Why has my previously straight nose healed crooked after Rhinoplasty? (photos)

Question

My nose was straight(ish) before (the tip slightly curved but it wasnt noticeable). My surgeon took down dorsal hump and corrected slightly deviated septum, and now it is a mess, the bridge is pushed far to the left. What reason would it have healed like this? It was straight after my cast was removed. Will revising this be challenging? I also want my bridge taken down further and tip taken in and lifted. Thanks

Steven M. Denenberg, MD · Answer

There are a million reasons a nose can appear crooked after surgery. It can be something unknown about the healing, scar tissue pulling on a cartilage. It can be because the septum was very crooked close to the bridge of the nose, and taking down the bump exposed that crooked septum. It can have to do with the skill of the surgeon.It's usually possible to improve the symmetry in a revision operation, especially if you want more of the bridge taken down: that often gives more options for how to correct the asymmetry.Lifting and taking in  the tip involved advanced techniques, so be sure you see before and after photos before proceeding.

William McClure, MD · Answer

Thank you for your question. Your nose is "crooked" following surgery. It appears that reducing the "hump" exposed the underlying crookedness of your nose, (though it's difficult to tell from a single photo). This is not uncommon. Technically speaking you would require further work to correct a pre-existing problem as opposed to a revision. Lowering the "bridge" more and changing the tip would be a revision. Revisional surgery is a part of doing rhinoplasties, since there is always some unpredictability in the results. I tell my patients that there is a 10 to 15% chance of requiring revision. Typically there is no charge for the procedure other than covering operating room expenses. It is important not to rush into surgery since it is many months until one sees the final result. Best wishes to you.

Brian J. Reagan, MD · Answer

Unfortunately a revision is necessary.  Even in the best of hands, rhinoplasty revision rates are reported to be 5-10 %.  Return to your surgeon to discuss your concerns.  Generally such a revision is done at a very reduced cost.  The good news is that it can be fixed!All the Best,Dr. Brian Reagan

William Portuese, MD · Answer

A revision rhinoplasty will be required to straighten the crooked nose. Osteotomies placed in the nasal bones can accomplish  straightening them. A cartilaginous  spreader graft will also be required to be placed underneath the concave upper lateral cartilage in the midportion of the nose. Yes, this is a challenge because  revision rhinoplasty for a crooked nose can be one of the most difficult procedures to perform correctly in the entire field of cosmetic surgery, so choose your surgeon very wisely based on  extensive experience

Matthew Hansen, MBBS, FRACS (retired) · Answer

Thanks for your question. From the frontal pictures provided it does look like your nose is more deviated now than before the surgery but more photos from different angles would be needed to make a full assessment. When your cast was first removed there would have been more swelling which can mask deviation but it is also possible that your nose was unstable and that relatively minor trauma may have cased things to shift. Most good Rhinoplasty surgeons try to ensure the structure of your reshaped nose is stable at the end of the operation so that the long term result is more predictable and in line with the preoperative plan. You should discuss your concerns with your surgeon but if you are unhappy with the result of that discussion then seek a second opinion from an experienced rhinoplasty surgeon (not just one who advertises a lot or has a large web presence). Correcting your problem should be possible but will be greatly assisted if you can bring preoperative photos and precise details of the operation performed to whoever you are consulting with

Why has my previously straight nose healed crooked after Rhinoplasty? (photos)

Answers (5)

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