What Should I Do About Complications After Rhinoplasty?

Hi Tiff,
Sorry for your bad experience with your rhinoplasty. Even in the best of hands sometimes unsatisfactory results may occur. Your surgeon has tried his best to get a successful result.
It sounds (no pun intended) like you may now have a perforation (a hole) in your nasal septum which would account for the noise that you are describing. If there is a perforation, it is correctable but would require another surgery.
Your breathing may benefit from reducing the size of your inferior nasal turbinates. There is a non-invasive, non-surgical method, Somnoplasty, which uses radiofrequency energy to reduce the volume of the turbinates. Hopefully you will be able to breathe well through your nose again.
You should discuss your concerns with your surgeon, and possibly get other opinions.
Good luck and be well.
Dr. P

It sounds like you have been through a lot. While you may have a very good surgeon, it sounds like you have had several setbacks and unfortunate outcomes. You may want to consider a second opinion. Every time you operate on the nose, you are causing more scar tissue and destroying tissues that may be needed for a later surgery. Right now, it sounds like you need spreader grafts modified and repair of septal perforation. You may also benefit from partial turbonate resection to help your breathing. To help your breathing in the mean time, you may want to try BreatheRight strips at night. These pull open your internal valve and allow more air to flow. Good luck.

The swelling inside your nose may take 6-12 months to slowly resolve. I would be patient and ask your surgeon if you have a perforation. If you have this you may want to have it repaired along with treatment for your breathing problem if it doesn't go away. You should see a revision rhinoplasty expert to evaluate your problem.

It is good that you had tried the cortisone nasal sprays to try to relieve your nasal congestion. Sometimes this can occur from unrelated issues such as allergies, and the swelling from turbinates, which can be caused from allergies. Cortisone nasal sprays will help with this. Bone and cartilage would need to be removed from the nose if the patient needs a septoplasty for a preexisting deviated septum that was not addressed by primary surgery. Sniffling and a runny nose are both related to allergies.

Rhinoplasty is the most complicated surgery that we do. The surgery is only half of the issue--post operative convalescence and encouragement is the second.
The first surgery sounds like it was overdone resulting in a collapse (albeit mild) of the middle 1/3 of your nose. It may look good, but it makes it hard to breathe through your nose.
This problem was addressed in the second surgery with spreader grafts--cartilage from the septum that widens the middle 1/3rd to allow for easier breathing. It sounds like the harvest of the cartilage may have resulted in a septal perforation. The noise can also be the result of natural post-operative swelling. I routinely fix these problems for patients in my own area and often advise them that it takes 6-12 months for the swelling inside the nose to resolve before the breathing can improve.
So for you, I suggest patients if the spreader grafts were performed. However, if you have a septal perforation, you should seek out someone who can address the problem.