Revision Rhinoplasty, columella strut was hit 30 days after. Should I be worried? (Photo)

Dear Rry,Thank you for your question and for sharing your photos. 30 days after a rhinoplasty, most of the tissues would have healed. Whilst direct impact to the nasal dorsum can affect the result of the rhinoplasty, there is also a good probability that nothing consequential would happen except a bruise and some tenderness. It is good that you managed to check back with you operating surgeon. It is too soon to decide upon a revision and it is good to be patient. In the meantime, you can help to reduce the swelling by taking painkillers, putting cold compress on the nose. The swelling should resolve within 2-3 weeks and you will have a better idea if there is any deviation of the nose.I hope this answers your question. Have a great week ahead and all the best!Dr. Terence Goh
Plastic Surgeon, SingaporeMBBS (S'pore), MRCS (Edinburgh), MMed (S’pore)Fellow, Academy of Medicine, Singapore (Plastic Surgery)President, Singapore Association of Plastic Surgeons (SAPS)International Member, American Society of Plastic Surgeons (ASPS)

As far as what the consequences go as a result of the
injury, there's a possibility that there will be no consequences.You need to see how it settles down in the
next twenty to thirty days by which time, if there has been any change in position,
it is going to be noted. At that point,
you can reconsult with your surgeon and make an evaluation. If there's no major change in shape nor
change in breathing, then it is not significant.Of course, these areas are sore when they are
injured, but the most important issues are if there has been a change in
form and function. If a cartilage graft has been placed or not is relatively unimportant because if
there is a change in the grafted tissue, it will show and manifest, as a change
in ungrafted tissue would show.



Best wishes,
Robert
Kotler, MD, FACS

Things that would be concerning after sustaining any level of trauma to a recent rhinoplasty would include persistent erythema, bleeding, or malposition of the strut graft or nasal tip. If you are experiencing any of those, you should return back to your plastic surgeon for evaluation. As long as nothing was disrupted the nose should continue to heal as per usual. It is not unusual to have persistent swelling in the nasal tip for up to a year postoperatively and I will counsel patients to not undergo a revision until one year postop.