Indention and tip rotation -what would cause this? Is this poor healing? (photos)

Question

I had a rhinoplasty and Septoplasty in November of 2020, about a year ago I started noticed an Indention on the left top of my nose near the tip. I have also noticed the tip seems to rotate to the right now. What would cause this? Is this poor healing? Or the technique of the surgeon? I was told he would use a graft and it was harvested from cartridge taken from behind my own ear.

Eric M. Joseph, MD · Answer

Based on your photos, you appear to have thin nasal skin, and a wide asymmetrical tip with an indentation. Since your skin is thin, you may be seeing the ear cartilage graft through your skin. The best way to understand your situation may be to consult with another reputable rhinoplasty specialist with your operative report and B&A photos. In some people, visible indentations after rhinoplasty may be filled permanently with microdroplet Silikon-1000. Hope this helps. Dr Joseph

Michael A. Persky, MD · Answer

Hi L,
The indentation is due to your surgery.  I would recommend discussing your concerns with your rhinoplasty surgeon.  Excessive tissue may have been excised, the graft may have moved or warped, or there may be scar tissue.  If your nose appearance bothers you then a revision surgery is indicated.  A temporary fix can be injection of fillers, though I would recommend considering consultation with a revision rhinoplasty specialist.  Good luck and be well.
Michael A. Persky, MD
Encino, CA

David M. Kowalczyk, MD, MBA, FACS · Answer

Good Evening! I see the indention you’re referring to. Indentions are most often caused by a lack of support relative to the surrounding nasal structures. Ear cartilage can work well for some things, but it tends to be soft and can curve over time, thus becoming visible. It’s not an ideal source for strong support of the tip. The deviation of the tip is likely the result of lack of structure at the tip area. This can be from any number of reasons. I can’t comment on technique that was utilized by the surgeon. And it doesn’t seem to be poor healing. If it’s been almost two years, it’s appropriate to consider a revision if it bothers you and hasn’t improved by this time. Hope this helps you!

Gianfranco Frojo, MD · Answer

Rhinoplasty is a very complex procedure. The tip is a unique combination of curvatures of the lower lateral cartilages. Ear cartilage is usually too weak to provide adequate structural support for rhinoplasty. The indentation may be from weak cartilages that are scarring down or poor technique with inadequate tip complex shaping at the time of surgery. I would highly recommend seeing a board eligible or board certified plastic surgeon with adequate training in rhinoplasty for a full evaluation and potential recommendations.

Indention and tip rotation -what would cause this? Is this poor healing? (photos)

Answers (4)

Answer: Indentation

Answer: Indentation

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Indention and tip rotation -what would cause this? Is this poor healing? (photos)

Answers (4)

Answer: Indentation

Answer: Indentation

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Recommended reading

Everything you need to know about Rhinoplasty

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