I recently had Rhinoplasty and once my cast was removed my nose looked very square, flat and bony, and looked unnatural. My nose quickly swelled up that day and I was relieved as it eventually looked rounder and more natural-looking. At 4 weeks following surgery I’m happy with my nose but worried that it will look unnatural again once all the swelling is gone. Does the pressure of the cast affect how the nose initially looks once it is first removed, or is this likely to be the new shape of my nose?
Will my Nose Look Unnatural After Swelling Subsides?
Doctor Answers 3
Distortion after Rhinoplasty
It is extremely difficult for the patient to evaluate their nose at the time of cast removal because the tape and cast can cause distortion. It is easier for us(the surgeons) ; we have seen the result before swelling is present. However, if you are happy at one month, it probably will only get better.
Rhinoplasty swelling takes at least one year to resolve
Swelling following rhinoplasty surgery occurs both on the outside and inside of the nose. All patients feel congested and have nasal obstruction and postnasal drip immediately after rhinoplasty surgery, which is normal. Patients are generally "restaurant ready" and socially acceptable within 2 weeks. Most swelling after rhinoplasty resolves within a month. The final 20% of swelling takes a much longer time to resolve, up to a year or longer after surgery. Fortunately, this final swelling is usually only evident to the surgeon and patient.
Rhinoplasty swelling varies greatly and is largely based on the areas of the nose treated, surgical approach to the nose (open or closed/endonasal), skin thickness, postoperative care, and your healing ability. The more extensive the surgery, the more you will swell and the longer the swelling will last. The tip of the nose holds onto swelling longer than the other parts of the nose. Open rhinoplasty, where there is an external incision at the base of the nose, swells more and longer than closed/endonasal rhinoplasty. Patients with thicker skin will also have more swelling.
The nasal cast may appear to contribute to an unnatural appearance to the nose. This brief unnatural appearance from casting resolves pretty quickly. Most plastic surgeons keep the the nasal cast for at least one week following surgery.
Keeping your head elevated, maintaining the nasal splint/cast, ice, arnica montana, and following your plastic surgeon's guideline may help reduce rhinoplasty swelling. Persistant swelling may also be reduced by steroid treatment into the nose. Don't hesitate to speak to your plastic surgeon about any swelling.
Your nose is swollen 1 month after surgery.
If you like your nose now, it's likely only going to continue to improve. I tell my patients that you'll look funny when the splint is removed. What you see now is more like the final result. Sit tight, and enjoy your summer, and new nose.
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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.