Rhinoplasty Recovery: Be Patient, The Results Take Time

C. Spencer Cochran, MD answers: Why is my nose the same size two weeks after an open rhinoplasty?

I had open rhinoplasty on 8/29/08.  Today my splint came off.  My nose is straight but still appears to be the same size.  I had a wonderful surgeon - no problem there! Will the size of my nose get smaller once the swelling subsides? Day one of these most important questions. Thanks for all that you and your site does for patients with complicated questions!

Donna


C. Spencer Cochran, MD
3 months ago

The final results from a rhinoplasty take time to become apparent. The nose undergoes significant changes in the first 2 to 12 weeks following rhinoplasty. The swelling gradually dissipates over the first several months and thus the appearance of the nose changes gradually.

* When the cast is removed after one week, the nose will look swollen.

* Usually by the end of the second week, the swelling and bruising have subsided enough that the casual observer will not readily notice that the nose has been operated on. Usually the nose will look large to the patient at this point.

* To the patient, the nose will look swollen or "puffy" for several months.

* By about 3-4 months, the majority of the swelling will be gone but will look larger in photographs.

* It can take as long as a year for the final shape to become apparent

If you have any questions as to whether your nose is healing at the appropriate rate, schedule a follow-up appointment with your surgeon.
 

A: Swelling after Nasal Surgery

Michael A. Bogdan, MD
14 months ago

Rhinoplasty is a wonderful surgery, but it takes quite a bit of time to see the final results. The majority of the operation is performed by re-shaping the cartilage and bones of your nose, and the skin has to be elevated off those structures to allow for this to occur. Depending on your anatomy and the preference of the surgeon, an open or closed technique can be utilized. After any operation, your body responds by swelling, and this swelling peaks at 48 to 72 hours. The nasal splint that you had worn basically helped "push" the swelling skin back down onto the framework of your nose, so that it heals adherently to the structures below, and prevents any collection of fluid between the skin and cartilage. After the splint is removed, you will be markedly swollen, such that if your operation was planned to be a minimal change, you may not see any difference at all! (Patients with extreme anatomy will notice a difference right away.) As time goes on, you will see the final results of surgery as the swelling disappears. I generally tell patients they will achieve the near-final results on the dorsum (hump location) in 6 months, and tip and sides of the nose in 12 months. Some patients do have swelling that takes 2 years to resolve. With an open approach, one avenue for the egress of fluid has been divided, so tip swelling takes slightly longer to resolve.

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