Rhinoplasty 2 years ago went well but still have small bump, can I could get it removed in-office? (Photos)

Hello and thank you for your question. After rhinoplasty (nasal surgery), the nose can become REALLY swollen, and this swelling can take a LONG TIME to resolve (up to 2 years to fully resolve). Given that your most recent surgery was 2 years ago, all the swelling should be fully resolved. The fact that the "bump" you are concerned with is mainly noticeable when you pull down the overlying skin envelope of your nose leads me to believe you are seeing a ridge/prominence of the underlying structural framework- likely the inferior edge of the nasal bones, which have been separated from the upper lateral cartilages at that site. This is NOT something which can be removed in the office. If you really want it addressed, know that there is no guarantee another operation will make things significantly better, but it is certainly something you can consider to smoothen the transition at that site.
Though some surgeons might say they can achieve your goal via a closed technique, I would argue that the open approach is much more effective in facilitating complex, precise maneuvers to refine the nasal shape and size to a particular aesthetic and look, particularly in a revision operation such as this. Rhinoplasty is arguably the most difficult procedure to perform in all of plastic surgery, and revision/secondary operations are much more difficult than primary operations. Consequently, I would recommend only going to see a surgeon who feels very comfortable with both primary and revision rhinoplasty procedures, and who has significant training and experience in these types of surgeries. This is a surgery of millimeters, so if the surgeon you're going to only does 1-2 per month, you are not going to get the best result possible.
Of course it is always difficult to provide tentative surgical recommendations, as there is only so much information to be gained from photos and descriptions provided. I recommend for you to come see me or another plastic surgeon comfortable with rhinoplasty procedures for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) and type of anesthesia for your specific case. I hope this helps!
Best Wishes,
Dr. Donald Groves
Plastic Surgeon

The question is whether the bump is of bone, cartilage or soft tissue. It is possible to make a direct decision if it is soft tissue. If it is bony or cartilage you may want to have it filed and smoothed. This would be done through the nostril.

Best Wishes,

Gary Horndeski, M.D.

BASED ON YOUR PHOTOS, YOU SHOULD BE EVALUATED BY AN EXPERIENCED SURGEON. YOUR BUMP MAY NOT BE RELATED TO THE PREVIOUS SURGERY AND COULD VERY WELL BE A CYST. IT SHOULD BE ABLE TO BE REMOVED IN A VERY SAFE AND SIMPLE PROCEDURE IN THE OFFICE.

This is not necessarily a normal outcome after a rhinoplasty. This would require a rhinoplasty revision in my professional opinion. It is difficult to provide an adequate comprehensive answer without additional information such as information on the original surgery (operative note) and doing a physical exam. It appears that there is a residual bony cap/hump, but given that surgery was already performed...there can be many reasons for this. Revisionary rhinoplasty surgery requires a highly trained plastic surgeon, ideally with at least of 6 years integrated plastic surgery training followed by an accredited aesthetic surgery fellowship. I highly recommend finding one of those if possible.

When you pull down on your nose, We can see a bony protuberance at the top of the bridge of your nose. It does not appear to be visible when you're not pulling on your nose, so it's unclear as to whether or not anything needs to be done. Generally, a visible bony irregularity on the mid bridge may be camouflaged permanently with microdroplet Silikon-1000 nasal injections. If you have asymmetrical nostril margins, the high side can be lowered a tad as well for improved symmetry. I hope this helps! Sincerely, Dr Joseph

It appears that your bump is probably at the lower end of the nasal bones. This could have resulted from inadequate reduction in this area or too much removal of the cartilaginous dorsum below (distal) to it. Without seeing the entire bridge, it is hard to say what should be done. If the bump is further reduced, it may contribute to a greater, unaesthetic depression. My best advice would be to see a nasal specialist to get his in-person opinion.