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Why is my Nose the Same Size Two Weeks After an Open Rhinoplasty?

I had open rhinoplasty on 8/29/08. Today my splint came off. My nose is straight but still appears to be the same size. I had a wonderful surgeon - no problem there! Will the size of my nose get smaller once the swelling subsides? Day one of these most important questions. Thanks for all that you and your site does for patients with complicated questions!

Donna

Doctor Answers (15)

Talk to your surgeon, too.

+4

First and foremost, be sure to talk to your surgeon about the swelling and size. After all, only he or she has examined you and can give you a better idea of what to expect in your particular situation.

That said, two weeks post-op is still very early in the healing period. Particularly if a patient has thick skin or is simply prone to swelling (everyone's different), the final contour will take a long time to appear.

As a general rule of thumb, I tell my patients that on average 60% of the swelling will resolve by six weeks, 85-90% by three months, and final contour by one year (longer for thick skin, longer for more aggressive changes to the nasal proportions, etc.). Even still, there is quite a broad range across individuals, but the point is that it takes time.


Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

Swelling After Open Rhinoplasty

+2

It is expected to have persistence of swelling after open rhinoplasty, particularly in the nasal tip.

The size of the tip may continue to change for 12 to 18 months!

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.0 out of 5 stars 12 reviews

Rhinoplasty Recovery: Be Patient, The Results Take Time

+2

The final results from a rhinoplasty take time to become apparent. The nose undergoes significant changes in the first 2 to 12 weeks following rhinoplasty. The swelling gradually dissipates over the first several months and thus the appearance of the nose changes gradually.

* When the cast is removed after one week, the nose will look swollen.

* Usually by the end of the second week, the swelling and bruising have subsided enough that the casual observer will not readily notice that the nose has been operated on. Usually the nose will look large to the patient at this point.

* To the patient, the nose will look swollen or "puffy" for several months.

* By about 3-4 months, the majority of the swelling will be gone but will look larger in photographs.

* It can take as long as a year for the final shape to become apparent

If you have any questions as to whether your nose is healing at the appropriate rate, schedule a follow-up appointment with your surgeon.

C. Spencer Cochran, MD
Dallas Facial Plastic Surgeon
5.0 out of 5 stars 90 reviews

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Rhinoplasty swelling takes months to resolve

+2

Thanks for your question and your update to your progress.

I agree with the other surgeons. Rhinoplasty can take months to a year for the swelling to resolve. The tip is usually the slowest to find its final shape. This seems consistent with your post-op course.

To answer your last question, most patients do not need revision Rhinoplasty but in any case, I would wait at least one year before considering any additional surgery.

I hope this helps!

Steven H. Williams, MD
San Francisco Plastic Surgeon
4.5 out of 5 stars 23 reviews

Final Rhinoplasty results may take several months

+2

Rhinoplasty results are specifically related to the length of time after surgery, the amount of tissue edema, and the structural modifications performed.

Although the general size and dimensions of the nose are obvious after surgery, the final results will take several months to manifest.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 47 reviews

Swelling after Nasal Surgery

+2

Rhinoplasty is a wonderful surgery, but it takes quite a bit of time to see the final results. The majority of the operation is performed by re-shaping the cartilage and bones of your nose, and the skin has to be elevated off those structures to allow for this to occur. Depending on your anatomy and the preference of the surgeon, an open or closed technique can be utilized. After any operation, your body responds by swelling, and this swelling peaks at 48 to 72 hours. The nasal splint that you had worn basically helped "push" the swelling skin back down onto the framework of your nose, so that it heals adherently to the structures below, and prevents any collection of fluid between the skin and cartilage. After the splint is removed, you will be markedly swollen, such that if your operation was planned to be a minimal change, you may not see any difference at all! (Patients with extreme anatomy will notice a difference right away.) As time goes on, you will see the final results of surgery as the swelling disappears. I generally tell patients they will achieve the near-final results on the dorsum (hump location) in 6 months, and tip and sides of the nose in 12 months. Some patients do have swelling that takes 2 years to resolve. With an open approach, one avenue for the egress of fluid has been divided, so tip swelling takes slightly longer to resolve.

Michael A. Bogdan, MD, FACS
Dallas Plastic Surgeon
5.0 out of 5 stars 48 reviews

I agree with Dr. Rand that the swelling will take time...

+2

I agree with Dr. Rand that the swelling will take time to subside, even a year or more. I also find that if you have thicker, olier skin, it may take a bit longer for the swelling to improve. Finally, I find that with an open rhinoplasty technique the swelling sometimes takes a bit longer to subside versus a closed technique. Both give excellent final results in experienced hands, but don't be surprised if it takes several months to see the final result.

Shahram Salemy, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 94 reviews

Early swelling after a rhinoplasty

+1

You are very early in the healing process and the irregularities that you are noticing are more likely due to swelling than anything else.     It will take you another 6 months before you can begin to judge your result.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 9 reviews

Size Expectations

+1

You are early in the healing process so it is too early to judge the results. Communicate clearly but calmly your concerns to your surgeon.  He/she can indicate the degree of swelling, and provide you realistic expectations regarding the size.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 16 reviews

Rhinoplasty patients have to be patient.

+1

Two weeks is way to early to be concerned about the results of a rhinoplasty.  I do open rhinoplasties for the most part and I feel that one disadvantage is a longer time for swelling to subside in the tip.   It may take a year or longer for the final result to emerge.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 8 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.