I got a closed rhinoplasty in 2019 to remove a dorsal hump. A callus formed over where the bump previously was, and after unsuccessful treatment with steroid injections and massages I decided to go back to my surgeon for a nasal rasping touch up in 2020. its been 2 years since then and now the original, and a new callus have formed on the bridge and near my forehead. will another rasping procedure make this worse? do i need a full revision?
June 27, 2022
Answer: Bone Callus after Rhinoplasty Sorry you are having this problem. It is unfortunately not an uncommon problem. First a little background. Our bones are designed to heal after fracture. If you look at an X-ray of ANY bone on the body after a fracture is healed (whether it was left to heal on it's own, whether it was casted, or whether the fracture was plated and screwed), some "callus" forms. Think of it like this. Skin heals ONLY by forming a scar; bone is the same. The bone does not "understand" your Doc casted it. Over many years, we have developed a protocol to minimize such issues. It still does not prevent 100% of these from occurring. First off, I do most rhinos open. This provides better exposure to the bony dorsum as well as the area just below it where the skeleton transitions to cartilage, some of which is partly calcified in the transition zone. Then, after rasping, we let the bone recover from the force of rasping for a few minutes and go work on something else. Sometimes a small projection will hide itself for a few minutes and then re-appear. Before closing, we thoroughly irrigate the area to wash out ALL bone fragments. Then, my RN I each carefully palpate the nose skin with wet gloves to detect the slightest projection. Then I do a final inside inspection. Postoperatively, we wait about six weeks for the bone to partly heal. Then we do a careful exam for the slightest bump. If we find one, we have YOU do twice daily compression of the area. Kind of like wearing a retainer after braces. The bump is more pliable and compliant to massage early on before it is fully calcified. We do occasionally do steroid injections for soft tissue bumps, but it would be ineffective for bony bumps. And yes. One time I had a recurrence of a bump after rasping! My hope for you is the bump is much more palpable than visible. You profile is pretty. If you were to carefully palpate the bony dorsum of some friends and family you will probably realize they have a few bumps too, rhinoplasty or not.
Helpful
June 27, 2022
Answer: Bone Callus after Rhinoplasty Sorry you are having this problem. It is unfortunately not an uncommon problem. First a little background. Our bones are designed to heal after fracture. If you look at an X-ray of ANY bone on the body after a fracture is healed (whether it was left to heal on it's own, whether it was casted, or whether the fracture was plated and screwed), some "callus" forms. Think of it like this. Skin heals ONLY by forming a scar; bone is the same. The bone does not "understand" your Doc casted it. Over many years, we have developed a protocol to minimize such issues. It still does not prevent 100% of these from occurring. First off, I do most rhinos open. This provides better exposure to the bony dorsum as well as the area just below it where the skeleton transitions to cartilage, some of which is partly calcified in the transition zone. Then, after rasping, we let the bone recover from the force of rasping for a few minutes and go work on something else. Sometimes a small projection will hide itself for a few minutes and then re-appear. Before closing, we thoroughly irrigate the area to wash out ALL bone fragments. Then, my RN I each carefully palpate the nose skin with wet gloves to detect the slightest projection. Then I do a final inside inspection. Postoperatively, we wait about six weeks for the bone to partly heal. Then we do a careful exam for the slightest bump. If we find one, we have YOU do twice daily compression of the area. Kind of like wearing a retainer after braces. The bump is more pliable and compliant to massage early on before it is fully calcified. We do occasionally do steroid injections for soft tissue bumps, but it would be ineffective for bony bumps. And yes. One time I had a recurrence of a bump after rasping! My hope for you is the bump is much more palpable than visible. You profile is pretty. If you were to carefully palpate the bony dorsum of some friends and family you will probably realize they have a few bumps too, rhinoplasty or not.
Helpful
June 16, 2022
Answer: Rhinoplasty You actually have a nice results even though there’s a small bump on the bridge. It may be worth rasping again but I don’t think you should get a full revision.
Helpful 1 person found this helpful
June 16, 2022
Answer: Rhinoplasty You actually have a nice results even though there’s a small bump on the bridge. It may be worth rasping again but I don’t think you should get a full revision.
Helpful 1 person found this helpful
