Nose Bump After Spreader Graft Was Inserted

Question

My doctor gives me no answers, Like I said my doctor spends about one minute with me and leaves the room quick. He wants me back in 3 months. He stated, "You have a bit of a knot here. Hopefully, it will go down, but if it doesn't, we'll file it down." Is that normal, and do you think the bump will go down on its own? What causes it?

Edward Buckingham, MD · Answer

Slight bumps and lumps occur about 5% of the time in rhinoplasty even in the best of hands. It isn't a big deal to have to file something down after the procedure. Be patient though. It is wise to wait at least 6 months and maybe longer if it is improving.

Remus Repta, MD · Answer

Hello Roccol,

	Thank you for the question.  A bump or hump on the bridge of the nose after spreader grafts can be caused by swelling, a piece of cartilage or bone from the dorsum being reduced, or from the spreader grafts being too high or irregular.  Discuss with your plastic surgeon about the timing of repair if needed.  Obviously swelling will go down and if this is the case the bump will go away on its own.  The other two options will likely require a revision.

	All the best,

	Dr. Remus Repta

William Portuese, MD · Answer

Occasionally, spreader grafts can shift, move, or migrate from their original position and can be seen and palpated along the bridge of the nose if they ride upward towards the skin. This will give the appearance of a small bump on the nose. If this is occurring, the graft should be removed and reinserted into its normal anatomical pocket through a revision rhinoplasty.

Robert M. Freund, MD · Answer

Your doctor is saying all the right things; only he should spend more time to alleviate your fears. The spreader graft can cause a bump if slightly displaced - which can be the result of scarring. Treatment should be to rasp it down when the swelling has resolved. 
Good Luck!

Theodore Katz, MD, FACS (retired) · Answer

You paid a lot of money for your surgery, I am sure. Surgery not only includes the pre-op preparation with the physician, the surgery itself, and I feel just as importantly the post op care and addressing of the patient's concerns. Insist that your doctor spend time with you to explain why they feel the problem has occured and not brush you off! I feel that a patient's post operative state of mind is critical in the perception of how the doctor himself/herself has addressed the surgery as well as the post op care. If he/she is rushing you through your post op follow ups and doesn't have the time for you, then many patient's wonder did he spend enough time on my procedure. I find that a few extra minutes with a patient pre and post operatively allays fears, decreases anxieties, and helps the patient to better participate in their post op care and certainly to trust the doctor. Bumps happen to everyone; how they are handled by the doctor can retain a patient or chase them elsewhere. I don't think that most patients expect perfection from their surgeons. They expect them to respect their concerns and let the patient know when things haven't quite gone as planned and what the future will hold.

Andres Gantous, MD - Account Suspended · Answer

It is not terribly uncommon to have a small bump or irregularity on the dorsum of the nose after a rhinoplasty. These may disappear on their own and if they don't they can easily be rasped down. With the use of spreader grafts, sometimes a small piece of cartilage can protrude a bit and cause this. i wouldn't worry too much about this and would wait for at least six months to see if ti disappears. Good luck!

Nose Bump After Spreader Graft Was Inserted

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