Jay Dutton, MD

This may not be the answer that you want to hear, but you had some very difficult problems preoperatively (severely twisted middle vault with collapsed  upper lateral cartilages and a saddle nose deformity). While not perfect, we rarely achieve perfection and that result  looks to me markedly improved from preoperatively. While you are now 5 months postop (not 1 month), things will continue to settle and improve for the next 6-12 months.

I am interested in answering your question because I am involved in martial arts too. How quickly you recover from a rhinoplasty depends on several factors, including how invasive your procedure was and genetics. The factor that you can control, however, is how much you limit activity directly after surgery. The more you limit activity, the quicker your nose will heal.

I believe that you should not exercise for 3 weeks after surgery and should not participate in contact sports for 6 weeks (including basketball etc.). The thought process being that the nose is very vascular so you don't want to get the blood pressure up that first couple weeks for risk of bleeding. Also, it takes about 6 weeks for the bones to set. While it would be better to never do contact sports and have the nose hit, it is unrealistic and the first 6 weeks are when it is most susceptible.

If you are not sparring, there is really no significant risk of nasal trauma just from martial arts classes. I suggest going back to regular martial arts classes at 3 weeks and returning to sparring at 6 weeks if you are wearing headgear and it is a “no blow to the head” type of sparring.

Swelling tends to peak two days after surgery. Approximately three weeks after rhinoplasy surgery, you should notice that 90% of your swelling has disappeared. Swelling can make your nose appear bigger or even a bit crooked. It is very normal for the remaining 10% of swelling to take up to a year to fully disappear. Because the nose is so complex (bone, cartilage, soft tissue, etc.) it can take a fair amount of time for the nose to completely settle and regain its shape. Final results should not be judged until 18 months.

When deciding to undergo any procedure, it is critical to have a consultation with your surgeon. This allows him to examine your features and discuss with you the most effective steps to take. When working on removing a bump in someone’s nose, I often accompany that with tip work to achieve optimal proportions.

At my office, we offer a system that allows you to see your results post-op without undergoing any procedure: Vectra 3D imaging. This new system focuses on the face and neck using cameras to capture high-resolution 3D images. You can view the images from any angle, superimpose the simulation over the pre-op photo and zoom in for a more detailed look. It’s like photoshop for surgeons. We make the exact changes you want to see and then I can print out a 2D image to use during surgery ensuring the perfect outcome.

Based on what I can see from your photos, there are certainly things that could be improved upon. It does appear wide particularly along the nasal sidewalls, and from I can see it isn't perfectly straight. With more appropriate photography one could determine if it was also out of proportion with your chin or the rest of your face, which can give the illusion that a nose is "too big" even when the issue is really that other structures (like the chin) are actually too small.

I would recommend consulting with a board-certified facial plastic surgeon that is comfortable with rhinoplasty, as it is an extremely challenging procedure.

Good luck!