I need to know what is wrong with my nose? I had rhinoplasty done 8 months ago.
Doctor Answers 3
Thank you for your clinical post and photographs. Although difficult to tell without pre-operative photos as you have stated there is a significant improvement in your nasal appearance, contour and shape and nasal facial proportion. There is still some residual asymmetry particularly the alar base, the left ala being somewhat more obtuse and wider than the right alar base and there appears to be some asymmetry of the nasal dome and lower lateral cartilages. It is quite common for the nasal tip to still be bulbous at 8 months and slow resolution of nasal tip anatomy can take 12-14 months. There may be some lateral nasal side wall asymmetry and some degree of internal valve collapse.
In general, most experienced rhinoplasty surgeons will not suggest a revision surgery to the nasal tip for at least 12 months following the original procedure. At that time a careful evaluation of the pre and post-operative photographs and current clinical anesthetic concerns that you have would be warranted. Depending on your levels of expectation, the enhancement that may be required, digital imaging performed by your primary rhinoplasty surgeon can be performed in order to determine if a secondary rhinoplasty will be of help in you achieving your goals. It is very important to have realistic sense of expectation of outcome as secondary rhinoplasty can be fraught with apparel in that the results are generally not as substantive as the first procedure especially when the first procedure improved significantly the appearance of the nose.
I would revisit with your operating surgeon discussing any functional aesthetic concerns you have and then follow-up at one year to see if any enhancement surgery can improve concerns that you have at that time.
Occasionally while waiting for that 12 month point internal valve collapse, nasal side wall asymmetries and even nasal tip asymmetry can be improved with the subtle use of soft tissue injectables such as Restylane and Juvederm. I was trained in both plastic surgery and ear, nose, throat, head an neck oncology and craniofacial trauma and have been using soft tissue fillers to camouflage subtle post rhinoplasty regulators that often resolve with time with soft tissue filler aiding in the aesthetic appearance until the resolution of the asymmetry or swelling.
Additionally, occasionally the use of anti-inflammatory injectables such as Kenalog can reduce soft tissue swelling edema and hasten resolution of your overall final result.
I hope this helps and best of luck.
For more information, please review the link below.
R. Stephen Mulholland, M.D.
Certified Plastic Surgeon