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Revision Rhinoplasty for Tip Refinement 4 Months After Initial Surgery?
I had a closed Rhinoplasty nearly 4 months ago. I have noticed that the swelling has gone from the bridge, but the tip doesnt seem to have gone down as much. I feel that the tip of my nose from the side now looks too big for the top part which has gone down, making my nose look unbalanced. By four months, I feel most of the swelling should have gone in the bridge and tip. Should i think about a revision?
Asked 38 months ago by
cupcakeceri in london
+2
Please Wait One Year before Revising Your Rhinoplasty
Hi Cupcakeceri,
You should wait for one year before considering revising rhinoplasty on the nasal tip. The tissues and the plane between them need that time to heal and soften.
Swelling following rhinoplasty takes time to resolve. Specifically, nasal tip is the last place for swelling resolution and absorption.
It may be difficult to wait but you will be best served to wait that time. It is possible that the swelling of the nasal tip will improve significantly enough that you...
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+1
Tip still appears swollen 4 months after Rhinoplasty
The nasal tip can still have some swelling at 4 months following a Rhinoplasty. You could ask your Rhinoplasty surgeon for kenalog injections or instruction on how to perform manual lymphatic drainage to remove this residual swelling...which is what I teach all my Rhinoplasty patients to di daily beginning at 1 month post op.
+1
Revision Rhinoplasty for Tip Swelling
Revision rhinoplasty should only be considered after one year since swelling and healing can still factor into the end result. However, I encourage you to explore kenalog/steroid injections to reduce the supratip swelling, commonly known as a pollybeak deformity.
Manhattan Beach Facial Plastic Surgeon
+3
Rhinoplasty and Tip Swelling
You still have significant tip swelling four months after your rhinoplasty. I don't see a hanging columella, but there still is a little too much supra-tip and tip fullness. The "ideal" tip to nostril proportion is 1:2 and right now your nose appears to be closer to 1:1. As your swelling resolves your proportions will get better. After one year, you may need a small amount of the supra-tip dorsum removed if the 1:2 balance is still off.
+2
Consider kenalog injections
As stated by other surgeons tip swelling is not uncommon, especially with thicker skin. Injection of steroids (Kenalog) will help the final result and how soon you get there.
+2
Tip Revision 4 Months after Rhinoplasty
Final maturation with total resolution of tip swelling usually takes longer than 4 months. Your tip does appear relatively big at this time, but it is best to wait up to one year before revision surgery. Serial photographs and examinations will help in the timing of that operation. A young lady like yourself wants this to be the final and definitive procedure.
+2
Tip swelling after rhinoplasty
Swelling after rhinoplasty can take several months (often 12+) to resolve, especially in the tip. This is especially true if the skin is thicker. Your tip wll likely continue to change over the next several months and up to 1-2 years.
Bay Area Facial Plastic Surgeon
+2
4 months is too early for tip Revision Rhinoplasty
You should definitely wait longer then 4 months before you consider revision rhinoplasty for the tip of your nose. I usually recommend a wait of at least a year but I have gone in earlier on rare occasions. Your surgeon should guide you appropriately if you are unhappy with your nose.
Beverly Hills Facial Plastic Surgeon
+2
It is best to wait before revision Rhinoplasty
Tip swelling is often the last area to resolve, especially if you had a wide or bulky tip to begin with. It can take up to 12 months for all residual swelling to go away in the tip. A rough rule of thumb is that if your tip still feels on the firm side, there is still swelling there. If it is still firm, gentle finger massage or the back side of an electric toothbrush can help. Most rhinoplasty surgeons will not consider a revision until 12 months from the original procedure.
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+2
If the hanging columella is your concern, time will help but can be corrected
Hey Cupcakeceri,
It's often hard to sit on your hands and do nothing, but as you can tell from all the advice, most people would recommend being patient and letting things settle down. If we go beyond this early advice and think of what may be bothering you about the tip we notice 2 things.
First let's start by saying that overall your nose looks very good for this early stage. The two things we notice are:
You look like you have a slender face, and the tip at this point still looks a...
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Beverly Hills Facial Plastic Surgeon
+2
Wait for at least 1-2 years
The tip is the last area where swelling will resolve after a rhinoplasty. There are very few surgeons who would recommend considering any secondary surgery until a minimum of one year and preferably two years have passed. Unless these is a very obvious deformity that must be corrected, it is best to give the healing process substantial time.
Additionally, the nature of your tip skin plays a role in the rate of recovery and it does appear that your tip skin might be a bit thick. This means...
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+2
Time is the best choice at this point
Four months is still early after a rhinoplasty. While it is a bit difficult to tell from your pictures, I think the skin of your nasal tip may be a bit thick and oily, and this type of skin takes a while to settle down after a rhinoplasty. On occasion, we can inject a small amount of steroid solution into the tip skin to help calm down some of the inflammation, but this is a discuss best had with your surgeon. Bt the worst thing you could do right now is rush back into the operating room--...
