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OPEN ROOF post op - please help

OPEN ROOF post op - please help

Postby jlsNJ » Sun Nov 12, 2006 11:45 pm

I am 6 months post op and I think I have what has been referred to as an "open roof." There's a dent on the bridge of my nose and although it is not extremely noticable, I can feel it. It feels like there is a hole on my bridge. It also looks a little black and blue in the spot where the hole is, it could be a vein. My bridgem seems very wide for 6 months post open and I wonder if it is because the bones didn't fuse together.

After surgery the doctor said that if became noticable when the swelling went down he could inject a filler. Does anyone have any information about this/share a common experience?

Thanks.
jlsNJ
 
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injectable fillers

Postby tempusfugit » Mon Nov 13, 2006 8:39 am

hi there,
here's a good website that shows exactly what can be achieved with injectable fillers. there's one really good before photo of a woman with open-roof deformity and then an after photo showing a good improvement.
the downside is they only last 3-6 months and the long-term effects of multiple injections isn't known.

http://www.westsidemedicalspa.com/before_after.html

tf
tempusfugit
 
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Postby voyager » Mon Nov 13, 2006 3:22 pm

Here's a good link w/open roof deformity explained:

http://www.therhinoplastycenter.com/Com ... ons14.html

V
voyager
 
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Postby rhinogirl76 » Wed Nov 15, 2006 12:48 pm

Hey, sorry to hear about your open roof situation. I think the same thing is happening to me. Did you surgeon admit that it was an actual open roof deformity? Did he suggest a revision? Did he say if this was endangering the strength of the nose? I'm trying to get in touch with my surgeon about it but he hasn't replied yet. Let me know what you have learned. Do you think you will need a graft? And do you know how long until he can do a revision? Sorry it's a lot of questions but i'm freaking out.

THanks
rhinogirl76
 
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Postby thicklids » Wed Nov 15, 2006 2:52 pm

Hi!
How do you know it's open roof deformity? Did it start with a bump on your nose or do you actually feel a hole in your nose?
thicklids
 
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Postby voyager » Wed Nov 15, 2006 3:55 pm

If you scroll down to the middle of the page of this link, look at the diagram on the left(I think you can click on it to enlarge).

http://www.plasticsurgery4u.com/procedu ... _hump.html

Though it's not a "open roof deformity" case, even so, the diagram shows how "open roof" could occur if osteotomy(infracture) is not performed(pic on left), and how it is corrected w/osteotomy(on right).

V
voyager
 
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Postby rhinogirl76 » Wed Nov 15, 2006 7:27 pm

Both, it started with a little bump and then i i noticed a hole whike touching the top of my nose. My nose is uneven, on one side it slopes down and on the other curves in. Does that make sense? Any how when i touch my nose, the bridge of my nose, it feels as though my septum is exposed, unprotected on the left side. I have bone on the right side, the side that curves in and there is a hole on the left side, the side that slopes down. I've tried to get in touch with my surgeon and address my concerns and he is not getting back to me. I'm getting really mad. So far he's been really good but i can tell that his staff is tired of me and is being unhelpful!!!! Also on the left side of my nose, i'm starting to have difficulties breathing. It seems that the more the swelling goes down the harder it is to breathe.
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Postby jlsNJ » Thu Nov 16, 2006 7:09 pm

The only reason I suggested possible open roof is because it is the only thing that I've found through research that could explain it. It could be something else...

I have bone on both sides of my bridge but there is a dent about halfway down. Almost like there's a space where the bone doesn't come together. As a result, this little area was blue, like a bruise.

When I went to the doctor on Monday, he didn't mention open roof. He said that it is not a dent, but some of the bone on the bridge did grow back on one side and made it seem like a dent below the bump. I don't know if i buy it because when I press on the spot there really doesn't feel like there's any bone.

Regardless, he gave me a radiesse injection. It helped the dent, gave me a small bump on the bridge, and a bruise. Pretty good result though.

Whatever it is, I don't know that it is a big enough deal that I would go through a revision. I'm just going to wait out the next 6 months, then consider my options.
jlsNJ
 
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Postby rhinogirl76 » Thu Nov 16, 2006 9:03 pm

Dumb question--At this point, there is no chance for the bones to grow right? What you are describing is very similar to what i'm experiencing although on top of it one side of my nose is totally different than the other. I'm hoping that there still may be some swelling and that i even out! This process is just a lot harder and longer than i ever though it would be.

