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Does Tip Get Bigger Before It Shrinks?

I had a tip plasty a year ago and my tip is actually larger and more bulbous than it was before the surgery. Is this normal or should I consider getting a revision to have it reduced? I don't want to revise it and then it turn out too small because it wasn't done shrinking. Please advise.

Doctor Answers (5)

Large tip one year after rhinoplasty

+2

Dear Shelley,

Although we usually consider swelling and healing complete after one year, this is not a universal rule. In some patients with thicker skin, it can take longer and the nose may continue to change after the one-year mark. If you have thin or medium-thickness skin, you may consider a revision at this point. However, it should be kept in mind that a revision of a tip that is large due to scarring requires special consideration on the part of the surgeon for a successful result. I would seek the opinion of a rhinoplasty surgeon experienced in revisions to counsel you. Best of luck. M. Samaha, MD 


Montreal Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Rhinoplasty swelling

+1

 

Dear Shelly, Hello,  you share the same name as my lovely wife! Rhinoplasty swelling may take an entire year to fully dissipate and the tip is the last swelling to totally resolve itself. With this said I find the majority of the swelling dissipates in the first 3 to 6 months and the last 30% in the final year. Depending on ethnicity and skin type you may have some residual swelling that lasts longer then that. I would suggest going to see your surgeon review with him your preoperative photographs so you may evaluate where you are in the recovery phase and propose a proper plan. Best regards! Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 127 reviews

Nasal tip swelling after rhinoplasty

+1
In primary rhinoplasty situations, swelling can persist for 12-18 months, but even fine subtle changes can occur even longer postop. The nasal tip is the last to de-swell after surgery. If you visit our office, you can view photos of primary patients in our practice at two weeks, six months, one year, two years, and three years postoperatively, and you can then appreciate the changes that occur in primary rhinoplasty patients through the scar maturation and refinement process. Patients with thicker, oily skin can have prolonged swelling that may take much longer than the average patient. Meanwhile, revision rhinoplasty patients (those undergoing more than one rhinoplasty) tend to exhibit swelling on average 6-9 months longer than the average primary rhinoplasty patient in my experience, depending on the extent of the revision. Evaluation for a revision should typically be undertaken no earlier than nine months postop to allow for most of the logorithmic decrease in swelling to occur so that the accuracy of nasal aesthetics diagnosis can be increased (although more exams may be needed leading up to the revision to account for further deswelling). When considering a revision rhinoplasty, make sure your surgeon has a passion and is specialist in revision rhinoplasty in order to maximize your chances of getting the results you desire. Good luck!

Thomas T. Le, MD
Baltimore Facial Plastic Surgeon
5.0 out of 5 stars 32 reviews

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Appearance of tip after a year

+1

After a year I would consider the swelling in the tip to be completely gone. I would suggest revision if you are still unhappy though without seeing photos it is hard to tell you how much more improvement you could expect. 

Ronald Schuster, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 23 reviews

Bulbous Tip After Rhinoplasty

+1

Dear Shelly,

 

Without the before/after photos, the details of your surgery and a physical examination it is hard to provide a solid a diagnosis.

Nonetheless, most of the patients take about 12 months to achieve the final results whereas others with thick nasal skin take more to meet the end results of a rhinoplasty.

I hope this helps.

Thank you for your inquiry.

The best of luck to you.

Dr. Sajjadian

Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 115 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.