Concerned about in office rasping results (Photo)

Question

Hello! I had a primary preservation rhinoplasty in May 2023. Pretty soon after, I had spring back of my bridge (confirmed by surgeron) that continued to get worse. My surgeon said this could be corrected with in office rasping, with local anesthesia. I am 5 weeks out from the procedure and worried because my nose looks worse. The bridge appears flatter and wider, the hump is still there, and now it looks crooked. Will I need a revision? Can I still get my expected results? Thank you!

Gurkan Kayabasoglu, MD · Answer

hello. Firstly I feel sorry that you live trough this after your surgery. 
In my opinion, the autootomy, that is, the shaping of the bones, was not done well enough in your surgery. For this reason, the upper part and the lower part are different widths. The correction you want will not be possible with a rasp alone.

You need a well-planned osteoplasty (bone shaping) and a cartilage nose tip adapted to the new bone shape. So I can say that a complete revision is required. Thus, the curvature you mentioned can also be corrected.

If you need more information you may always contact with my assistant Dila trough this number +90 533 015 95 95 via WhatsApp.

hope this helped.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. I don’t recommend having rasping performed under local anesthesia. This will usually make the nose look better for 1-2 months and then it will actually get much worse long-term afterwards, with contour irregularities developing. This is because the skin of the dorsum is extremely thin. A much better approach is to do a formal revision with rasping and placement of a dorsal onlay fascial graft to help smooth the dorsum. Based on your photographs, you may benefit from nasal tip deprojection during your revision. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

William Portuese, MD · Answer

From these photographs, you do appear to have a crooked nose, open roof, deformity and continued residual hump, which is composed about bone and cartilage. Rasping will only accomplish removing a boney hump, not a cartilaginous hump. You going to need to wait at least one year before undergoing revision rhinoplasty to reset your nasal bones straight, and shave down the dorsal hump and close the open roof that has been created as well.

Concerned about in office rasping results (Photo)

Answers (3)

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