BonBoz Clinic

Rhinoplasty

Deviated nose after rhinoplasty

Nasal deviation following rhinoplasty can be attributed to two possibilities: temporary asymmetry due to uneven swelling during the first 2–4 weeks, which resolves on its own once the swelling subsides; or true deviation caused by implant shifting, cartilage graft warping, trauma, or improper splinting. True deviation detected within the first 1–2 weeks can be manually realigned and re-splinted; if detected later, revision surgery must wait until the tissues have stabilized.

Medically reviewed by BS.Ths.CKII Nguyễn Xuân Vũ — BonBoz Clinic

Swelling Asymmetry or True Deviation?

Post-operative swelling is rarely symmetrical on both sides, which is why your nose will almost always look slightly crooked during the first week—this is completely normal and something your surgeon will have mentioned beforehand. True deviation, on the other hand, presents as a visibly misaligned nasal bridge axis when viewed from below, a palpable tilt of the implant, or a nasal tip rotated to one side that does not improve as swelling subsides.

Causes of True Deviation

Implant displacement when the surgical pocket is too wide or due to early accidental impact; cartilage graft warping over time (costal cartilage has this tendency if not properly carved and handled); premature splint removal or splint displacement; sleeping on your side with pressure on the nose or wearing heavy eyeglasses during the first month; and pre-existing bony/cartilaginous framework deviation that was not fully corrected during the initial surgery.

Why Should You Contact Your Doctor Early?

During the first 1–2 weeks, before the tissues have fully adhered and healed, your doctor can manually adjust the alignment and re-splint the nose without the need for surgery. After 4–6 weeks, the materials become firmly integrated into the surrounding tissue, and manual manipulation is no longer effective; at that point, you must wait about 6 months for the tissue to stabilize before undergoing revision surgery. Do not attempt to self-adjust your nose or adopt a 'wait and see' approach for too long.

What You Can Do to Minimize the Risk of Deviation

Keep the nasal splint on for the exact duration instructed by your doctor, sleep on your back with your head elevated for 2–4 weeks, avoid wearing eyeglasses that rest on the nasal bridge for at least 4–6 weeks, avoid accidental impacts and prolonged head-down posture, and attend all scheduled follow-up visits so your doctor can evaluate the nasal axis.

What BonBoz Does

Our doctors examine you promptly as soon as you report any concern of deviation: distinguishing between swelling asymmetry and true deviation, readjusting the splint or performing manual alignment if you are still within the golden window, or establishing a monitoring and revision plan once the tissues stabilize. Every rhinoplasty case at BonBoz includes a structured follow-up schedule to catch any such issues early.

Severity levels

1

Swelling-induced asymmetry (Weeks 1–4)

Uneven swelling on both sides; nasal bridge axis remains straight upon palpation. Continue monitoring, keep the splint in place, and attend follow-up visits as scheduled.

2

Early-detected mild deviation (≤2 weeks)

Mild bridge deviation; tissues have not yet fully adhered. Can be manually adjusted and re-splinted at the clinic.

3

Pronounced, late-detected deviation

Visible axis deviation after swelling subsides. Wait for tissues to stabilize (6 months) before revision surgery—often combined with structural framework correction.

When should you see a doctor?

  • After 4 weeks, swelling has subsided, but the nose remains visibly deviated when viewed from below.
  • You can feel a tilted nasal bridge or an uneven bump on one side.
  • Your nose has recently sustained an impact, or you notice the splint has shifted or come off prematurely.
  • Deviation accompanied by pain, redness, and warmth—infection must be ruled out.

How BonBoz treats it

Early Follow-Up and Realignment

Within the first 1–2 weeks, manual realignment and re-splinting can be performed at the clinic if the tissues have not yet fully adhered.

Learn about this method →

Surgical Revision After Tissue Stabilization

Repositioning the implant, adjusting the framework, or replacing it with autologous cartilage, depending on the underlying cause.

Learn about this method →

Post-Op Care Instructions to Prevent Displacement

Splinting, sleeping positions, eyewear use, and avoiding impacts — the doctor provides specific instructions after each procedure.

Learn about this method →

Cost guidance

Early adjustments during scheduled follow-up visits are included at no extra charge for rhinoplasty procedures performed at BonBoz. Surgical correction for deviation after the nose has fully stabilized is treated as revision surgery — the doctor will provide details following an examination.

The final price follows the doctor’s recommendation after an in-person exam. A confirmed quote has no hidden extras.

Chân dung BS.Ths.CKII Nguyễn Xuân Vũ

BS.Ths.CKII Nguyễn Xuân Vũ

Department of Plastic and Aesthetic Surgery

  • Master of Medicine and Pharmacy — Specialist Level I Surgical Resident, Hue University of Medicine and Pharmacy (2014–2017)
  • Specialist Level II Doctor in Plastic and Aesthetic Surgery
  • Specialist Level I in Plastic and Aesthetic Surgery — Pham Ngoc Thach University of Medicine; Specialist Level II in Healthcare Management — University of Public Health
  • Specialty Certificate in Orthopedics and Traumatology and Certificate in Plastic and Aesthetic Surgery (2017)
  • Medical Practice License No.: 007827/ĐL-CCHN — Issued by Dak Lak Province Department of Health on 04/12/2017
  • Over 15 years of experience, more than 20,000 surgeries
  • Specialist Level II Doctor in Plastic and Aesthetic Surgery at Ho Chi Minh City Hospital of Dermatology (2020–present); previously Lead surgeon for major and minor procedures at Sao Han Hospital (2018–2020)
  • Member of international humanitarian organizations Operation Smile and ReSurge International — performing pro bono reconstructive surgeries for patients with congenital deformities, cleft lip, cleft palate, and ptosis (2022–present)
  • Affiliated with Alcon Pharmaceutical (USA)
  • Member of the Korean College of Cosmetic Surgery (KCCS)
  • Medical Director of BonBoz Clinic
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Frequently asked questions

How long does swelling-induced asymmetry last after rhinoplasty?

Most swelling subsides after 2–4 weeks; symmetry gradually improves over 1–3 months. If significant asymmetry persists beyond 4 weeks, a follow-up examination is recommended.

Can I massage my nose at home?

No. Incorrect massage can worsen asymmetry or damage the skin. Let your doctor examine and perform any necessary adjustments.

When can I wear glasses after rhinoplasty?

Heavy-framed glasses that press on the bridge should be avoided for 4–6 weeks; contact lenses can be used sooner as advised.

Can sleeping on my side cause my nose to become crooked?

It can during the first month, especially if your face presses against the pillow. Sleeping on your back with an elevated pillow is the safest option.

Can rib cartilage warp?

It has a tendency to if not properly carved; experienced surgeons process the cartilage to minimize this risk. Warping typically becomes apparent after several months.

Can a crooked nose affect breathing?

Potentially, if the septum or nasal valves are affected. Have your breathing function checked if you experience unilateral nasal obstruction.

Does correcting asymmetry require removing all materials?

It depends on the cause: sometimes only repositioning is needed; if the skin is thin or the material is unsuitable, it may be replaced with autologous cartilage.

Does mild asymmetry require revision surgery?

Not necessarily. Very mild asymmetry that doesn't affect aesthetics when viewed straight on may be acceptable; the decision should be made after discussing with your doctor.

How long after rhinoplasty can the final shape be assessed?

Approximately 6–12 months; the nasal tip is the last area for swelling to resolve.

Who handles follow-up at BonBoz?

The primary surgeon directly conducts follow-up examinations and treatments — not delegated to others.

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