After Cast Removal (Rhinoplasty), How Much is Swelling?

I had a dorsal hump removed, the projection of the nose was reduced and my tip was very slightly narrowed. I love the profile, except the elevation of the tip. My doctor said he did not shorten or raise my tip at all. Why am I like Miss Piggy currently? My doctor says there is a lot of swelling present. Does that mean my tip is raised because of that? I'm 10 days post op. Also, the front view of my nose looks very wide. How much does a nose change when the swelling goes?

Doctor Answers 11

Swelling after rhinoplasty cast removal

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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. 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, you may notice that your tip derotates and deprojects.

At 10 days following rhinoplasty, you are still very early in your recovery. Recovery after rhinoplasty will vary based on the person, characteristics of the nasal tissues and 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. As swelling resolves, the tip definition will improve and the size will decrease.

Swelling can cause shape change in tip and nostrils

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Thank you for the question.  It is possible to have shape change in the tip and nostrils secondary to swelling.  I would definitely give it at least a couple of months, ideally 6 months or more, before you can start assessing the final result.

All the best,

Dr. Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 reviews

Give it time before you try to judge rhinoplasty results

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You are very early in the healing process and the irregularities that you are noticing are more likely due to swelling than anything else.  The upturning of the nasal tip is  also due to swelling.  It will take you another 6 months before you can begin to judge your result.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Swelling after rhinoplasty

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You should not be overly concerned with the appearance of your nose at this stage as you still have a significant amount of swelling which will take several months to fully resolve.  I would recommend you revisit any concerns you may have with your surgeon. You should review your pre and post operative photos at the 3 month mark so that the you can assess your results without the edema present.

Best Regards,

Jacque P. LeBeau, MD


Jacque P. LeBeau, MD
Pensacola Facial Plastic Surgeon

Post Rhino Swelling

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Most of what you describe is most likely residual swelling. As a matter of fact, de-projection of the nasal tip may actually cause less nostril show, so most likely the tip elevation is not a permanent condition.

Elliot M. Heller, MD
New York Facial Plastic Surgeon
4.5 out of 5 stars 96 reviews

Swelling after splint removal

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Swelling will sometimes change tip position and this should improve with time.  It is not uncommon for the tip to rotate slightly upward with cartilage trimming and suturing.  Discuss this with your surgeon so that he may address your concerns.  Donald R Nunn MD Atlanta Plastic Surgeon.

Donald Nunn, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 51 reviews

Rotated nose after rhinoplasty

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Given what your surgeon told you I suspect what you're seeing is the result of swelling at the base of the nose. This can push the tip upward temporarily. This should settle out over time as the nose heals further.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 22 reviews

Post rhinoplasty swelling

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Post rhinoplasty swelling is a reality and takes months to resolve. Unless something was done to shorten the nose the length will be the same. Many surgeons routinely shorten the septum and cause the {miss] piggy look. Be patient.

David A. Bray, Sr., MD
Los Angeles Facial Plastic Surgeon

Many noses look short immediately after surgery

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Removing a bump can shorten the nose, and narrowing the tip cartilages can rotate the tip upward, giving the appearance of shortening the nose.

However, it is much too soon to worry.  If your surgeon did not shorten the end of the septum or alter your upper lateral cartilages, your nasal length should be close to the same.  Nasal length an improve by itself for months. 

Try to be patient.  The more you worry, the longer it will take.

Mark B. Constantian, MD, FACS
Nashua Plastic Surgeon

Swellin of Nose when Cast is Removed

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Swelling is always present when the cast is removed after rhinoplasty. This will temporarily make the nose look wide in the front view and over-rotated secondary to the swelling of the base of the nose and upper lip. This will resolve. It is impossible to evaluate your result this soon after surgery. Be patient.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 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.