There are several things I have my patients do in order to decrease swelling after rhinoplasty. I have them take both Arnica montana and Bromelain, two herbal supplements that help reduce swelling and bruising. I have them start one week before surgery and have them continue for at least one week afterwards. It is also very important to avoid any exertion or bending with the head below your waist and to keep as relaxed as possible for the first two weeks after surgery. When sleeping, you should try to stay on your back with your head up at a 45 degree angle. An easy way to do this is to sleep on a lounge recliner chair. Otherwise, sleep with 3 or 4 pillows behind your head and one on each side to help keep you from rolling completely over. I also encourage my patients to try and stay on a very low salt (sodium) diet, less than 1500mg per day, as salt causes fluid retention which will make the swelling worse.
Despite these techniques, swelling tends to be different for every patient. Thicker skin, older age, previous nose surgeriers, more tip work, open approach can all prolong swelling. However, all swelling will resolve with time. Occasionally steroid injections may be used for abnormal swelling but that decision is made on an individual basis.