Why does my nose still look crooked after rhinoplasty?

I am four weeks post-op and my nose still looks crooked. I had really hoped this rhinoplasty would give me the nose I dreamed about having but now it looks almost as bad as it did before surgery. Could it just look crooked because the swelling has yet to go down? Is there a chance that it is still crooked?

Consensus

  • It is normal for some temporary nasal distortion to occur during the healing process following a rhinoplasty procedure. This is because swelling in the bridge of the nose will usually subside long before swelling in the nasal tip goes down.
  • The temporary nasal deviation that you experience during the recovery process should correct itself within six months to one year.
  • It is very uncommon for permanent nasal deviation to appear within the first months of recovery. Permanent nasal deviation would only be visible towards the one year mark following the procedure, as swelling in the nasal tip subsides.
  • If a deviation remains visible after 12 months, speak with your plastic surgeon about the possibility of rhinoplasty revision surgery.

The consensus is based on 5 doctor replies to this question. For more details, scroll down to read them.


Sorry for your problem but both your statements may be correct.  So be patient but express your concerns to your surgeon 

Dr Corbin

www.noseexpert.com

Dr. Frederic Corbin has 1 Nose job before & after:

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Don’t worry if you still have a crooked nose four weeks after nose reshaping surgery. It will take time for your nose to assume its new position.

The way your nose heals and straightens is largely a function of what actions the surgeon took during surgery.

Crooked bones in the upper third of the nose are easy to repair. The surgeon usually fractures the bones and realigns them (osteotomy) and the success rate of this technique is high.

Crooked cartilage in the middle third of the nose is relatively easy to repair. In many cases the surgeon will cut the cartilage of the septum as well as the upper lateral cartilage; some suturing and, possibly, cartilage grafting, will likely be necessary. I often intentionally overcorrect the other side of the midline to encourage a successful correction. The cartilage can always return to its previous position but this is not the norm.

Misshapen cartilage in the lower third of the nose is the most difficult to repair. The reason for this is twofold: first, because the cartilage of the nasal tip is the weakest nasal cartilage and second, because the cartilage isn’t connected to anything solid, which makes it very difficult to prevent scarring.

Nevertheless, in my experience with rhinoplasty and revision rhinoplasty, it is very uncommon for lasting nasal crookedness to appear just four weeks after a nose job. Usually the crookedness is due to asymmetrical swelling or blood accumulation, and this is likely what is happening in your case.

Generally speaking, plastic surgery to straighten a crooked nose is a very difficult and complex procedure. If you had rhinoplasty due to a broken nose, for example, the nasal bones may be severely damaged and the cartilage of the nasal septum compromised. In these instances it is not always feasible to achieve a perfectly straight nose through cosmetic surgery.

However, since it’s only been four weeks since your surgery, the crookedness you’re noticing is probably caused by asymmetric swelling. Most of this swelling will subside within three months, and the rest will subside as time goes on.

Give your nose some time to heal. In the meantime your surgeon will be able to advise you on how best to reduce any swelling.

Alexander Ovchinsky has 10 Revision Rhinoplasty before & afters:

Revision Rhinoplasty before image performed by Dr. Alexander OvchinskyRevision Rhinoplasty after image performed by Dr. Alexander OvchinskyRevision Rhinoplasty before image performed by Dr. Alexander OvchinskyRevision Rhinoplasty after image performed by Dr. Alexander OvchinskyRevision Rhinoplasty before image performed by Dr. Alexander OvchinskyRevision Rhinoplasty after image performed by Dr. Alexander OvchinskyRhinoplasty (nose job) before image performed by Dr. Alexander OvchinskyRhinoplasty (nose job) after image performed by Dr. Alexander Ovchinsky

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It’s normal if certain features of your nose look crooked following rhinoplasty surgery. Many patients have minor crookedness as a result of swelling for a period of weeks or months afterward but ultimately end up with a symmetrical nose and great results.

That being said, in an ideal scenario, the nose should be relatively straight when the cast is removed, with even swelling and, possibly, a mark from the splint. A significantly deviated septum at this stage probably does mean you will continue to have a deviated nose in the future. If your nose only looks slightly crooked, it’s probably just normal swelling.

As you stated, you only had nasal surgery four weeks ago. If your surgeon performed the procedure using the open approach, swelling in the nose tip will probably be what lasts the longest.

I recommend that you visit your surgeon for a full evaluation.

The crooked appearance is probably due to asymmetric post-operative swelling, i.e., uneven swelling. This is very normal and not a cause for concern, particularly for the first few weeks after nose surgery.

Note that swelling in the bridge will usually subside before nasal tip swelling goes down. Also be aware that a bulbous tip caused by postoperative swelling usually takes six months to a year to subside. I tell my patients that it can take up to a year for the final results of their surgery to take hold. I suggest you wait a few months before concluding that the nasal swelling or crookedness is a problem.

Your surgeon will further advise you about how to reduce the swelling. They will evaluate you and let you know what to realistically expect with regard to the progress of your results.

Dr. Frederic Corbin has 1 Nose job before & after:

Nose job before image performed by Dr. Frederic CorbinNose job after image performed by Dr. Frederic Corbin

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