My jaw surgery included a 4mm vertical rise of the maxilla and a 3mm palate expansion. My nose has changed dramatically and my surgeon claims he has never seen anything like this before. Since he's not offering me much in the way of answers I'd like to know if any of you have had a similar experience.
I'm curious if it has anything to do with my palate having been expanded?
My orthodontist also floated the theory that the excess muscle from where bone was removed may be bunching up, and that eventually that could settle.
My surgeon also says my alar width has only changed by 2mm (or 5mm depending on what day you ask him). It's possible the actual volume of my nose has changed? I do notice my nostrils have a different shape than previously. In profile it is less noticeable but from any other angle it's hard to ignore (for me, anyway)
About a month ago my surgeon did a minor procedure to pull in my nostrils (with sutures) and hopefully help improve the situation, but if anything it is now worse. It did nothing to solve the width problem, and now my nose tips up even more, giving me a weird, wide ski slope look from some angles.
If you have any knowledge or experience to offer up I'd love to hear it!
Dramatic nose change after surgery?
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Dramatic nose change after surgery?
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Re: Dramatic nose change after surgery?
My nose changed pretty dramatically after SARPE surgery last year (no impaction, expanded by 13mm), and while it is still slightly different a year later, I think most of the change was from residual swelling. It took more than 6 months for all of my swelling to go down. 6 weeks after surgery, I looked like I had a snout. Months after surgery, my nose still looked noticeably turned up with wider nostrils.
I know permanent changes to the shape of the nose are common among upper jaw surgery patients, but I'm a little surprised your Dr. didn't suggest that you wait longer before doing a nose procedure. You'll think all of the swelling is gone by 6 months post op, then another 6 go by, you look at pictures from the 6 month mark, and you realize your face was still "settling in".
What kind of surgeon did your nose surgery (same one as your jaw surgery? maxfac or oral surgeon?) ? If they're 100% positive there's no residual swelling from the jaw surgery, maybe your surgeon could refer you to a different Dr. (maybe a cosmetic surgeon?) to get your nose back to a shape you're happy with?
Sorry, I know "It might be swelling" is not a great answer to hear, and I'm not a professional so I couldn't say for sure if it's swelling or a permanent change to your nose. But hopefully, it will resolve itself over the next 6 months or so, and if it doesn't maybe you could get a different surgeon to correct the change.
I know permanent changes to the shape of the nose are common among upper jaw surgery patients, but I'm a little surprised your Dr. didn't suggest that you wait longer before doing a nose procedure. You'll think all of the swelling is gone by 6 months post op, then another 6 go by, you look at pictures from the 6 month mark, and you realize your face was still "settling in".
What kind of surgeon did your nose surgery (same one as your jaw surgery? maxfac or oral surgeon?) ? If they're 100% positive there's no residual swelling from the jaw surgery, maybe your surgeon could refer you to a different Dr. (maybe a cosmetic surgeon?) to get your nose back to a shape you're happy with?
Sorry, I know "It might be swelling" is not a great answer to hear, and I'm not a professional so I couldn't say for sure if it's swelling or a permanent change to your nose. But hopefully, it will resolve itself over the next 6 months or so, and if it doesn't maybe you could get a different surgeon to correct the change.
Treatment-
- Braces: In-Ovation L (lingual) on top, and In-Ovation R (metal) on bottom
- SARPE
- BSSO advancement
- estimated 18-22 months
- Expander installed Jan 14th 2013
- Surgery Feb 18th 2013
- Turn 26 days to 13mm. Gap between teeth maxed out at 12-13mm.
- Gap down to 7mm Apr 18
- Gap Closed Aug 6
- Expander out Sep 19
- Insurance approved, surgery scheduled for Dec 18!
Re: Dramatic nose change after surgery?
Did the nostrils eventually regain their regular shape? Mine are so flared out and that seems to be a major contributor to my current state of not quite looking like myself.
My surgeon (same one who did the jaw surgery) performed the secondary procedure a little over 7 months after my jaw surgery. When we spoke about it he said whatever residual swelling there still was wouldn't be a problem.
The thing that bugs me almost as much as not seeing my own nose in the mirror is that my surgeon performs at least one jaw surgery a week. He is quite experienced (which is why I chose him) and yet all he can tell me is that he's "never seen this before" and "doesn't know why it happened." Very frustrating. So believe it or not, you telling me it might be swelling is even more than he seems willing to admit!
