After rhinoplasty how long should the swelling last?

For patients undergoing rhinoplasty, swelling is not uncommon. In some approaches to rhinoplasty, swelling may persist for a year or longer. In general, most of the swelling will be gone in about a month. There are many factors which can aggravate swelling and can change this timing though. If you have a concern, I would suggest visiting with the surgeon who performed the proedure to ask them if this is something that is normal.

The swelling varies for each individual patient.  Open rhinoplasty techniques tend to cause more post-operative swelling that persists for a longer time than closed rhinoplasty.  Most swelling will dissipate after 3-4 weeks.  However there can be residual swelling and changes for up to 1 year especially with open rhinoplasty.  This be said, it usually is very minor swelling that the patient and doctor would appreciate and not so much friends and acquantances.  But, "open" definitely persist longer. Also increased activity level can increased swelling.

Approximately 70-80% of the swelling will subside one month after Rhinoplasty surgery.  It takes a full year for the other 20-30% of the swelling to resolve. At this time final results are seen.  Most of the residual swelling after the Rhinoplasty settles in the tip of the nose, this takes the longest to subside.  These observations are based on the last several thousand nasal surgeries Dr. Portuese has performed.

The general rule of thumb for resolution of swelling after rhinoplasty is the following:

• 80% reduction of swelling within 6 weeks
• 90% reduction within 6 months
• 100% reduction within 1 year

Although this serves as a good rule of thumb, it is important to remember that there is interpersonal variation.  Some patients have very little swelling, and some have tremendous swelling that lasts a long time.  Observations of patients with previous rhinoplasty has also demonstrated that some patients may have ongoing changes in their nasal appearance for several years after surgery.

Many factors are involved, including:

1. Skin thickness
2. Method or approach to rhinoplasty (open vs closed) - there is generally slightly greater swelling with open procedures
3. Use of grafts during surgery
4. Co-existing medical conditions
5. Tendency to scar
6. Infection, or blood clots underneath the skin
7. Revision vs. primary - revision rhinoplasty often leads to greater and longer lasting swelling

My staff and I have observed decreased swelling, faster resolution of swelling and bruising with use of arnica montana (homeopathic medicine available over the counter), which we provide to all of our patients to begin before and after surgery.

Rhinoplasty is an operation that takes at least a year to fully recover from.

• I recommend icing and sleeping with the head of the bed elevated during the first 7-10 days to keep swelling to a minimum. 
• My patients all get Aquaplast nasal casts placed to keep swelling down for 7 days.
• It can take 2-4 weeks before the nose shrinks enough to become socially acceptable to most patients.
• The biggest change in swelling occurs between the 8th-12th months.
• Postoperative massage and injectible steroids are often used, along with taping of the nose, to help it mold nicely.

Hope this helps!