Will I require a revision rhinoplasty to correct asymmetrical shape? 9 months post op

Question

I had cosmetic rhinoplasty in feb 2024 - currently 9 months post of. Noticed very asymmetrical on bridge of nose/definition of nostrils as one side is clearly more defined than the other. 1st pic is pre op, 2nd & 3rd photo are 9 months post op. Surgeon recommended a cream as I have thick skin on tip but it hasn’t helped the shape. Is this scar tissue, cartilage etc please help and if revision will be needed?

Philip S. Schoenfeld, MD, FACS · Answer

You have quite thick and likely somewhat sebaceous skin.  It absolutely can take longer for post operative swelling to subside.  Your surgeon can try injectional low dose steroids but time is still your best bet.  I would also not focus so closely on your current result as it is not a bad outcome and there is still time.

Selcuk Inanli, MD · Answer

Hello! Thank you for your question
As far as I can see from your photos I definitely recommend a revision operation, your nose tip is low and there are quite swellings, it is possible to correct them with revision rhinoplasty.
It would be better face to face consultation
Best Regards!

Gary M. Horndeski, MD · Answer

You will need a revision rhinoplasty to correct the bone and cartilage asymmetry.  Creams will have no effect on this.

Best Wishes,

Gary Horndeski, M.D.

Eric M. Joseph, MD · Answer

Based on your progression from three months to nine months, I suspect that you are seeing changes as you are headed towards your final result with less swelling. I do not think that a topical cream will help you. You appear to have a small indentation along the right side wall of your nose at the level of your nasal bone, and there is also a slight indentation along the cartilaginous portion of your left nasal side wall. Depending on your examination, microdroplet Silikon 1000 injections may be considered for achieving a straighter and less operated nasal appearance, without the inconvenience of additional surgery. I hope this helps. Sincerely, Dr. Joseph

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. 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

Best wishes and good luck.

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

Pawel Szychta, MD, PhD, DSc · Answer

Asymmetry after rhinoplasty, especially at nine months post-operation, can be due to several factors:
- Scar Tissue Formation. Thick skin can lead to more scar tissue, which may cause unevenness or less defined contours.- Residual Swelling. Swelling can persist longer in some areas, particularly in patients with thicker skin, contributing to asymmetry.- Cartilage or Bone Irregularities. Slight differences in how the cartilage or bone healed or were reshaped during surgery can result in asymmetry.
Since the cream hasn't improved the shape, it would be advisable to consult your surgeon again. They can assess whether the asymmetry is due to scar tissue, cartilage issues, or other factors, and discuss whether revision surgery or other treatments might be necessary.

Will I require a revision rhinoplasty to correct asymmetrical shape? 9 months post op

Answers (6)

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