How and when Does the Nose Collapse After Rhinoplasty?

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.

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. 

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