Dent in nose and uneven closed rhinoplasty - is this a collapse? How can it be fixed? (Photos)

Question

I had gotten a closed rhinoplasty may of 2023 for my nose. I have a few concerns since and feel as though it’s a good time to judge after 2 1/2 years. I have noticed some contouring & lines that appeared after on side side and also unevenness. The right side on the photo you will see it almsot sunken in causing a noticable line especially when smiling. I also notice a dent on the side where my nose divets inwards. The on the left side it sticks out quite a bit causing an even more uneven look. I have had many people comment on this and they all noticed the difference. Is this a collapse?

Luis A. Mejia, MD · Answer

What you’re describing is a valid concern, especially this far out from surgery. At 2½ years after a closed rhinoplasty, what you’re noticing is not normal swelling. In my opinion, the denting and asymmetry especially the area that sinks in when you smile are most consistent with loss of cartilage support or a partial collapse on that side, which makes the opposite side look more prominent.
 
When this happens, the appropriate solution is usually a structural revision rhinoplasty using cartilage grafts to restore support and smooth the contour. Fillers may hide a small dent temporarily, but they don’t fix the underlying problem.

Whenever you’re ready.
Let’s make it better.

Warmly,
Dr. Luis Mejía, MD
Board-Certified Plastic Surgeon
CECILIP – Dominican Republic

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you may benefit from a revision rhinoplasty. A surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose. Fascial grafts may also be used to help improve tip refinement. This can be designed to improve the symmetry of your nasal tip. 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

Dent in nose and uneven closed rhinoplasty - is this a collapse? How can it be fixed? (Photos)

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