Ask the Doctor: Can my nose twist after nose surgery?

Yes, after rhinoplasty (nose surgery), there is a possibility that the nose can become twisted or deviated from its intended position. There are several reasons this could happen:

1. Post-Surgical Swelling: After surgery, the nose will naturally swell. As the swelling subsides, it might do so unevenly, which could give the appearance of a twisted nose temporarily.
2. Healing Process: Everyone’s body heals differently, and sometimes the healing process can cause the tissues to contract asymmetrically. This can result in a nose that appears crooked or off-center.
3. Surgical Technique: The outcome of the surgery can be influenced by the technique used, the extent of the changes made, and the surgeon’s experience. Choose a board-certified facial plastic surgeon with experience in rhinoplasty to reduce the risk of undesirable outcomes.
4. Pre-existing Asymmetry: Sometimes, a patient might have had a slight asymmetry before the surgery that becomes more noticeable after the procedure, especially if the surgery didn’t adequately address it.
5. Trauma: Any trauma or injury to the nose during the recovery phase can affect the final outcome, potentially leading to a twisted appearance.
6. Cartilage Warping: Cartilage grafts, which are sometimes used in rhinoplasty to provide support or augment the nose’s structure, can warp or shift over time, leading to a twisted or asymmetric appearance.
7. Scar Tissue: The formation of scar tissue inside the nose can sometimes lead to asymmetry or a twisted appearance.

If someone believes their nose is becoming twisted or asymmetric after surgery, it’s crucial to communicate with the surgeon. They can provide guidance on whether the change is temporary due to swelling or if it’s something that might require intervention or revision surgery. Remember, the final results of a rhinoplasty can take up to a year (or sometimes longer) to become fully apparent due to the slow resolution of internal swelling and tissue settling.