How and when Does the Nose Collapse After Rhinoplasty?

Question

I saw collapsed noses in before pics of rhinoplasty revision pics. How did this happen? Can I have a good nose for months , then it suddenly/gradually collapse? Or the collapse happens during the surgery. I am sorry for being a little paranoid and obsessive , but its a really difficult experience for me during the first weeks post-op.

Thomas A. Lamperti, MD · Answer

Nasal collapse after rhinoplasty typically occurs gradually over several years. Very often the nose looks fine initially (even the first year or so) before the weakened underlying nasasl structure is overcome by scar contracture and the shrink-wrap effect of the skin.

	The areas that can be affected by this contracture process include:

	
		middle third of the nose which can cause narrowing and possibly nasal obstruction due to its effect on the internal nasal valve
	
		supra-alar tip which would lead to an unnatural pinching of the tip
	
		tip projection/rotation leading to drooping of the tip over time
	
		tip cartilage distortion or irregularities


	This nasal collapse can be prevented by using a structure-based rhinoplasty approach where the nasal structure is augmented (typically using your own cartilage) to ensure that it can withstand this force. This method is a little more involved and takes a bit more time but I find that it is definitely worth it in the long term.

Richard J. Bruneteau, MD · Answer

Unfortunately, patients who undergo rhinoplasty surgery can occasionally suffer collapse of the nasal dorsum. This can occur for a variety of reasons including over resection of the upper lateral cartilage, nasal septum and nasal bones. Under these circumstances the problem becomes noticeable with the resolution of swelling in the immediate post-operative period.
                In other cases, these changes may be subtle and take longer to develop. In this situation weakened structures may settle with tightening and shrinking of the skin envelope secondary to scarring.
  
                Fortunately, this problem is relatively rare. When collapse of the nasal dorsum occurs secondary surgery is usually always necessary.

Kevin Sadati, DO · Answer

What you are referring to is a middle vault collapse. This occurs during surgery and is due to over reseceted upper lateral cartilage, nasal septum, or nasal bones. If a rhinoplasty is well performed and adequate tissue is resected, the nasal structure will not collapse months after surgery. Good luck

Houtan Chaboki, MD · Answer

Hello again,

	The nose can collapse for multiple reasons with nasal surgery. More commonly the skin and cartilage gradually becomes weaker with age causing collapse. Only after a comprehensive evaluation can a rhinoplasty surgeon help determine appropriate options for you. Best of luck.

	Dr. Chaboki

Steven Wallach, MD · Answer

Sometimes mid vault colapse becomes more apparant after the swelling dissipates. This usually occurs during the first year post-op.

How and when Does the Nose Collapse After Rhinoplasty?

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How and when Does the Nose Collapse After Rhinoplasty?

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