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Nose tip swollen, hurts. Had rhinoplasty three years ago. Advise for other procedure or treatment?

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ENT Specialist
Practicing since : 1991
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I had rhinoplasty three years ago. The tip is still swollen, and crooked. It also hurts when I put pressure on it. I think something was left behind. There is also way more cartilege that seems to have moved down into the left cavity causing a smaller airway. There is plenty of room to breath, just annoying.
Why would the tip still be swollen? Also, why does it hurt when I pinch it (ex. blowing my nose stings)? Would you advise another procedure? Do you know good rhinoplasty surgeons close to Indianpolis area?
Posted Tue, 22 May 2012 in Ear, Nose and Throat Problems
Answered by Dr. Sumit Bhatti 4 hours later

Thank you for your query.

1. Do you have any written details about the surgical steps taken during your rhinoplasty? That would be the best guide as to the reason for the tenderness at the nasal tip.

2. A CT Scan is another way to see what changes have taken place.

3. Most probably, as you have felt, the cartilage used to augment the tip has moved and changed the nasal valve area leading to increased resistance in the left nasal airway.

4. If you do a Cottle's test: Place your palm or two fingers on the left cheek and press the cheek away from the nose, does your left nostril open up? If your nasal airway opens up, then surgery will help.

5. Tenderness and swelling of the nasal tip may represent chondritis (inflammation of the cartilage). This may also occur spontaneously or if any part of the cartilage is exposed or handled often. You may discuss with your physician for medication to relieve the pain and inflammation.

6. Sometimes, a foreign body reaction may be present. The nose may also sting on blowing as the air shears the inner lining (mucosa) where there are sharp edges of cartilage. Dryness in the nasal mucosa (possibly scarring and synechiae from the previous surgery) is another reason. Neuromas (small nerves damaged during normal incisions and surgery) can cause pain and altered sensations for many years.

7. If medication controls your discomfort, I would not recommend another revision surgery. If your slight nasal blockage is annoying, you may proceed for surgical evaluation.

8. You need a revision surgery. You may search local blogs for revision nose surgery / surgeons. Here are some suggestions:
Facial Plastic and Reconstructive Surgery
San XXXXXXX Face and Neck Specialties
University of California, San XXXXXXX Medical Center
Director of Facial Plastic and Reconstructive Surgery
Division of Otolaryngology-HNS
University of Utah School of Medicine
Salt Lake City, UT, USA
Division of Facial Plastic and Reconstructive Surgery
Department of Otolaryngology – Head and Neck Surgery
University of Illinois at Chicago
Chicago, IL, USA

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

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