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Steven M. Denenberg, M.D.
Steven M. Denenberg, M.D.
rhinoplasty
 
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The nasal septum is the wall that divides the inside of the nose into a left airway and a right airway.  When the septum doesn't sit in the middle, it can obstruct airflow through the nose instead of guiding the airflow.  We then call it a "deviated septum," and that deviated or crooked septum can be straightened during a rhinoplasty.

Most commonly, the deviation of the septum cannot be seen from the outside of the nose.  The deviation that obstructs the airflow is deeper inside the nose, where you can't see it.  This patient's septum was so bad that you could see it before surgery.


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"He is a perfectionist and will honestly give you your best nose. "
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Questioner: 7 weeks post surgery, nose still looks worse/the same. Should I consider revision?
I have read from many doctors on real self by 6-8 weeks 80% of swelling after rhinoplasty should have gone. I'm 7 weeks post op and nose looks slightly worse than before op. I had the procedure as my nose was wide and pointed before. When I smiled my nostrils flared out and upwards, the tip pointed dropped down pointed into my teeth, as well as the whole thing looking wider. Nothing has changed post op. Should I consider revision?
(Questioner submitted photos)

Dr. Denenberg's answer: Your nose still looks long to me
These photos don't show your entire face, and there are no *true* profiles, but it seems that one of the main changes you nose required was to shorten it, raising the tip upwards.

Unfortunately, the tip doesn't tend to elevate with time. I would much rather that my patients are nervous because the tip is too high at seven weeks, than they be nervous because the tip is too low.

To get a substantial elevation of the tip, you will probably need a revision rhinoplasty. Elevating the tip, even during a revision, is quite predictable, if the doctor is expert at making those changes during a revision, so you must see a doctor's before and after photos before you have the operation. See the attached video and Web reference link for examples of what can be done in the right hands.

Link to this question on RealSelf.com



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