Still have a dorsal hump on my nose 3 weeks after surgery. Will a procedure to remove this hump produce major swelling again?

I still have a dorsal hump on my nose after my primary closed rhinoplasty 3 weeks ago. Will I have to pay for a revision and will this produce major swelling on my nasal tip and nose again? Is it normal to remove the hump with filing and minimal swelling?

Doctor Answers 9

Too early to make a judgment

Thank you for your question!

It is understandable that you are concerned. Changes after rhinoplasties vary with every patient and what you are experiencing is normal especially that swelling takes time to subside as it masks the results of your surgery.

It is important to keep in mind that it is early to pass a judgment. Usually, a year is required before formulating how your nose will be. Even then, your nose will keep shaping itself and to complement your face for better results in the years to come.

My best recommendations at the moment is to be patient, allow nature to take its course and edema subsides for better results. There is no doubt that once the swelling subsides, more definition and shape will be achieved and you should be happier with the results.

Also, it is important that you keep communicating with your surgeon and work as a team together to achieve the best results possible.

Congratulations on your surgery and please remain positive!

Ali Sajjadian, MD FACS

Orange County Plastic Surgeon
5.0 out of 5 stars 195 reviews

Still have a dorsal hump on my nose 3 weeks after surgery. Will a procedure to remove this hump produce major swelling again?

It is simply too early to make a judgement about the final result or the need for revision.

Kenneth Hughes, MD

Los Angeles, CA.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Revise dorsal hump 1 month post op

Yes there would be more swelling and bruising if the revision is done this early.
Although I don't do many revisions I recommend waiting a few months in order for the initial swelling to abate before revising.   The original surgeon  should have a policy regarding charging for revision.

Richard O. Gregory, MD
Orlando Plastic Surgeon
4.6 out of 5 stars 12 reviews

Dorsal hump at 3 weeks

At three weeks if you have a dorsal hump it may be related to swelling.  Best to give it time anyway to heal. No one would do a revision a this early a time.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Dorsal Hump three weeks post surgery

If you still have a dorsal hump three weeks post surgery then you may need revision surgery. The extent of the revision procedure will depend on if you need just a simple rasping of the dorsum or a combination of excision and rasping. Depending on your need will determine the amount of swelling you will have, it could be very minimal. As far as payment goes this is something you will need to discuss with your surgeon and what his/her policy is and what you had agreed upon as your proposed result. Most surgeons will provide minor revisions at no charge. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 208 reviews

Dorsal hump revision

The dorsal hump is composed of cartilage and bone and frequently requires a combination of rasping and sharp excision.  A revision will cause swelling again but not anything out of the ordinary.  A 4-6 weeks period of swelling is a small price to pay to obtain the right dorsum you desire. 

John Michael Thomassen, MD
Fort Lauderdale Plastic Surgeon
4.9 out of 5 stars 49 reviews

Still have a dorsal hump on my nose

After three weeks if the hump is there it is likely to stay. A revision might cause less swelling depending on what need be done, however as we always recommend, wait six months or more before you decide.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews

Still have a dorsal hump on my nose 3 weeks after surgery. Will a procedure to remove this hump produce major swelling again?

You will need to talk to your surgeon regarding payment of revision surgery.  In general, if revision surgery is needed, it can be done in an office setting.  The swelling is usually very minimal.

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 60 reviews

Be patient

Dorsal hump removal is a very common maneuver during rhinoplasty.  There are several key ways to do this and the technical aspect will depend on the amount of reduction and your surgeon's preference.
3 weeks out from surgery you can expect to still have quite a bit of edema.  Hump reduction removes bone and underlying cartilage while the skin is left to redrape and contract over this new skeleton.  Without examining you, I cannot say whether a hump (excess bone &/or cartilage) remains or if this is expected postoperative swelling that will take time to resolve.
Nasal surgery imparts nasal trauma to the nose.  With some of the thinnest skin on the body, nasal swelling can be significant and will ALWAYS be present after rhinoplastic surgery - primary or revision.  In fact, swelling can be worse after a revision procedure.
Be patient and discuss your concerns with your surgeon.  I ideally perform revision cases after at least 1 year has passed.  Payment for revision work is between you and your surgeon, but typically is required.  Hope this helps.

Christian L. Stallworth, MD
San Antonio Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.