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+2
Give it Time, and Avoid the See-Saw
At four months post-op, there is likely to still be some tip swelling after Rhinoplasty. Because this is the most dependent (lowest) part of the nose, it takes longer for the lymphatic drainage of the nasal tip to return to normal.
Most surgeons would advise you to wait a full year before considering a revision, unless there is an obvious problem that is unlikely to resolve spontaneously with the passage of time.
Also, further refinement or narrowing of the nasal tip may make you perceive...
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+2
Time... and maybe a chin
Certainly a full six months at least need to elapse before considering any revisions. And the aesthetic cost of revisions also must be calculated. For example, further reduction of the tip may indeed reduce the size of the tip but can cause notching to the side of the tip, a "pinched look" that is a giveaway that surgery has been performed.
Your plastic surgeon can also discuss with you the role of the nose-chin relationship and how it affects perceived nasal size. As plastic...
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+2
Time after a rhinoplasty
Rhinoplasty tip edema can be a persistent problem even 4 months after surgery. For patients that present to my San Francisco area office my recommendation usually involves waiting at least 8 - 12 months after primary rhinoplasty when the concern is edema or swelling in the tip.
Give it a few more months and then re-evaluate. In addition discuss your concerns with your treating surgeon.
I hope this helps.
Steven Williams, MD
+1
You should wait a year before revision rhinoplasty
I know it's frustrating 4 months after rhinoplasty to look in the mirror and see a round tip. This is normal healing. It takes at least a year or more for the final swelling to fully go down. It is important to allow all the healing to take place, not only to avoid what may be un-necessary revision surgery but allow all the scar tissue to soften and the cartilages to achieve their final contour.
I have had many patients who thought that they might need revisions to further narrow the...
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+1
Revision Tip Plasty
AT four months following rhinoplasty surgery, there is still healing going on. There is usually tip swelling which may persist up as long as 12 months. Like all areas of the body, swelling occurs post trauma. Feel your tip. Does it feel full? I suspect so. That suggests that there is still edema post surgery which means that there is still healing going on. To decrease ankle swelling, ace wraps are applied and leg elevation recommended. You...
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+1
4 months is too soon for revision of the tip
Thank you for sharing your photo. Although, it is difficult to tell from the photos, the tip need to be felt. In general, 4 months is too soon to consider a revision of the tip. You need to wait 2 to 8 months before thining about anything like that. Meanwhile, discuss your expectations with your doctor.
I hope this information has been useful to you.
Jon I Sattler, MD, Board Certified Plastic Surgeon, Glendora, California
+1
Revision rhinoplasty after four months?
Absolutely not. The last place that swelling resolved is the tip. At four months, the tip is just starting to be defined, and will change dramatically over the ensuing nine months. Unless there is significant asymmetry, you should wait at least nine months to one year after surgery. Speak to your original surgeon express your concern and I am sure your surgeon will address your fears.
+1
Tip issues 4 months after rhinoplasty
Four months is very early after a rhinoplasty. The tip is the last area to de-swell, and the supratip area in particular can linger in swelling for 12-18 months after surgery. The reason it takes so long for swelling to decrease is because the scar maturation phase of healing takes that long. Steroid shots can be beneficial to reduce your swelling faster. See your surgeon to express your concerns. If the issues persist at 12 months, then...
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Baltimore Facial Plastic Surgeon
+1
Timing for a Revision Rhinoplasty
One of the many key elements in revision rhinoplasties is that you have to wait at least 12-15 months after the primary rhinoplasty to allow for normal wound healing and to see the true secondary deformity. One needs to see what the final result will be from the deformity and to allow for normal wound healing. If one operates much earlier then scar begets scar and you have a further exaggerated poor result. I have seen this time and time again as I do a significant number of secondary...
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+1
Revision Rhinoplaasty at 4 Months? Not a Good Idea
Patience pays in Rhinoplasty. It is totally normal to have tip swelling 4 months after your procedure. As you may read elsewhere on this forum on from other opinions on this topic, the final Rhinoplasty result takes a year and sometimes longer to develop. Returning to the OR at this time would only complicate your healing and lead to more prolonged swelling.
+1
4 Months is Too Soon
Generally, 4 months is much too soon for evaluating the size of the tip of your nose.
Swelling can take 18 months to dissipate from the tip of your nose after rhinoplasty.
As you continue to heal, ongoing evaluation and discussion with your surgeon is the best course to determine if and when a revision might be appropriate.
+1
Revision Rhinoplasty for Tip Refinement 4 Months After Initial Surgery?
Persistent tip swelling after a revision is not uncommon. It may take months to years. Ask your surgeon if you are an appropriate candidate for cortisone injections (e.g. Kenalog) which may help hasten the process.
Austin Facial Plastic Surgeon
+1
You do not need a revision!
The tip is one of those structures that takes the longest to heal. The dorsum will come down rather quickly with respect to swelling. However, the tip can hold on to swelling for 6-9 months. Just give it some time before you make any decisions. You will be surprised to find out how much your swelling will go down in a few months. I would not contemplate revision surgery till 9-10 months following primary surgery!
