After rhinoplasty how long should the swelling last?
I had a Rhinoplasty 3 weeks ago and my nose is still very swollen. Is this normal?
Answers (6)
It can be
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.
Swelling after rhinoplasty
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:
- Skin thickness
- Method or approach to rhinoplasty (open vs closed) - there is generally slightly greater swelling with open procedures
- Use of grafts during surgery
- Co-existing medical conditions
- Tendency to scar
- Infection, or blood clots underneath the skin
- 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.
Swelling from rhinoplasty changes over time
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!
Healing after rhinoplasty
Rhinoplasty may produce swelling that can last for a prolonged period of time. The definition of 'prolonged' may be different between patients and surgeons, so I always try to talk to my patients in absolute time periods.
Typically, I tell my patients that reduction of swelling to a point of 'social acceptability' is between 1-2 weeks. Healing occurs over a long time but 70-80% of swelling will be gone by 1 month. This is especially true in the tip and the sides of the bones near the eyes if work is done on those areas. The last 20-30% will go away over the next 3-9 months and will be the time when the finer shadows and contours of the surgery will begin to appear.
Besides the specific surgery that is done, several other factors will increase swelling and healing time. Patients with thicker skin will have more swelling, which may require post-operative steroid injections to speed recovery.
The more of a reduction in size, the longer the period of swelling, as the skin needs to redrape and contract around a smaller structure.
Diets high in salt can add to swelling, as can sun exposure, exercise, and sleeping flat at night.
All in all, 3 weeks is fairly early in the healing process. Remember that you want your result to last a life time. Since the nose heals over a long period of time, a perfect result on the day the cast is removed might mean a much smaller nose in the end than you wanted.



12/1/08
I had a plastic surgery on my nose twenty years ago, but still around my nose is very swollen. Everyday is different. I had different exams, such as allergy,... but all results were negative! I know it's not normal. I'm wondering if I can do anything, anything for that???