I'm sure there IS still internal swelling, I'm just nervous about how much that is impacting my nose vs. how much might be permanent. How did you feel about your appearance at a year? I'm coming up on 9 months soon!
My surgeon (same one who did the jaw surgery) performed the secondary procedure a little over 7 months after my jaw surgery. When we spoke about it he said whatever residual swelling there still was wouldn't be a problem.
The thing that bugs me almost as much as not seeing my own nose in the mirror is that my surgeon performs at least one jaw surgery a week. He is quite experienced (which is why I chose him) and yet all he can tell me is that he's "never seen this before" and "doesn't know why it happened." Very frustrating. So believe it or not, you telling me it might be swelling is even more than he seems willing to admit!
I'm sure there IS still internal swelling, I'm just nervous about how much that is impacting my nose vs. how much might be permanent. How did you feel about your appearance at a year? I'm coming up on 9 months soon!
Re: Dramatic nose change after surgery?
When I was researching surgery an increase in angle was my major concern with regards to getting an impaction, because of my terrible starting point. There are documented cases where the nose changes have been pretty bad. While I was at it I also read about how the issue could be fixed, and from what I could understand, it's rather tricky (involves addition of cartilage). I believe rhinoplasty tends to increase the angle further - you can see this sometimes in celebrities that have clearly had nose jobs.
Some years back a relative was rolling out a piece of defrosted pastry, they wanted to get it even and just right (rather pointlessly I might add given it was just going to get folded up like a nappy). The problem was that the continued 'fiddling' resulted in the piece of pastry being dry, cracked and of inferior taste. Maybe it sounds weird, but in my mind it's always been the perfect analogy for plastic surgery, and especially rhinoplasty. If I were you I'd proceed only with an extremely experienced conservative plastic surgeon in this field.
Some years back a relative was rolling out a piece of defrosted pastry, they wanted to get it even and just right (rather pointlessly I might add given it was just going to get folded up like a nappy). The problem was that the continued 'fiddling' resulted in the piece of pastry being dry, cracked and of inferior taste. Maybe it sounds weird, but in my mind it's always been the perfect analogy for plastic surgery, and especially rhinoplasty. If I were you I'd proceed only with an extremely experienced conservative plastic surgeon in this field.
Re: Dramatic nose change after surgery?
mmkay, do you have links to any of the articles you read? I'd be interested to read them.
Re: Dramatic nose change after surgery?
It was about a year ago, I didn't keep any specific links but if you search for:
"nasolabial angle" impaction
You'll get a bunch of results e.g. good after shot (no before unfortunately) here:
http://content.yudu.com/Library/A1upd4/ ... ces/65.htm
Such results will often mention the issue of the nose widening, also.
As I understand it the problem is not so much that the magnitude of the change itself is often drastic, but rather if someone has a questionable/bad starting point, small changes can have a significant effect - sort of like the straw that breaks the camel's back. Sounds like maybe you don't fit into this category though.
With regards to the rhinoplasty I mainly read some responses by plastic surgeons on realself.com (all results found via google). As I recall the questions were only from people who were either born with a dodgy nose like me, or where the angle had increased due to a nose job (not jaw surgery).
"nasolabial angle" impaction
You'll get a bunch of results e.g. good after shot (no before unfortunately) here:
http://content.yudu.com/Library/A1upd4/ ... ces/65.htm
Such results will often mention the issue of the nose widening, also.
As I understand it the problem is not so much that the magnitude of the change itself is often drastic, but rather if someone has a questionable/bad starting point, small changes can have a significant effect - sort of like the straw that breaks the camel's back. Sounds like maybe you don't fit into this category though.
With regards to the rhinoplasty I mainly read some responses by plastic surgeons on realself.com (all results found via google). As I recall the questions were only from people who were either born with a dodgy nose like me, or where the angle had increased due to a nose job (not jaw surgery).
Re: Dramatic nose change after surgery?
Thanks, this is helpful. Really crossing my fingers for a natural resolution, and hopefully soon! I feel like I've been waiting to see my own face for so long, it can get hard to hold onto that hope but I'm trying. Really don't want to have to see a plastic surgeon.
Re: Dramatic nose change after surgery?
