Hard Bumps on Nose After Rhinoplasty

You are correct that it typically takes about 1 year to see the final results following rhinoplasty. At this stage of your recovery, the bumps that you are describing may very well be swelling created by osteotomies (the controlled breaks that are made to reshape the nasal bones). It is common for patients to feel a small 'pea-sized' bump on each side of the nose in the locations that you are describing especially after percutaneous lateral nasal osteotomies (using a very small and sharp instrument that is actually passed through the nose/cheek skin instead of internally to make the osteotomies). The bumps are the result of swelling in the skin where the instrument was passed through. If your bumps are secondary to the osteotomies, gentle massage of this area will help these bumps to resolve in a few weeks and this is normal following rhinoplasty. Alternatively, an irregularity in the location you described could be the bones themselves. You should discuss this again with your surgeon.

When any bone in the body is broken, it can heal with some callous formation. For example, if you break your arm, let it heal, and then take an X-ray, you will not simply see a straight line where the fracture was. Instead you may see a collection of extra bone growth around the healed break called a callous. The same thing can happen in the nasal bone area, especially if there was a big hump that was taken down. Now it is certainly possible that it is simple swelling and will improve over the next month or two. A regular massage of the area can definitely help. But if it is a little extra bony growth then it is very easy to go back in under local anesthesia and file the bone down some. Be sure to keep in constant discussion with your surgeon about your concerns.

Hello and thank you for your question. The hard bumps you are referring to may be your nasal bones. If those are your nasal bones, it may not get better with time and may even worsen as the swelling resolves. The final results take at least 1.5 years for the swelling to fully resolve. This can require lots of patience and waiting. Steroid injections performed by your surgeon can be extremely helpful. I usually start steroid injections around 1 to 2 months after surgery and continue as needed. I recommend that you maintain close follow up with your surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Thank you for your questions and as hard as it might be to hear your surgeon say “wait and see,” it really is the best strategy as five weeks post rhinoplasty is too soon in your recovery to know exactly what is causing the bumps. Once the swelling resolves after the first year, the bumps should have resolved. You could talk to your surgeon about lymphatic massage, which helps reduce the swelling at the site. Try to be patient and give your body time to heal after rhinoplasty, which can be a very technically challenging procedure.

Dear Nancy67Thanks for the question. A couple of weeks is too early to make a comment about the healing process. You should wait your rhinoplasty operation result because a year later we can evaluated. I wish you all the best.

The areas you describe may be where your osteotomies were performed, and the skin at the top of your nose is much thinner than on the bottom. Consider re-asking your query with modesty photos, or if you are not satisfied with your surgeon's response, consider getting an opinion from another rhinoplasty specialist.Thank you.Dr Joseph

The bumps near your eyes are very likely swelling from the osteotomies.  These may be asymmetric and can feel quite hard initially making it difficult to differentiate from bone.  Unfortunately, its too early to make any determination and certainly too early to do anything about it even if it were something like a "Rocker deformity".  Keep in communication with your surgeon as a hands on exam from an experienced rhinoplasty specialist is going to be the best way to evaluate the recovery and expected results.  All the best!

Hard bumps after rhinoplasty can be from a variety of causes:-Swelling- Early swelling can sometimes feel hard. This can be hard to distinguish from a remnant bump. Waiting for an appropriate amount of time to see if they resolve can be helpful.-Residual bone- Bone may not have been filed completely and can create an edge-Stepoff- Sometimes there is a stepoff between the nose which can be addressed-Callous formation- The perisoteum of the nose can form a hard callous which may need to be filed down or could resolve on its own with time.-Cartilage graft- If any cartilage grafting was performed it can translate into a bumpSpeak with your surgeon about your concerns and possible remedies for the bumps.

Thank you for your question and excellent description. The bumps you feel are likely related to the osteotomies (surgical fracture of the nose bones). It is common to feel a little bump or slight edge in the early post-op period. This generally resolves over time. In some cases, massage to the area may help. However, make sure to review this with your surgeon before starting massage.

The type of contour irregularity that you describe is very common following rhinoplasty surgery.  During this procedure the nasal bones are filed and the nasal cartilage is shaved to reshape the nose.  It’s not unusual to have residual boney irregularity, cartilaginous irregularity, scarring and swelling following this procedure.  When these bumps occur, they can usually be felt, but not seen.  In some cases, they may be visible as well and this can be a major source of anxiety for patients.
In the vast majority of cases this problem resolves without secondary surgery as the soft tissue swelling disappears and the underlying structures undergo remodeling.  In many cases this can be facilitated with gentle massage.  In some cases these deformities persist and secondary rhinoplasty is necessary.
It’s important to wait at least six to twelve months before proceeding with revisional surgery.  During this time period scar tissue softens, swelling resolves, and underlying structures remodel.  The situation stabilizes and the surgeon is no longer trying to hit a moving target.
If you have concerns about contour irregularities following rhinoplasty surgery, good communication with your surgeon is essential.  Your surgeon has probably seen this before and should be able to reassure you regarding your ultimate result.