About the injection, is it the kind of injection you would need to get every six months?

Are there any injections that can stimulate bone growth? This last question may be sound pretty dumb also...I'm a little desperate/freaking out so i might have lost all common sense. Sorry if that's the case. :oops:
rhinogirl76
 
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Postby voyager » Fri Nov 17, 2006 9:41 am

Hi rg76,

No dumb ?'s zone :o

You asked:
At this point, there is no chance for the bones to grow right?


There is a chance for regrowth and other assymetries to appear post op. Here's a reply I got(directly from a ps) from another msg boards q&a section:

Surgeons reply(edited)
Postop, occasionally the following can occur especially in patients with traumatic nasal deformity which may explain the situation:

1. scar tissue can develop in any and all areas of the nose including the bridge
2. you could develop a process called osteoneogenesis where small bone spicules that form around the areas that are rasped

I would wait a full year and if your problem exists, I would see a rhinoplasty expert and consider revising the problem. You may want to have osteotomies this time to make sure the bones are realligned.
Babak Azizzadeh, M.D., F.A.C.S.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Regarding fillers: Injectibles are temporary and may lead to further issues.

Do a keyword search on injectibles, fillers, etc in the search box on this site and rhinoplasty4you.com msg board.

V.[/i]
voyager
 
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Postby rhinogirl76 » Fri Nov 17, 2006 2:03 pm

Thanks voyager. I know i just need to be patient and suck in in, who knows it might even out and look better in a couple of months, let's hope for that. I just have to listen to your wisdom and take the wait and see approach.

Thanks again.
rhinogirl76
 
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Postby voyager » Fri Nov 17, 2006 2:58 pm

...you're not alone...

I'm constantly singing a Tom Petty song: The waiting is the hardest part :wink:
voyager
 
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Postby jennylb » Sat Nov 18, 2006 7:54 pm

I had to laugh when I read this...I just posted a similiar question, I just had a revision done because I could see dents on the sides of my nose and they made me look like I had a bump on my nose again. My 2nd looks great, my bridge is straight, but I can still feel a dent on one side and am hoping it doesnt look weird again when the swelling goes down.
jennylb
 
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Open roof deformity

Postby amanda1234 » Mon Jul 20, 2009 2:41 am

My 3 year old son fell and hit his nose. As a result of the fall on his nose he got an open roof deformity with the right nasal bone displayed outwards. The surgeon has done a MUA and tried to push it back into place. Does anyone have any information if this is likely to have worked, if not what can we do and what problems can this cause as he still has a long way to grow.
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Re: Open Roof Bone Growth

Postby SeriousRP » Thu Oct 22, 2009 7:24 pm

I know it would be off-label but has anyone heard of a rhinoplasty surgeon using Bone Morphogenetic Proteins (BMP2) to aid in bone regrowth. It's typically used for long bones but theretically could be used on all types of bones (eg. nasal bones).

I wonder if any surgeon has considered this.


voyager wrote:Hi rg76,

No dumb ?'s zone :o

You asked:
At this point, there is no chance for the bones to grow right?


There is a chance for regrowth and other assymetries to appear post op. Here's a reply I got(directly from a ps) from another msg boards q&a section:

Surgeons reply(edited)
Postop, occasionally the following can occur especially in patients with traumatic nasal deformity which may explain the situation:

1. scar tissue can develop in any and all areas of the nose including the bridge
2. you could develop a process called osteoneogenesis where small bone spicules that form around the areas that are rasped

I would wait a full year and if your problem exists, I would see a rhinoplasty expert and consider revising the problem. You may want to have osteotomies this time to make sure the bones are realligned.
Babak Azizzadeh, M.D., F.A.C.S.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Regarding fillers: Injectibles are temporary and may lead to further issues.

Do a keyword search on injectibles, fillers, etc in the search box on this site and rhinoplasty4you.com msg board.

V.[/i]
SeriousRP
 
Posts: 45
Joined: Fri Jan 30, 2009 1:54 pm




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