Bumps on bridge of nose after rhinoplasty. Will rasping solve this? (Photo)

Question

I had primary rhinoplasty about 7 months ago. Already at the one-month mark, I noticed irregularities on the bridge and flagged it to my surgeon. He said it would smooth out, but it hasn't, so last week I got steroid injections, however ever since then the bumps are looking worse and much more prominent than a week ago. I'm very concerned and not sure what's going on. Could it be scar tissue, a callus. Will rasping solve this?

Tyler Okland, MD · Answer

Good morning,
I'm sorry you've had this outcome. Without examining you (and seeing your previous surgeon's operative report) it's difficult to say for sure, but those bumps look either like irregularities on your dorsum (if they don't move when you push the skin), and if they do move they are likely bony shards from rasping your dorsum down during surgery.
I would not inject steroids there. The skin is thinnest on the nose in precisely the area where your bumps are, and steroids can cause dermal thinning and subcutaneous loss, which can exacerbate the bumps (making them more obvious). 
If these are bony debris in the skin it will likely resolve with time (be resorbed). If it is irregularity of the bony dorsum, this will not improve. Rasping could help but because of how thin your skin is I would probably recommend a soft tissue overlay, such as fascia from behind your ear to be laid down under the skin over your bony dorsum to camouflage any minute irregularities after rasping. 
A revision rhinoplasty specialist should be able to help you with this. Hope this is helpful, and I'm sorry you didn't have a great outcome,
Tyler Okland, MD

Eric M. Joseph, MD · Answer

It's not clear from your photos whether these white bumps are firm bony spicules or if they are related to your skin, in which case they would be soft. If they are firm, this could represent irregular fragments of bone which may get worse after a steroid injection. Believe it or not, sometimes steroid injections can leave temporary white pigmentation in the skin. If that were the case, these white pumps would feel soft. Thank you for your question. Sincerely, Dr. Joseph

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.
As far as I can see from your photos. I definitely recommend you a revision operation, but if you can send your photos in a better light from the front and side profile, we can make a more detailed evaluation.
It would be better face to face consultation.
Best Regards!

Lexie Wang, MD · Answer

These look more like a skin level issue to me than something from the undersurface of the nose, although I'm only guessing since I don't know exactly what was done during your time of surgery. I would consult with a dermatologist and see if a little laser or something could help.

Giray Genc, MD · Answer

Hello, because of bony work during rhinoplasty surgery you may feel some bone irregularities in bony area. Generally feeling it, not cause a big problem. But if it reflects view of your nose rasping or other interventions can be done

Bumps on bridge of nose after rhinoplasty. Will rasping solve this? (Photo)

Answers (5)