Nasal width post surgery and plates?

[jusken]

So I've been investigating my discontent with my nose post surgery and have come to the conclusion that most of it is due to these enormous plates right underneath my nostrils.  I asked for the scan data my surgeon took and used Slicer to create a 3d model of this data.  Here is what it looks like (there's quite a bit of artifacting going on here but I think it clearly shows the problem):



I'm not sure why there's a giant step-off on the plates, but it definitely protrudes a lot and certainly flares my nose because of that.  I can say that removal of these plates likely won't make it look exactly like it used to, but will relieve these concerns a lot.  Anyone who has had jaw surgery and has issues with the flaring of their nostrils should probably first check to see if they have these large step-off plates. 

I know I've seen several users here talk about getting rhino work done post-op.  I feel like this might help out some of you who have had similar concerns...

[PloskoPlus]

The side walls of the nasal bone slope at an angle- it's like this for practically every person.  If you move the upper jaw cutting below or slightly above the premaxilla  (where the upper meets the base of the nose) it's going to change this angle (that step pff you're referring to).  A surgeon that says otherwise is crap. I've pressed them about this question and some will lie and others will say it's a "slight change to no change to the nose".  Uh, sure....

Anyhow, a nose job is probably needed after jaw surgery.  You can get your alar trimmed or laced from the base and the results look good.

My cut was a couple of millimeters higher.  My nose did not change much from the front ie. still big.  I would have needed a nose job regardless.

[jusken]

27F: Looking at the picture I linked and the fact that I can feel these plates raised high above the bone, you still believe what you just said in my case?  I don't.  I think simply removing the plates will alleviate most of my concerns.  There is a huge hole between those plate step-offs, not bone. 

Anyway we'll see.  I feel that removing these plates first is the right way to go.

[jusken]

I thought I'd make an illustration of my last point here:



The GREEN area is the volume the will be removed from my nasal base by removing the plates.

The BLUE region is a plate, not bone.  Just in case there was confusion.

The ORANGE line is where the base of my nose rests.  RIGHT on top of the plate.  This is strongly suggestive that removing that GREEN volume will return my nose back to its original shape more (as I'm only concerned about the flare right at the sides).

I feel that anyone with a similar plate situation as me, who got rhinoplasty without removing the plates first, would be making a horrible mistake.  That's part of the reason I started this thread.

Again, I'll report back after the plate operation.  I've scheduled it in April.

[PloskoPlus]

Do you expect to be swollen from this operation?  Is there a chance of numbness?

[jusken]

I've spoken with a couple members here and read many accounts of having this hardware removal done.  Most of them have swelling for a week or two and zero change in numbness from the original surgery.  There are a few where the swelling lasted longer, but most of them I think were because it was an infection scenario from the original surgery. 

I expect this to be a very simple, low risk procedure.  Then again, I have another talk with Gunson in the coming weeks to ask any additional questions about the risks.