Can this be fixed in a closed rhinoplasty approach? (Photo)

Hello and thank you for your question. Based on your photographs, I would recommend doing this revision open as there will be lots of scar tissue internally, especially given the prior alloderm placement . For indents such as this, I always use mastoid fascia to produce a smoother contour. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

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

Hello,
Thanks for your questions. It looks like you have some subdermal fat atrophy in this area. Did you get a steroid injection? If so, nanofat injections will help improve tissue blood supply. You may need a few rounds of injections (2-3). Once the tissues behavior improves, a small fascia graft can be taken from behind the ear and placed using a closed approach to fill in the leftover space.
I hope this helps.
Dr. Shah