Bumps and scar tissue 4 years after rhinoplasty - Can a revision correct it? (photos)

Question

I had a rhinoplasty 4 yrs ago and since then I have noticed some things that bother me. Firs there seems to be either ragged cartilage or scar tissue bumps all over the bridge which creates a bumpy texture. It is more noticeable when the skin is pulled. I also have a ‘column’ of scar tissue in one nostril which I believe creates asymmetry between the two nostrils. Is this a sign of a poorly done rhinoplasty, or are these common complications that can result from rhinoplasty? Revision needed?

Eric M. Joseph, MD · Answer

Some people who have thin nasal skin and relatively firm underlying cartilage experience what is called the shrink wrap phenomenon. That is when the skin shrinks down onto the underlying nasal skeleton after several years, causing irregularities to become visible. In general, many of these indentations or protuberances may be camouflaged permanently with microdroplet Silikon-1000 injections. The bulge in your left nostril at the base view of your nose appears to be a small piece of prolapsed cartilage, which is relatively inconsequential, unless it is causing breathing difficulty. I hope this helps! Sincerely, Dr Joseph

Gianfranco Frojo, MD · Answer

The contour irregularities you are seeing are quite common in thin skinned patient when open structural techniques are utilized. If you are seeking a revision, I would recommend using mastoid fascia to provide an extra layer to help camouflage the irregularities. There would also be work to contour the irregularities and make them more smooth. The asymmetric nostrils can be fixed with tip work, alar work, or alar base work.  I would go see an American Board of Plastic Surgery certified surgeon with experience in rhinoplasty/revision rhinoplasty. You can look up if your surgeon is American Board of Plastic Surgery certified by Googling "is my plastic surgeon certified?".

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 and the areas mostly bothersome to you.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you may benefit from a revision rhinoplasty to help correct the contour irregularities of your tip. Maneuvers would include nasal tip deprojection, and placement of a mastoid fascia tip graft to help improve the contour, among other maneuvers. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Bumps and scar tissue 4 years after rhinoplasty - Can a revision correct it? (photos)

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