Nose swells 9 years after rhinoplasty - how can this be treated? (Photos)

Question

Hello, so I asked my doctor to kind off push back my columella, as it was hanging too much, thats what I thought. He did the job for my columella with "open surgery", no implants or anything was put there. My nose tip was and still is swollen 9! years after. Its not as swollen as first months but its swells a lot. My tip never returned in size to my original before the operation nose tip. The job to my tip was not done, it didnt change Also my columella is hard and bit swollen. Also all year after surgery my columella area was very itchy and my orl found thread in there after surgery and removed it. The question is what should I do? I have bulbous tip now that swells, what can it be or who should I ask? The photos are - first before surgery and all other photos 9 years after surgery

Alejandro Nogueira, MD · Answer

Your columella was not really hanging, at all, this condition only exists in the elder after the 70s, not in young people, that was a terrible diagnosis misjudgement and the treatment you received... very likely we can assume was a tongue-in-groove maneuver... was an error.

You had a bad alar retraction due to having a boxy tip (you still have it untreated) and verticalized lateral cruras (aka parenthesis tip), this should have been treated to push down the nostril rims and let the courtains cover the columella; you only had a columellar show but the cause was not on the columella, a terrible mistake happing very often due to lack of anatomical understanding from surgeons about the structural issues they are dealing with.

The persistent sweeling might be due to the tongue-in-groove maneuver, it can be easily reversed.

Seek the advice and help of talented and passionate revision rhinoplasty surgeons, you need a comprehensive re-structuring.

Eric M. Joseph, MD · Answer

When permanent sutures are used in the tip of somebody's nose, rarely they can cause an inflammatory response. I mentioned this since you pulled a thread out, and that could be indicative that your body is sensitive to the suture material that was used, and that it is likely permanent. If your nasal tip is not fluctuating in size, and it's simply wider than preoperative, revision rhinoplasty may be considered for achieving a narrower nasal tip appearance. Please consider getting an opinion, in person, from several reputable rhinoplasty specialists. Thank you so much for this question. Sincerely, Dr Joseph

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