Rhinoplasty Swelling

Thank you for your question. Swelling after rhinoplasty surgery is somewhat dependent on your skin thickness and condition prior to surgery.  Patients with thin skin have their swelling resolve more quickly.  Thicker or more oily skin tends to stay swollen longer.  The more involved the procedure, the longer swelling will persist.  On average, about 30-35% of the swelling resolves at about 3 weeks.  At about 3 months about 60-65 % of the swelling is gone,  The remaining swelling takes about 12-18 months to resolve. Each week and each month will be better.  Avoid strenuous exercise, hot weather and hot showers to avoid increases in swelling.  In oily skin, RetinA can help shrink the sebaceous glands.  Taping of the supratip region can also be beneficial in some patients. Consider discussing your concerns further with your surgeon.

The amount of swelling and how long it persists after rhinoplasty depends on several factors such as the surgeon's technique, open versus closed approach, whether the nasal bones were broken, and the number of prior nasal surgeries.

Patients in whom open rhinoplasty techniques were used, cases in which the nasal bones were broken, and a history of one or more previous nasal surgeries often will have more prolonged swelling.

During the first week, most patients will have moderate swelling . Usually, by the end of the second week, much of the bruising and swelling have subsided to the point that it is not obvious to the casual observer that the patient has had surgery.

However, the nose will look swollen or puffy to the patient for 3 to 4 months. It usually takes a full year for the residual swelling to resolve and the final result be apparent.

Rhinoplasty swelling occurs both on the outside and inside of the nose. Patients are generally "restaurant ready" and socially acceptable within 2 weeks following surgery. Most swelling after rhinoplasty resolves within a month. The final 20% of swelling takes a much longer time to resolve, up to a year after surgery. Fortunately, this final swelling is usually only evident to the surgeon and patient.

Rhinoplasty swelling varies greatly and is largely based on the areas of the nose treated, surgical approach to the nose (open or closed/endonasal), skin thickness, postoperative care, and your healing ability. The more extensive the surgery, the more you will swell and the longer the swelling will last. The tip of the nose holds onto swelling longer than the other parts of the nose. Open rhinoplasty, where there is an external incision at the base of the nose, swells more and longer than closed/endonasal rhinoplasty. Patients with thicker skin will have more swelling.

Keeping your head elevated, maintaining the nasal splint/cast, ice, arnica montana, and following your plastic surgeon's guideline will help reduce rhinoplasty swelling. Persistant swelling may also be reduced by steroid treatment into the nose. Don't hesitate to speak to your plastic surgeon about any swelling.

Rhinoplasty swelling is common immediately after surgery. The amount of swelling can depend on procedure performed, surgical technique and individual differences in your healing.

Tip swelling is usually the last to resolve.

Head elevation and post-operative splinting can help reduce swelling and speed recovery.

I hope this helps

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!

Swelling after rhinoplasty can be very annoying for patients. Often times I have less patience than even my own patients to see what we have really created in the nasal shaping! However, you must trust your surgeon in that he/she knows what was created in the operating room. That is what counts. Your surgeon should not leave the Operating Room until everything looks as good as possible. Then it is just a matter of being patient and waiting for time to pass.

Taping and massaging can help a great deal so discuss these options with your surgeon. Many ethnic patients with thick nasal skin can swell for longer and may require a customized taping, molding and steroid injection program, which I perform in my practice. Also, males sometimes can swell more as well. Three Weeks is still too early to tell anything but as time goes by and your and your surgeon do swelling reduction post-op care, then by 6 weeks you should start to really see the shaping that will finalize over the next year.

Be patient. I know it is hard.

Web reference: http://www.rhinoplastycenter.com/gallery-rhinoplasty.html

The duration of swelling depends on what was done, the thickness of the skin covering, and the change in size of the nose.  The longer the surgery takes and the more maneuveres performed in general will lead to more swelling.  Thicker skin will also take a longer to time to contract and resolve swelling.  Finally reduction surgery (making the nose smaller) creates a situation in which the skin must "shrink to fit" the reduced infrastructure of the nose--this takes longer than cases in which the size of the nose is left the same or made bigger.

It is hard to give specific time ranges because it depends what you mean "swelling".  For 50% of the swelling to resolve it can take a few weeks to a few months depending on the factors listed above.  For 80+% of the swelling to resolve the range could be a few months to 1-2 years. 

Web reference: http://dwkimmd.com/

Rhinoplasty swelling is different for everyone but I will generalize.  Most patients have a good looking nose about 10 days after the surgery.  The swelling is far from gone at this point but it is no longer obvious.  Within a couple months it is over 90% gone.  It may take several years for 100% of swelling to be gone.  Swelling is very dependent on skin thickness.  The thicker the skin, the more significant the swelling.

Web reference: http://www.dr-apo.com/surgical-procedures/rhinoplasty/

Web reference: http://www.seattlefacial.com/photogallery/rhinoplasty_photos24.html

Due to the complex nature of the nose, swelling may take 12-18 months to resolve after surgery. Most swelling resolves after two weeks. If you have any redness, or increasing tenderness you should call your doctor. If any grafts were used in the rhinoplasty, check with your doctor to make sure you do not have any excessive swelling thqat could be a sign of infection. 8-10% of the population are MRSA carriers so it is always better to have your doctor evaluate you if you have concerns, which you obviously do as you have posted your question.

A high salt intake can cause you to hold onto swelling too. Keep your head elevated too. The bottom line is swelling is very individual.