Will an In-office Tweaking to Correct Rhinoplasty Asymmetry Interfere with a Possible Future Revision Rhinoplasty?

Question

At a 6-wk check-up, my doc said 1 side of my nasal bridge looks more "hollow" & the other side has a bump. He blamed nasal bones and their "memory" of where they used to be. He said they must have moved a bit, & told me to press (hard enough that it is uncomfortable) for 5 min, 3 X a day, on the side that seems to have more of a bump. He also said at @ 6mos that we may need to use filler for the "hollow" side and shave some of the bone. Is this routine? Should I let this guy touch my nose again?

Eric M. Joseph, MD · Answer

I read your concerns and reviewed your photos. The indentation you're describing is barely visible on the left side of your bridge. And you don't have an unsightly wide appearance of your bridge on front view that could indicate that your nasal bones have shifted outward. You appear to have a lot of tip swelling which takes the longest to resolve. Your profile-bump should continue to improve as swelling continues to resolve.

	You don't have a horrible nose job only 7 weeks post-op. In my opinion, it's impossible to know whather you would need further surgery based on how you're looking now. You may want to sit tight for the next 6 weeks to see what transpires as your healing progresses. 

	If you're uncomfortable with the suggestions from your surgeon, or if you're concerned by what you're seeing in the mirror, you should get a second opinion from a reputable rhinoplasty surgeon to see what might be best for you.

	I hope this is helpful for you.

	Regards from NJ.

Michael L. Schwartz, MD · Answer

I think you need to meet with your surgeon and discuss what you are trying to achieve here. Smoothing a bump is simple and ususally definitive for that type of problem. Using filler to balance asymmetry is something that will need to be repeated over and over again. It also sounds like your nose is still changing so I'd recommend waitng at least 9-12 months before doing anything.

Francis R. Palmer, III, MD (retired) · Answer

I have performed Rhinoplasty for over 20 years and from the last statement "should I let this guy touch my nose again" it appears that you may no longer have confidence in your Rhinoplasty surgeon.  IMHO, it's always best to try and work things out with your plastic and cosmetic surgeon both mentally and financially.  

	 Things happen after all surgery, including Rhinoplasty, and as long as your surgeon has the willingness, experience and skill to make your nose more attractive...why not let him.  However, both you and the surgeon must still have mutual respect for each other or things will most liekly not work out IMHO.

Daniel Greenwald, MD (in memoriam) · Answer

First of all, if you are satisifed with the result don't listen to what your doctor says.  The primary goal of cosmetic surgery is to satisfy the patient, not the doctor.  If there is something you notice and don't like it is important to bring it to your surgeon's attention. 

	If there is a problem with your bridge that bothers you, it is unlikely that pressure and massage will change it.  Adjusting the nasal bones can be done in the office or the surgical suite.  Be sure to get another opinion (or ignore the whole thing if you are happy with the way it looks).

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi,

I'm not sure the asymmetry will change over time even with pressure or massage. You may need a formal revision rhinoplasty to correct the asymmetry. Seek a second and even third opinion.

Best,

Dr.S.

Will an In-office Tweaking to Correct Rhinoplasty Asymmetry Interfere with a Possible Future Revision Rhinoplasty?

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