Scar or Cartilage in Nostril After Rhinoplasty

Question

I had a rhinoplasty and inside my left nostril there is a large mass, it looks like a scar but it is in on the line where the typical incision is made. It feels lumpy and there is lack of hair growing in the area which makes me think it is scarring. It blocks a lot of my nostril and causes a whistle when I breathe which I can not stand. It always feels like there is something up my nose. I have some collapse in that nostril also, is there anything at all that can be done to fix this?

Umang Mehta, MD · Answer

This is an problem I see fairly often when patients come in seeking revision rhinoplasty. If the lower lateral (tip) cartilages are aggressively narrowed to refine the nose during the initial surgery, the nostrils can lose support. This may result in collapse of the underside of the tip cartilage into the nostril and/or a "pinched" or twisted nasal tip. Without seeing a photo or examining your nose, this is my best guess as to your concern. 

	I would recommend that you address your concern with your rhinoplasty surgeon or, should you decide to seek another opinion, consult with a revision rhinoplasty specialist. Placement of a cartilage graft (from your septum) underneath the lower lateral cartilage on this side, can strengthen this cartilage and lift the collapsed portion. This graft is called a lateral crural strut graft. 

	Best regards,

	Dr. Mehta

Kevin Sadati, DO · Answer

Dear Rhinoplasty Patient from Palm Beach, FL
	It would be useful to know when you had your rhinoplasty. If it was done less than a month ago it is most likely swelling. However, if it was done more than 3 months ago, you’re dealing with scar tissue. Based on what you’re describing there might be scar tissue on the left nostril causing nasal obstruction. This can be fixed. You need to have a consult with a rhinoplasty specialist to examine and evaluate your nose. Good luck

Steven Wallach, MD · Answer

The lump that you describe is hard to determine without seeing a photo or performing an exam. It may be scar tissue, it may be cartilage.

Peter A. Aldea, MD · Answer

Partial Nose obstruction and airway collapse are NOT normal and should not be part of recovery from nose surgery. You need to have your surgeon evaluate the reason for both. Depending on how much time has elapsed from your surgery, the obstruction can be caused by different processes - all of which are correctable. The nose pinching / collapse on inspiration is worrisome and suggests that the lower lateral cartilage arches which maintain the nose opening may have been weakened and cannot withstand the inspiratory pressures. Correcting this may require placing a stiffening cartilage graft to prevent collapse.

You need to see your surgeon and have our nose evaluated.

Dr. Peter Aldea

Steven Schuster, MD, FACS · Answer

Sometimes this is swelling while other times this can be an inclusion cyst. Follow up with your doctor. Swelling will resolve, don't worry. If this is an inclusion cyst or scar tissue it can easily be resolved with a minor revision under local anesthesia. Speak to your doctor to decide which way to proceed. Good luck, Dr. Schuster in Boca Raton.

Scar or Cartilage in Nostril After Rhinoplasty

Answers (5)