Alar retraction? 5 weeks post open rhinoplasty surgery. what are my options? how soon i can fix it? (photo)

Question

5 weeks post open rhinoplasty surgery. what are my options? how soon i can fix it?

Jeffrey Marvel, MD · Answer

You do have a slight bit more retraction of the left ala compared to the right, but bear in mind you may still have edema of the tip of the nose.  When this swelling goes down, you may have less obvious retraction or none at all.  In any event re-operation is best delayed for at least 6 months.

Jeffrey Epstein, MD, FACS · Answer

Too early yet to do anything about the retracted ala.  However, in cases such as yours, I have had success with the placement of an alar rim graft, a procedure that can be done as soon as 3 months post-op, with the placement of a small strip of ear cartilage right into the area of retraction.  This procedure is done under local anesthesia most commonly.

Steven J. Smith, MD · Answer

It would be helpful to see your preoperative photos for comparison.  The alar retraction is visible in the frontal view.  Overall, your nose looks very nice and there is mild tip edema as expected at this point in your recovery.  Generally, most surgeons recommend waiting 6 months to one year to allow the swelling to subside and complete healing to occur before any revision is considered.However, another option would be to inject an HA filler in the retracted area once the skin is soft enough to allow some expansion with the injection.  Hyaluronic acid fillers (i.e., Juvederm, Restylane, etc) can be quite effective for minor postoperative rhinoplasty irregularities.  The longevity in the nose is generally good and can be repeated in the future if needed.

Jason J. Hall, MD, FACS · Answer

The alar retraction that you are seeing is there but it's still very early after surgery to think about correcting it...depending on what was done in surgery, these minor areas of retraction can take care of themselves with time.  Talk to your surgeon and have them go over options, but the general rule is that most surgeons won't re-operate on a nose for a year to let the body's natural healing occur.

Harry V. Wright, MD · Answer

sandity,Based on the photo supplied it appears that there may have been some subtle improvement since you last posted a week ago. It's still much, much too early to consider revising. Discuss with your surgeon their time frame for observing the alar retraction and revising it. I feel most surgeons would advise waiting between 6-12 months.Harry V. Wright MD, Sarasota, Florida

Alar retraction? 5 weeks post open rhinoplasty surgery. what are my options? how soon i can fix it? (photo)

Answers (5)

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