Concerns about v-shaped bone and saddle shape after rhinoplasty

Question

I'm seeking advice on concerns following my rhinoplasty in 2020. After significant swelling, I've noticed a V-shaped bone at the top of my nose and a saddle shape of bridge. I've used temporary fillers, but I'm hesitant to continue this approach. My previous surgeon suggested removing part of the V-shaped bone, but I'm unsure if that will help. Are there alternatives, like closed rhinoplasty, without using ear cartilage? What would recovery look.

Eric M. Joseph, MD · Answer

Based on your photos, you do not appear to have a saddle nose deformity. That could be because you may have persistent temporary gel filler in your nose. At the root of your nose, you may have 2 small indentations. Depending on your examination, microdroplet Silikon-1000 injections may be considered for permanently raising the bridge of your nose, and for filling in visible irregularities at your nasal bone. I hope this is helpful! Sincerely, Dr Joseph

Ajaya Kashyap, MD · Answer

Thank you for your query. A minor revision using a closed approach can help as suggested by your surgeon, but fillers are also a great option, and these can last for several years. You can even consider a long lasting autologous fat grafting for the small depressed area. Please discuss your concerns with your Plastic surgeon who can help. All the best!

Mats Hagstrom, MD (license on probation) · Answer

To make equality assessment, we usually need to see a complete set of proper before and after pictures.
It’s important to differentiate if the contour irregularity is based on the shape of the bone or if there is soft tissue contribution as well.
A cartilage graft is probably going to be the most stable long-term solution.
I suggest you rely on in person consultations to get a more accurate assessment and better understanding of treatment options. 
I would be reluctant to recommend either silicone injections or fat grafting as recommended by others. 
Finding the right provider is usually the most important variable.
Best,
Mats Hagstrom MD

Concerns about v-shaped bone and saddle shape after rhinoplasty

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