Why is my nose leaning more after 7 months surgery? (photos)

I did my rhinoplasty about 7 months ago. I was happy with the results for the 1st 3 months. On the 4th month I realized that my hump was slightly showing again and that my nose was leaning more to the left. My doctor suggested that its tissue scaring and that I should get a Triamcinolone shot. I feel like that problem is more complex and I probably need to get a revision. What's causing my nose to lean and why is the hump showing again? My nose also looks bigger than it did before the surgery :(

Doctor Answers 5

Search for a rhinoplasty specialist...

It can be hard to judge rhinoplasty initially because of the swelling, but a bump that is persistent will most likely need some additional work. Also, your tip is a bit rounded. Revision rhinoplasty should be able to create a thinner, more refined tip, and possibly straighten it as well. The most important thing is to find someone that specializes in rhinoplasty to do this revision.

Edison Facial Plastic Surgeon
4.8 out of 5 stars 180 reviews

Even though it's somewhat early....

There several issues with your nose that will likely remain unhappy with.... it appears that you had a closed rhinoplasty (no incision on the bottom of the nose) with irregular dorsal resection and minimal tip workIt appears that you would benefit from a revision rhinoplasty complete with structural grafting which would likely include at least bilateral spreader grafting to restore your dorsal aesthetics...The decision to undergo a revision rhinoplasty needs to be considered carefully ..Unfortunately, unsatisfactory results and secondary deformities from primary rhinoplasty are common.... like many other advances in science and technology, the techniques and approaches to rhinoplasty have become significantly refined over the last 20 years..... much of what is done now by qualified rhinoplasty specialists is much more 'constructive' than the 'destructive' methods of the past.... still many patients have suboptimal surgeries that result in asymmetry, over-resection of supporting structures and ultimate collapse over time. Im sure that here are several rhinoplasty 'experts' within a short drive of you.... now your work begins...unfortunately many plastic surgeons who hold themselves out as rhinoplasty experts are not...You need a thorough evaluation and a well thought out plan....you will need to gain the confidence that your surgeon has the skills and aesthetic judgment to fix your problem....you will need to see several doctors to become convinced of what an actual expert is...find out who OR nurses and doctors go to and who their family/friends go to.... do your homework and be sure that your revision rhinoplasty surgeon has: 1. many years of rhinoplasty practice experience
2. judgment and techniques that have evolved over time
3. a practice focused on rhinoplasty 
4. a willingness to do difficult, secondary and reconstructive cases
5. an interest in teaching others how to evaluate and do rhinoplasty properly
6. a willingness to share rhinoplasty resume, photos and patient experiences with prospective patients good luck...

Healing following rhinoplasty

Your nose will certainly continue to change in appearance even after one year following surgical correction.  I suspect that if your nose is leaning in any particular direction at this point it will likely continue to lean in that direction even with steroid injections to your nose.  I do see some fairly significant tip and dorsal edema that might benefit from steroid injections.  If you are confident in your rhinoplasty surgeon, then I would suggest listening to what they have to say and I am sure your happiness is their ultimate goal.

Philip S. Schoenfeld, MD, FACS
Chevy Chase Facial Plastic Surgeon
4.6 out of 5 stars 23 reviews

You would benefit from a revision rhinoplasty. It could be a lot better!

There are many problems I see with your nose.  You have both asymmetry and a very large bulbous tip.  I would not have anyone inject steroids because it will not help.  It is true that waiting about a year from the original operation is a good idea.  However, after 7 months, the idea that by waiting another 5 months will dramatically change the way your nose looks for the better is misleading.  The reason to wait about a year is for the scar tissue to mature, which will clarify what should be done in a revision.  However, you have structural problems that can only be improved with a revision.  I would advise you to see a board certified plastic surgeon with a lot of experience in rhinoplasty and revision rhinoplasty for a second honest opinion.  Good luck!

Post Operative Rhinoplasty Concerns

Thanks for your post and photos. Your nose after rhinoplasty will continue to change for up to 1 year or longer from your surgery. The fact that you were happy with the result at 3 months but started to become concerned about your nasal appearance in the next few months suggests that additional changes to appearance and nasal support may continue. I am sorry that you are unhappy and feel that your nose is too large at this point. I share your concerns about the nose tilting, irregularity of the nasal bone and size and shape of your tip. You may benefit from a revision but I recommend waiting at least 1 year from surgery before considering a revision rhinoplasty. Steroid shots (Triamcinolone) may help in your recovery, but may not be enough to improve upon all your concerns. Fortunately, comprehensive correction via a revision rhinoplasty by an experienced Facial Plastic Surgeon can address any persistent nasal concerns and fix them. Cartilage grafting and tip modifications may need to be considered. Best wishes. 

Fred J. Bressler, MD, FACS
Houston Facial Plastic Surgeon
5.0 out of 5 stars 7 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.