Why is my nose the same size two weeks after an open rhinoplasty?

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.

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.

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.