Can Anything Be Done to Help Nose Asymmetry After Upper Jaw Surgery?

Question

I had upper jaw surgery last year (Feb 2009). It appears that the screw and plate on one side of my nose is causing a bulge/shadow/redness and messes up the contour, since my skin in very thin. I do not want to have it removed since the hardware is higher up than usual, requiring a hospital surgery. Plus, I will bruise and swell all over again, as bad as the original surgery. I am disheartened that this can't be done as an outpatient procedure as originally thought, due to the placement of the hardware.

	How can this be helped? thanks.

Sam Naficy, MD, FACS · Answer

Maxillofacial (jaw) surgery may cause displacement of the nasal septum and asymmetry of the nose.  This can be improved/corrected with a septoplasty and rhinoplasty and at the same time the metal plates/screws can be removed.  This can be done in an office-based ambulatory surgery setting under IV sedation.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Unfortunately, the picture is a bit fuzzy but I can appreciate that you have more nostril flare on one side versus the other.  This flare can be do to many things. 
Nasal septum (middle cartilage) may be off, the nasal muscles that are usually tightened at the base of the nostrils may have been tightened unevenly or could have relaxed,  or the upper jaw may be more prominent on that side due to its position to allow your teeth to fit just to name a few.  It would be unusual for the plates and screws to causes that fullness.  The plates and screws are very small/thin.  It is best to visit with an oral and maxillofacial surgeon or a plastic surgeon to have a complete eval as a second opinion.
Good Luck.

David C. Pearson, MD · Answer

While the attached photo is too small to clearly assess, it's quite unlikely that merely removing the hardware would require a hospital admission, and usually swelling is much less with such a procedure.
The massive swelling that accompanies maxillofacial surgery such as you've described is primarily related to the cutting and manipulation of the bones of the midface and not merely the surgical dissection itself. As a result, airway issues and the potential for bleeding necessitate the hospital stay.
Removal of the hardware--while not trivial--is often much less traumatic since no bony manipulation is necessary.
All the best,
--DCP

Eric M. Joseph, MD · Answer

The quality of the photo you provided is not adequate. I can see more nostril show on your right, and possibly a bulge above your left nostril. If you'd like, email me a better photo along with a description of where the bulge is, and I'll be glad to share my thoughts with you.

William Portuese, MD · Answer

Any hardware can be removed under IV sedation and a brief general anesthetic.  This is a much smaller surgery compared to your original jaw surgery and can be done as an outpatient surgical procedure.  A rhinoplasty can also be performed to address nostril and tip asymmetry, but will not address any thin skin that is present on the nose.

Can Anything Be Done to Help Nose Asymmetry After Upper Jaw Surgery?

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Answer: The asymmetry of your nose after jaw surgery is not easily seen on your photo.

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Answer: Nose asymmetry after upper jaw surgery

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Can Anything Be Done to Help Nose Asymmetry After Upper Jaw Surgery?

Answers (8)

Answer: The asymmetry of your nose after jaw surgery is not easily seen on your photo.

Answer: The asymmetry of your nose after jaw surgery is not easily seen on your photo.

Answer: Nose asymmetry after upper jaw surgery

Answer: Nose asymmetry after upper jaw surgery

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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.