Revision Rhinoplasty Swelling

I had open revision rhinoplasty 11 weeks ago and the sides of my nose are still swollen as well as my nostrils are uneven. Also, when I smile my face looks swollen still and the left side of my nose goes up more than the right. Will this get better over time? I am getting very frustrated.

Doctor Answers (20)

Long term results and swelling with revision rhinoplasty

+3

Revision rhinoplasty will cause prolonged swelling as the lymphatics are further disrupted with surgery.  I would wait longer than the anticipated time to see final results.  When I perform revision rhinoplasty, I recommend patients wait 3 months to see most of the swelling subside. 


Los Angeles Plastic Surgeon
5.0 out of 5 stars 49 reviews

Swelling after revision rhinoplasty

+2
  • Swelling after a revision nose surgery can take up to two years to resolve.
  • Having said that, most of the swelling comes down in the first six months.
  • Sometimes swelling can occur more on one side than another and cause asymmetries.
  • Though it is difficult, be patient for now.
  • Discuss your concerns with your surgeon.

Anand D. Patel, MD
Austin Facial Plastic Surgeon

Open Rhinoplasty results in prolonged swelling adn should be generally avoided

+1
Unfortunately you are in good company. Most rhinoplasty patients out there are very unhappy with their results in 1-2 years. The explanation for this is very simple: Most surgeons performing rhinoplasty do not have advanced training or experience, they perform the rhinoplasty of 50 years ago. Decades ago thought process of rhinoplasty was to remove cartilage to refine the shape of the nose and perform it through an open approach. An open approach makes it easy for neophyte surgeons to access visualize and manipulate the structures but also unnecessarily destroys two arteries and veins that are important for nasal vascularity. The open approach thus ensures that patients have 1-2 years of risidual swelling which hides the final result. Most rhinoplasties out there I consider cartilage robbing thus when the swlling resolves there is inadequate structure to provide aesthetic appearance and fight the cicatriacial forces or the continued scarring that results from the lowered oxygen tension and fibrosis of tissues. One additional problem it that most rhinoplasty surgeons out there inadvertently break the connection between the bony nose and the cartilagenous nose. this can cause irregular narrowing and what we calll "the inverted V deformity" which means the outline of the nasal bone becomes visible through the skin particularly in flash photography under certain lighting conditions.

In my opinion, an expert level rhinoplasty is always performed in a closed technique and ALWAYS involves grafting to add to the structural integrity of the nose. The act of opening the nose even under the closed technique causes healing and some contraction, thus for a long term beautiful result the nose must be left more structurally sound than it was found. This is missed upon most rhinoplasty surgeons.

In secondary cases such as yours it is even more crucial that sound grafting techniques are used. It sounds like  you will need bilateral spreader grafts and a columellar strut but a complete L-strut should be considered and harvesting a small bit of rib cartilage may be necessary depending on your findings.  Definitely do not consider any rhinoplasty procedure that does not include grafting preferably by an experienced Plastic and reconstructive training with ddition fellowship level craniofacial and aesthetic training. Of course this is my bias because it is my training but I think this level of training is very necessary for success in secondary and tertiary rhinoplasty because there is delicate nuance involved and every patient requires different maneuvers. Because you have had two open rhinoplasties I would wait one year MINIMUM to see where the result is heading. I hope this helps!

All the best,

Rian A. Maercks M.D.

Rian A. Maercks, MD
Miami Plastic Surgeon
5.0 out of 5 stars 36 reviews

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revision rhinoplasty swelling

+1
 The swelling that occurs from your revision rhinoplasty is greater then the primary rhinoplasty because of the previous interruption of cartilage and bone, altered lymphatics and scar tissue. Be very patient, and followup with your surgeon. It is best to wait at least a year before making any decisions about  revision rhinoplasty or touch up procedure.

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 58 reviews

Revision Rhinoplasty Swelling

+1
Even primary rhinoplasty takes many months for swelling to resolve.  In your case, a revision rhinoplasty takes longer.  11 weeks is far too early to tell and the answer to your question is the swelling will decrease over time.

For more information, please go to my website at:
WirthPlasticSurgery.com

Garrett A. Wirth, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 5 reviews

It will get better

+1

Your concerns are common.  During this time your patience can be one of the most difficult parts of your recovery.  The nasal tip is the most cosmetically sensitive region of the nose also it is the most gravity dependent. Revision rhinoplasty patients can expect longer healing times because of altered anatomy and scar tissue. It is important that you communicate your concerns with your surgeon. 

 

Edward S. Kwak, MD
Manhattan Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews

Nose still swollen 12 weeks after a revision Rhinoplasty.

+1

Yes, Revision Rhinoplasty can be swollen for up to 1 year although the swelling shouldn't effect the shape of the nostrils which are supported by the lateral (outside) sections of the tip cartilages.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 12 reviews

Swelling persists longer than first time rhinoplasties

+1

Rule of Thumb for most swelling to go down

primary rhinoplasty 3-6 months

revision rhinoplasty  4-8 months

Meanwhile, warm soaks, gentle massage.

I hope this information has been useful to you.
Jon I Sattler, MD, Board Certified Plastic Surgeon, Glendora, California
 

Jon Sattler, MD
Glendora Plastic Surgeon
3.0 out of 5 stars 14 reviews

Swelling after revision rhinoplasty

+1

Swelling after revision rhinoplasty may take longer than with primary rhinoplasty.  It may take up to a year or longer for all swelling to resolve.  Donald R. Nunn MD, Plastic Surgeon.

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

SWELLING AFTER REVISION RHINOPLASTY

+1

swelling after a secondary rhinoplasty will last longer and may be more pronounced, depending what was done.

sometimes the swelling can be asymmetrical and uneven,

 

be patient for the new revised nose to show itself.

if you have concerns, don't hesitate to ask your plastic surgeon.

 

dr cordoba

AESTHETICA MD
4055 Ste. Catherine Ouest
Suite 100
Montreal, Quebec
Canada H3Z 3J8
Tel:  514. 932. 7667
Email: AESTHETICAMD@GMAIL.COM


 

Carlos Cordoba, MD
Montreal Plastic Surgeon
5.0 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.