Weird swelling at top of nose - 1 year post op - swelling or cartilage? (Photos)

Hello there,
The first question that comes to mind is when did you notice this swelling start to take place? Any trauma, infection or injectable treatments performed to the nose recently? Were any grafts or implants placed in your nose that you are aware of? Tip swelling can take up to a year to resolve, however, your nasal tip appears somewhat bulbous for your face for being one year out. Did you nasal tip look like this at 1-2 months post-op or was it more defined? Help answer some of these questions and than perhaps we can try to understand what might be going on.

Without seeing an arrow pointing EXACTLY to the area you are concerned about, I can only guess that what you are noticing is the prominences of your lower lateral cartilages. If that is the case, then it is unlikely to be related to scar tissue buildup given how symmetric and even it is - it could be that they were inadequately reduced at the time of the first surgery or that your skin thinned so much that you can now see them. Again, unclear especially without preop photos. I would check with your surgeon and see if they she has any thoughts.

It appears to be scar tissue that leads to swelling over time. The best treatment is to use steroid injections initially. That can be combined with taping. If that does not resolve it then surgical excision of the scar would be the next step.
Regards
Dr. J

The tip of the nose is formed by two cartilages, one on the left and one on the right. When those cartilages are strong and broad, they make the tip look wide, and when they are strong they also tend to hold the tip down, so the nose looks long. If the skin isn't particularly thick it's possible to see the outlines of those cartilages. Hard to say for sure from just these two similar angles, but it's possible that the "dent" you see isn't really a dent, it's that the cartilages just below where you see the dent are prominent, and that makes the area just above the prominence appear to be a dent. Get it? Someone with a detailed surgical knowledge of the anatomy of those tip cartilages should be able to feel the tip of your nose and know the answer right away. The tip of your nose still looks a bit wide-ish to me. If the cartilages were less wide, then maybe there would be no dent.

It does appear that your tip was either not reduced sufficiently or possibly there is a cartilage graft there. It could be improved with a revision.

Your lower lateral cartilages make up the tip of your nose, and it is common to see a V shape where they join in the midline. If this v-shape configuration is bothering you, perhaps it could be filled in with a Filler, rather than undergoing revision rhinoplasty surgery. Adding a filler, however, would lead to a wider nasal tip appearance. You should certainly discuss your concerns with your surgeon and I hope this is helpful. Sincerely, Dr Joseph

Based on the 2 posted photo you tip cartilage was NOT correctly reshaped. So you can try non surgical HA filler rhinoplasty to indent area ($1,200). Or Revision tip rhinoplasty ($8,000). Best to virtual consult with.....

Are you referring to the subtle "upside down 'V" at the top of your nasal tip?
If so it's the upper edge of your nasal cartilages or the skin memory of where the upper edge of your cartilages used to be..................
Depending on which of the two possibilities it turn out to be will determine the best course of treatment.
Hope that helps

At one year, you are no longer swollen, and the results are final.
To make an assessment regarding the outcome of a plastic surgery procedure we need to see a complete set of proper before and after pictures. If you don’t have before and after pictures, then ask your surgeon to forward the pictures they took. I also recommend you follow up with your provider regarding your concerns and outcome. The outline you are referring to is your alar Cartlidge. some plastic surgeons remove subcutaneous fat below the skin to create better Cartlidge definition.
Best,
Mats Hagstrom, MD