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 24

Open Rhinoplasty results in prolonged swelling adn should be generally avoided

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.

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.

Anand D. Patel, MD
Brookfield Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

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. 

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 70 reviews

Revision Rhinoplasty Long Term Results

One of the most important thing is being patient if you had a Revision Rhinoplasty. Healing takes longer time than Rhinoplasty. In order to see the final results you need to wait at least 1 year. 

Abdulkadir Goksel, MD
Turkey Facial Plastic Surgeon
5.0 out of 5 stars 1 review

Revision Rhinoplasty Swelling

Your nose will be swollen and will remain so for several weeks. In fact, it takes at least one year for all swelling to subside.

Jose E. Barrera, MD, FACS
San Antonio Facial Plastic Surgeon
5.0 out of 5 stars 19 reviews

What to Expect After a Revision Rhinoplasty

Swelling after a revision rhinoplasty procedure is normal and takes time to resolve. Fortunately, since you are only 11 weeks post-op the swelling that you are describing sounds completely normal. Many patients notice an asymmetry after surgery because your body doesn't heal in an organized and symmetric way. These differences will even out as you complete the healing process. My patients notice significant changes in their swelling over the first few months after surgery, and even when the swelling seems to be gone, there is internal healing that takes place throughout the first year. I know it can be frustrating, but try not to let it be your sole focus. It's easy to drive yourself crazy analyzing it in the mirror every day, but remember that healing takes time. It's also important to keep in mind that a certain amount of asymmetry is normal and that no patient prior to, or after a rhinoplasty has a perfectly even nose. If you feel that something is abnormal, you can always contact your surgeon and have it checked out. 

Babak Azizzadeh, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 5 reviews

Swelling after rhinoplasty

One of the downsides of the open approach to rhinoplasty is the duration of post-op swelling.  I counsel my patients that undergo open rhinoplasty to expect nasal swelling to hang around for 6-9 months.  Of course, that swelling decreases at time goes along; but some edema should still be present 9 months post-op. 

All of your complaints should resolve with time as the surgical edema resolves.

Hope this helps. 

Clyde Mathison, MD
Knoxville Otolaryngologist
5.0 out of 5 stars 5 reviews

revision rhinoplasty swelling

 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
4.5 out of 5 stars 72 reviews

Revision Rhinoplasty Swelling

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:

Garrett A. Wirth, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 8 reviews

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. 


Edward S. Kwak, MD
Manhattan Facial Plastic Surgeon
5.0 out of 5 stars 13 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.