Question:

I had a closed rhinoplasty six weeks ago to remove a hump on my nose, however no tip work was done. I have since seen my surgeon after the operation and a slight bump has developed on the end of my bridge causing a pollybeak appearance. I am very stressed about it as it doesn't make my nose look that much better or different from before.

My surgeon has told me that he could do a minor operation to remove the cartilage creating the bump, under a local anaesthetic, but I am worried about going under local and would prefer general. He also said he could do this operation so soon after the primary rhinoplasty, when I thought you had to wait a year.

I am also unsure whether I need tip work now because I feel my tip is still big from the side profile.

Answer:

Six weeks after a rhinoplasty is a difficult time to assess what the final result will be due to swelling. This is why it is common to wait a full year to assess the final result before planning a revision. In the early post-operative period though if a surgeon feels that a problem is not due to swelling alone they may advise an early revision surgery.

Pollybeak deformity or supratip fullness could be due to excess cartilage or swelling, if the problem is excess cartilage a revision will be required. That surgery can be performed under local or general anaesthetic and is at the preference of the patient as well as surgeon with different people favouring different options. With regard to the tip, it will certainly be swollen so soon after a rhinoplasty and this swelling will resolve over time to give you the tip you started with before the rhinoplasty.

My advice would be that nothing is lost by waiting until the post-operative swelling resolves and prior to any revision surgery a clear plan is agreed upon between yourself and surgeon as to what the goals of surgery are going to be.

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