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.
Revision Rhinoplasty Swelling
Doctor Answers 21
Open Rhinoplasty results in prolonged swelling adn should be generally avoided
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.
Long term results and swelling with revision rhinoplasty
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.
Swelling after revision rhinoplasty
- 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.
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All of your complaints should resolve with time as the surgical edema resolves.
Hope this helps.
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It will get better
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.
Nose still swollen 12 weeks after a revision Rhinoplasty.
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.
Swelling persists longer than first time rhinoplasties
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
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.