I am nearly 6 weeks post-op. I had a three piece lefort 1 and a BSSO and my nose changed a lot as well although I asked my surgeon before about the effects the surgery would have on my nose and he assured me that the effect would be really minimal. Now my nose is much wider. Also, before the operation I had asymmetrical nostrils, but it was not noticeable. Unfortunately, I found that after the surgery since my nose became wider the asymmetry is more exaggerated. I discussed this with my surgeon at my one month post-op appointment and he told me I still have some swelling and my that my nose would get better. He said he did some sort of stitch to my nose during surgery but didn't pull it tight enough for some reason? and that if later on I'm still not happy he could do the same procedure hidakat had to reduce the width of my nose base and pull my nostrils together. I am just really hoping it would settle down and become somewhat smaller because a wide nose just doesn't go well with the rest of my features and doesn't look natural. I really don't want to get into the whole plastic surgery thing as well.
hidakat, did the procedure help with reducing the width of your nose? I hope it all turns out for the best!
hidakat, did the procedure help with reducing the width of your nose? I hope it all turns out for the best!
Re: Dramatic nose change after surgery?
Unfortunately no, he was afraid to pull in the nostrils the full width we'd originally discussed and instead brought it in only 2mm--which as I understand it really isn't visible to the human eye as far as reducing nose width goes. He spoke with some colleagues and determined the muscles around the nose had been permanently stretched and that I will need to seek a rhinoplasty. Still letting that one sink in, haven't made any decisions yet.
Like you, I feel it really messes with the balance of my features.
I'm also now a little worried that this "muscle pull" could also be affecting my lips as they're much thinner than they were pre surgery. I don't know if you've experienced the same?
The good news for you is that 6 weeks is still quite early into your recovery. I still looked like I'd been punched in the face at that point, and things have improved vastly since then, so don't lose hope completely!
Like you, I feel it really messes with the balance of my features.
I'm also now a little worried that this "muscle pull" could also be affecting my lips as they're much thinner than they were pre surgery. I don't know if you've experienced the same?
The good news for you is that 6 weeks is still quite early into your recovery. I still looked like I'd been punched in the face at that point, and things have improved vastly since then, so don't lose hope completely!
Re: Dramatic nose change after surgery?
Hope it all works out! Keep us updated.
As for the lips, I felt they were thinned out at first but now they're pretty much back to normal. However, I have a different issue where one side protrudes more than the other side which also slanted downwards. My surgeon said this is because one side of my teeth (specifcally the canine) protrudes more than the other side and it must be fixed with orthdontics. He said I wont see the full results of the operation until I get it fixed, so my ortho is working on it now.
As for the lips, I felt they were thinned out at first but now they're pretty much back to normal. However, I have a different issue where one side protrudes more than the other side which also slanted downwards. My surgeon said this is because one side of my teeth (specifcally the canine) protrudes more than the other side and it must be fixed with orthdontics. He said I wont see the full results of the operation until I get it fixed, so my ortho is working on it now.
Re: Dramatic nose change after surgery?
Sorry I can't be more help. I can say that I'm very happy with my results at this point, but it's almost a year and a half after my surgery and I still have one more surgery to go. At this point, my nostrils look basically exactly the same as before surgery. My nose is a little bit more turned up. No one else would notice but me.
If you think at all that there may be residual swelling causing your nostrils to look different, I would highly highly suggest you try some methods of reducing swelling before committing to a permanent solution like rhinoplasty. I have nothing against plastic surgery, but I always think it's best to try less invasive solutions if there is no harm that will come from them. If it's as simple as taking some bromalain and arnica for a few weeks to start to feel better about it, it may save you a lot of time and money.
Something like these suggestions might help: http://thenaturalbite.com/natural-ways- ... w-surgery/
You might also try lymphatic drainage techniques that you can do at home, or other facial massages that help fluids move and drain from your face. Anything that reduces inflammation should also be good. If there are any foods that you know of that cause you to feel achy, puffy, or bloated, I would avoid them for a couple of weeks while you're trying to reduce your fluid retention.
Again, there's no guarantee that it's just residual fluid retention that's causing the effect, but it if is fluid retention in or around your nose, then you would definitely want to rule that out before choosing a more permanent and invasive correction like rhinoplasty.
xgx- I would say 6 wks post op is way way too soon to judge what your nose will look like. Like I said above, it takes quite a long time for all of the swelling to go down, and even though you may feel like it's gone it can still affect the appearance of your nose and upper lip area for quite some time.
If you think at all that there may be residual swelling causing your nostrils to look different, I would highly highly suggest you try some methods of reducing swelling before committing to a permanent solution like rhinoplasty. I have nothing against plastic surgery, but I always think it's best to try less invasive solutions if there is no harm that will come from them. If it's as simple as taking some bromalain and arnica for a few weeks to start to feel better about it, it may save you a lot of time and money.
