Thanks for your question. It's
clear you have been doing your homework, so kudos. I agree that a closed
rhinoplasty will result in less swelling of the tip, and there will be much
less bruising if there is no osteotomy. However, I would not be afraid of an
osteotomy, which can be done with either an open or closed approach. Eye bags
are unusual even with osteotomies, and I tell my patients they can confidently
return to work after 1 week even with osteotomies, with only modest amounts of
makeup to hide any residual bruising if there is any. An in-person consultation
would be necessary with an experienced surgeon to evaluate whether you can get
the result you want with just the filing down of the bump. There is a new laser
we are using (Cynosure/Palomar) that has been extremely helpful in rapidly resolving
bruising for the occasional patient who has more bruising than usual. However,
eye bags are really not something you need to worry about except in unusual
You need to submit more views. A simple hump reduction is possible but depending on the size an osteotomy may be necessary to avoid a flat dorsum. Brusising is highly variable, from none to quite a bit, but usually it is gone in 7 days or so.
The nose is a three-dimensional structure, and you are only looking at one dimension which is the hump removal. Once the hump has been removed, an open roof deformity or flat top nose will be created. Medial and lateral osteotomies of the nasal bones are required to be performed on your nose once the hump has been removed. From a examples of hump removal, please see the link below and look at the three-quarter profiles, side profiles and frontal profiles, since the nose is a three-dimensional structure.The bruising that occurs after the rhinoplasty will last approximately 2 weeks after the procedure.
Bruising is variable in its duration depending on the patient, procedure and some degree of luck. Also, you cannot dictate how your rhinoplasty is performed. If you reduce a bump on the bridge you will have a broad flat nose if no osteotomies are performed.
You should see a board certified rhinoplasty surgeon in your area to get a formal opinion through and in-person consultation.
Best of luck,
Vincent Marin, MD
San Diego Plastic Surgeon
A closed approach for rhinoplasty may be associated with less swelling, bruising, and scarring. The associated potential swelling and bruising around the eyes will generally resolve in 7-10 days. However, there may be a more important issue here. I would NOT recommend a rhinoplasty procedure if you are unwilling to have a osteotomies or potential tip modification. These things are often required to bring balance to the nose. As always, it important to personally consult with a board-certified Plastic Surgeon who has a particular interest in rhinoplasty. Good luck!
Having an osteotomy after a hump removal is very common and usually necessary when taking down a sizeable hump. If not done, this can lead to what is called an "open roof deformity" or a flat spot on the bridge. Instead and osteotomy can close the open roof and therefore recreate the triangular appearance of the bridge (from base view). The point of what I'm writing, is that I wouldn't get sidetracked from the ultimate goal of having a nice shape due to concerns over a short healing time period.
I typically inform my patients that the black/blue puffy eyes will go away in about 7-10 days. The puffiness will go away first, followed by the bruising (that can be covered with makeup). They are temporary and will not stay as a result of surgery. Noticeable swelling of the nose (if just the bridge is treated) is usually 2 weeks, but can be longer depending on your skin type and what was done.
Hope that helps.
In my experience in rhinoplasties where there are no osteotomies performed, there is a very low risk for bruising and the bruising that occurs is minimal.
Kenneth Hughes, MD
Los Angeles, CA