Post Revision Rhinoplasty: Nose Still Crooked

Question

I had rhinoplasty when I was 14 and continued to have complications breathing and it still had a very bulby appearance. I had a revision rhinoplasty done this past June so it has now been 11 months.

	I know one side had collapsed and he built it back up with cartliage, but the side he built up is slightly larger than the other side almost like it's portruding. is this just swelling that has yet to subside? it gives my nose a crooked appearance even though the bridge is very straight. any advice?

Mario J. Imola, MD, DDS · Answer

Hi, thank you for submitting your photo, sorry things have not turned out the way that you would like.  From what I can tell there seem to be 2 components that may be contributing to your nasal assymetry or crooked appearance.  First, the bone-cartilage pyramid or bridge of your nose appears to be shifted with a straight line deviation off to the right side of your face.  Second, the middle third of your nose seems to have some excessive tissue further contributing to protrusion on this side and this may indeed be a 'spreader graft' of cartilage which is commonly placed to correct a collapsed upper lateral cartilages.  You are 11 months down the line from your revision surgery and likely things will not change much beyond this as virtually all of the swelling has subsided.

	If you are unhappy and want things further improved, you need to balance the pros and cons of a second revision rhinoplasty.  The more revision procedures performed in a given patient, the more difficult it is to predict the reponse of the skin and soft tissue envelope ... eventually this will become the limiting factor.  In other words, expectations following revision rhinoplasty need to be lower than with primary rhinoplasty.  It may be possible that definite improvements are still possible with minimal risks but only an experienced revision rhinoplasty surgeon can answer that for you.  In crooked noses, revision surgery can range from simple such as camouflage grafts to very complex where the bone - cartilage framework is completely revised with osteotomies and grafts. 

	Perhaps revisit things with your current surgeon as he knows your nose best but also seek out other opinions.

Sam Naficy, MD, FACS · Answer

Your nose may get a bit thinner but it will likely stay deviated.  As others have said it is important to diagnose the cause of the deviation.

Thomas A. Lamperti, MD · Answer

The area where cartilage was grafting to repair the nasal collapse may take over a year to settle out.

	From your photo your nose seems to deviate to your right. It's hard to tell if this is because your head is turned slightly or if this is related to an overall facial asymmetry (in which case a perfectly straight nose may not go well with the rest of your face).

	I'd recommend dicussing your concerns with your surgeon.

Gary Motykie, MD · Answer

It is difficult to assess you overall nose with only one view and a blurry photo, but swelling after a rhinoplasty can last up to 18 months depending on the technique (open vs closed).  After 11 months, however, the majority of your swelling should be subsiding and the "protrusion" might be the cartilage graft placed by your surgeon which could make your nose appear crooked.

Michael L. Schwartz, MD · Answer

You still have swelling but it does appear that you still may have some deviation present or recurrent. Your face may also be asymmetric as well. Revision noses with deviation are among the hardest to fix. See what your surgeon thinks about your progress and if you might need further work.

Post Revision Rhinoplasty: Nose Still Crooked

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Answer: Revision Rhinoplasty: Nose still crooked

Answer: Crooked nose.

Answer: Crooked nose.

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Post Revision Rhinoplasty: Nose Still Crooked

Answers (9)

Answer: Revision Rhinoplasty: Nose still crooked

Answer: Revision Rhinoplasty: Nose still crooked

Answer: Crooked nose.

Answer: Crooked nose.

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Everything you need to know about Revision Rhinoplasty

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