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Large Tip and Possible Bossae Formation, Is it Possible this Could Just be Swelling?

Open rhinoplasty/septoplasty 3 1/2 months ago. 1) My tip looks huge to me. 2) The sides of the tip now seem back to normal in terms of stiffness/sensation. But the middle of the tip is still firm and still feels a little numb. I have noticed what feel like bumps/hardness near the tip corners. I am concerned that I am developing Bossae as it feels like 2 firm bumps. Is it possible this could be swelling/healing and not Bossae, would my surgeon be able to tell at this point? What if it is Bossae

Doctor Answers 7

Time is required

Thank you for your question!

It is understandable that you are concerned. Changes after rhinoplasties vary with every patient and what you are experiencing is normal especially that swelling takes time to subside as it masks the results of your surgery.

It is important to keep in mind that it is early to pass a judgment. Usually, a year is required before formulating how your nose will be, but longer with a thick skin. Even then, your nose will keep shaping itself to complement your face for better results in the years to come.

My best recommendation at the moment is to be patient, allow nature to take its course and edema subsides for better results. There is no doubt that once the swelling resolves, more definition and shape will be achieved and you should be happier with the results.

Also, it is important that you keep communicating with your surgeon and work as a team together to achieve the best results possible.

Congratulations on your surgery and remain positive!

Ali Sajjadian, MD FACS

Orange County Plastic Surgeon
5.0 out of 5 stars 176 reviews

Healing Process

You still need to wait. Three and 1\2 months is early in the healing process. It is also hard to say if you are developing bossae at this stage. The treatment for true bossae formation, if it developes, is a surgical correction.

Large Tip 3 1/2 Months after Rhinoplasty

The firmness of your tip indicates swelling is still present - this is normal 3 1/2 months after rhinoplasty. You cannot determine the final tip contour by palpation at this stage. Discuss your concerns with your surgeon, but patience is necessary at this time. Any tip irregularities can be corrected in 6-9 months.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 22 reviews

Swelling of Nasal Tip, Questionable Bosse 3 1/2 Months After Rhinoplasty

Hi Talk,  It is still too early to tell.  What you are feeling in your tip may be edges of tip cartilage grafts, most likely.  You should discuss your concerns with your rhinoplasty surgeon.  After 12 months your surgeon will be able to correct any residual problems if need be.  Good luck and be well.   Dr. P



Michael A. Persky, MD
Encino Facial Plastic Surgeon
5.0 out of 5 stars 28 reviews

Post op rhinoplasty

It is still too early to make a final judgement on the ultimate result.  Swelling will persist for over a year.  It is at that time the surgeon can diagnose the problem.  Donald R. Nunn MD  Atlanta Plastic Surgeon.

Donald Nunn, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 17 reviews

Nasal tip

At three months post-surgery, the nose is slowly going back to  normal. But as you said the tip is still numb, so it still may take a while.  Give it some more time.

Steven Wallach, MD
New York Plastic Surgeon
4.5 out of 5 stars 21 reviews

31/2 Months post op Rhinoplasty

Your results after such a short time may not be indicative of the final product. We usually like to wait at least 6 months, and sometimes a year for all the post op changes to occur. However , you should be seen by your surgeon for evaluation, and documenting with pictures, of your short term results. Perhaps, a routine injection with a small amount of steroid medication is in order, which can hasten the development of the final product. Since there are no pictures to evaluate, hopefully these changes you question are subtle and will improve with more time.  "Bossae" are small visable bumps, usually seen on the tip, representing an abnormal folding or bend in the tip cartiledges, that may need further surgery to correct. Depending on what is happening to the tip cartiledges, the revision surgery can range from minimal trimming to tip reconstruction using septal or ear cartiledge.

I hope this helps your understanding and resolves some of your concerns.

Maurice P. Sherman, MD
San Diego Facial Plastic Surgeon
4.5 out of 5 stars 26 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.