Recovery after rhinoplasty will vary based on the person, characteristics of the nasal tissues and what was done during surgery. Immediately after the splint or cast is removed, it is common for the nose to look more defined. After the compression has been removed, the skin and soft tissues can swell and this can take weeks to months to significantly improve. Following rhinoplasty, the nose has a tendency to swell and this is greatest in the first 10-14 days. After rhinoplasty, tip shape is typically the last thing to settle before seeing the final result; this can take 12 months or longer. During this time you will notice that the size of your tip decreases as swelling resolves and subtle details and tip definition appear. Additionally, the tip may descend causing the tip to rotate downwards (depending on what was done during surgery). Around the 4-6 week mark, most patients are able to appreciate most of the changes from surgery as a significant amount of swelling has resolved. However, it can take somewhere in and around 12-18 months to see the final results. The areas with thicker skin in the nose such as the tip, alar rims and radix will require longer to settle.
Also there appears to be a linear decrease in swelling for the first several months followed by a period where the swelling fluctuates (sometimes little or no swelling and other times more swelling) before the nose settles. Again, after 4-6 weeks, although you will continue to notice changes in your nose, they are subtle and imperceptible to most other people.
At 13 months postop, you should be able to appreciate the changes from your surgery. I would suggest you follow-up with your surgeon to discuss your concerns. Additionally, your surgeon may be able to show you standard pre and postop photos so you can more accurately evaluate your results-in many instances it is impossible to objectively compare photos unless they are taken in a standardized manner (i.e., the photos you have taken may not tell the whole story).
Every patient is so different from a healing perspective. The amount of swelling and duration are proportional to the amount of surgery performed, your skin thickness, and your general health. We routinely tell patients 1 year, however, many patients take longer to see the final result. Stay in communication with your surgeon.
Time and healing are you best options for now.
at the end of 2 weeks your nose will look better than pre-op. However, it takes 1 full year to see the final results. Have your surgeon show your before and after photos
It usually takes a month for all of the swelling to come down except for the tip which can take a full year. I found the tip continues to change until that point. Good luck!
For any revision, it is always helpful to know exactly what was done in the previous rhinoplasty and to have before and after pictures. It would be hard to advise you without knowing these things and examining you.
Kenneth Hughes, MD
Los Angeles, CA