remove the fat if excess remains. Im not sure what you were trying to correct when evaluating your pre-op photo.Continue to follow up with your surgeon to ensure that you progress as planned. 
Best of luck,
Vincent Marin, MDSan Diego Plastic SurgeonMarinAesthetics.com

Jarrod Little, MD · Answer

Fat grafting can be somewhat unpredictable when used in the nose.  Atlhough controversial, 50-90% of fat graft volume may remain long-term.  You currently have 2 variables at work- nasal swelling and fat graft stabilization.  You may not see your long-term results for 6 months, or longer.

Ronald V. DeMars, MD (Retired) · Answer

The very worst thing to do now would be anything surgical or otherwise invasive. Fat grafting the nose anywhere except very high up on the bridge is usually not the best idea, but now anything else you do is going to complicate the problem. This is an area notorious for poor survival of the graft and most of it will go away. After 4-6 mopnths if it is still not to your liking, the skin can be elevated from the bones and cartilage and the fat removed.

Michel Siegel, MD - Account Suspended · Answer

You have a very difficult situation at hand, and I am not sure that there is a good solution for your dilemma.I am not a fan of fat grafting anywhere, as it is unpredictable and there's very little room for error.From all places, I cannot think of a worst place to inject fat that the lower one third of the nose. In my opinion any further injections of anything, including steroids will put your skin at a greater risks for complications.Your best best bet, in my opinion is to do NOTHING, and hope that most of what was injected dissolves. Again, fat is very unpredictable so the long term result is anyone's guess at best.The other issue is that there may be permanent damage to your skin and doing a rhinoplasty may compromise the viability of the skin envelope. Still the problem is not the underlying cartilage, but the skin. So rhinoplasty surgery may not be the solution.I would seek a local facial plastic surgeon that could manage your condition.Best of luck,

My fat grafted nose now looks disfigured and swollen. Am I a candidate for a Revision Rhinoplasty? (photos)

Answers (7)

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