Something like these suggestions might help: http://thenaturalbite.com/natural-ways- ... w-surgery/
You might also try lymphatic drainage techniques that you can do at home, or other facial massages that help fluids move and drain from your face. Anything that reduces inflammation should also be good. If there are any foods that you know of that cause you to feel achy, puffy, or bloated, I would avoid them for a couple of weeks while you're trying to reduce your fluid retention.
Again, there's no guarantee that it's just residual fluid retention that's causing the effect, but it if is fluid retention in or around your nose, then you would definitely want to rule that out before choosing a more permanent and invasive correction like rhinoplasty.
xgx- I would say 6 wks post op is way way too soon to judge what your nose will look like. Like I said above, it takes quite a long time for all of the swelling to go down, and even though you may feel like it's gone it can still affect the appearance of your nose and upper lip area for quite some time.
Treatment-
- Braces: In-Ovation L (lingual) on top, and In-Ovation R (metal) on bottom
- SARPE
- BSSO advancement
- estimated 18-22 months
- Expander installed Jan 14th 2013
- Surgery Feb 18th 2013
- Turn 26 days to 13mm. Gap between teeth maxed out at 12-13mm.
- Gap down to 7mm Apr 18
- Gap Closed Aug 6
- Expander out Sep 19
- Insurance approved, surgery scheduled for Dec 18!
Re: Dramatic nose change after surgery?
Thanks, I've actually come across that article before and I've been following a few of the suggestions to help things along. I have been drinking a homemade tea of turmeric, ginger and black pepper since May, and I've been using a face massaging brush twice a day for even longer than that. I drink a lot of water, I stay busy, and I eat pineapple whenever I can.
I've gotten a little bit of clarification on the "muscle pull" situation, and what I'm getting is that the muscles that are attached to the bone in that area got stretched when my palate was widened, and that in turn is pulling the tissue around my nose, so it's not a question of a pulled muscle (which would eventually heal) as I originally understood it. I've been putting off doing a rhinoplasty consultation for a while now, but I think it might be time to bite the bullet. I'm getting married in 2 months, so I couldn't do it until after that. By the time I come back from honeymoon I'll be a few weeks past the year mark. Do you think that is still too soon to consider rhinoplasty?
I've gotten a little bit of clarification on the "muscle pull" situation, and what I'm getting is that the muscles that are attached to the bone in that area got stretched when my palate was widened, and that in turn is pulling the tissue around my nose, so it's not a question of a pulled muscle (which would eventually heal) as I originally understood it. I've been putting off doing a rhinoplasty consultation for a while now, but I think it might be time to bite the bullet. I'm getting married in 2 months, so I couldn't do it until after that. By the time I come back from honeymoon I'll be a few weeks past the year mark. Do you think that is still too soon to consider rhinoplasty?
Re: Dramatic nose change after surgery?
For anyone who's curious for an update: I did wind up undergoing rhinoplasty. It turns out the aesthetic problems I was struggling with were the mark of damaged internal structures. My septum got completely twisted during upper jaw surgery and and as a result part of my cartilage collapsed.
I'm a week out now. Since going back in time is not an option, it was the right choice for me.
I've added a section to my blog called "nose diaries" where I'll track progress.
http://orthognathicadventures.weebly.com/
Thanks everyone for your support!
I'm a week out now. Since going back in time is not an option, it was the right choice for me.
I've added a section to my blog called "nose diaries" where I'll track progress.
http://orthognathicadventures.weebly.com/
Thanks everyone for your support!
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ticktickatick
- Posts: 11
- Joined: Thu Nov 01, 2012 3:17 am
Re: Dramatic nose change after surgery?
I'm a little late to the party, but my nose profile looked exactly like yours after surgery.hidakat wrote:For anyone who's curious for an update: I did wind up undergoing rhinoplasty. It turns out the aesthetic problems I was struggling with were the mark of damaged internal structures. My septum got completely twisted during upper jaw surgery and and as a result part of my cartilage collapsed.
I'm a week out now. Since going back in time is not an option, it was the right choice for me.
I've added a section to my blog called "nose diaries" where I'll track progress.
http://orthognathicadventures.weebly.com/
Thanks everyone for your support!
It took 3 MONTHS to go back to normal. Now it looks almost exactly the same as pre-op. I did not have any special sutures or anything done to the nose.
I should note that I already had a deviated septum before surgery and yet it still returned to its normal amount of crookedness or whatever. Swelling really does strange things.