Rhinoplasty Swelling

I had a Rhinoplasty 3 weeks ago and my nose is still very swollen. How long is it normal to have rhinoplasty swelling after surgery?

Doctor Answers 195

Swelling after Rhinoplasty: Gradual Improvement

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The amount of swelling and how long it persists after rhinoplasty depends on several factors such as the surgeon's technique, open versus closed approach, whether the nasal bones were broken, and the number of prior nasal surgeries.

Patients in whom open rhinoplasty techniques were used, cases in which the nasal bones were broken, and a history of one or more previous nasal surgeries often will have more prolonged swelling.

During the first week, most patients will have moderate swelling . Usually, by the end of the second week, much of the bruising and swelling have subsided to the point that it is not obvious to the casual observer that the patient has had surgery.

However, the nose will look swollen or puffy to the patient for 3 to 4 months. It usually takes a full year for the residual swelling to resolve and the final result be apparent.

Rhinoplasty swelling

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Rhinoplasty swelling is common immediately after surgery. The amount of swelling can depend on procedure performed, surgical technique and individual differences in your healing.

Tip swelling is usually the last to resolve.

Head elevation and post-operative splinting can help reduce swelling and speed recovery.

I hope this helps

Rhinoplasty is an operation that takes at least a year...

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Rhinoplasty is an operation that takes at least a year to fully recover from.

  • I recommend icing and sleeping with the head of the bed elevated during the first 7-10 days to keep swelling to a minimum.
  • My patients all get Aquaplast nasal casts placed to keep swelling down for 7 days.
  • It can take 2-4 weeks before the nose shrinks enough to become socially acceptable to most patients.
  • The biggest change in swelling occurs between the 8th-12th months.
  • Postoperative massage and injectible steroids are often used, along with taping of the nose, to help it mold nicely.

Hope this helps!

One year is not enough. Also a note on how to take postop photos

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One year is not enough to see the final result.  It takes years to see the final outcome.  The nose (especially the tip) continues to shrink  over several years after rhinoplasty. Patients with thicker tip skin tend to have more swelling.   I have been seeing  these postrhinoplasty changes over a number of years  in many of my patients  and  in patients  from elsewhere who see me  for revisions.  Most noticeable facial swelling will resolve within 10 days to two weeks.  The profile  will look better if the hump was removed but the front will still appear wide.  Swelling in the upper part of the nose goes away faster than in the midnasal area and tip. Typically, the following happens:

-  By  12 months,  about 20% of swelling may still be present in the tip.   The tip may still feel hard and have numbness.  Tip skin may still be  hard to pinch away from the underlying cartilages and tip cartilages are not showing well through the skin yet.  Some patients  may express concerns that the tip still looks wider than they prefer.  Swelling in the tip may fluctuate (ie worse in the morning).

- By  2 years, the midnasal area and tip will  look slimmer.   About  5-10% of swelling may still be present.   

-By 3 years,  the tip definition is nearly final. Examination and follow up photographs show that the tip is slimmer and softer that at 2 years.

Even after  3 years, many patients (especially those with thick tip skin) report that the tip continued to improve. As swelling resolves over the years,  some patients reported that asymmetries and imperfections   become more noticeable .  That is why it is crucial to make sure the nose is as perfect as possible in the operating room!

      A important point of photographs taken after surgery using phone cameras!     The face and nose on your photos will be  stretched by the phone cameras when the photos are taken too close.  Taking face photos with short lens cameras (and too close)  results in the whole face, nose, and eyes  appearing  wider and nose / lip longer than in real life and causing the ears to disappear in the photos.     Many patients look at those photos and find that their noses appear  wider than they like.

To get a more realistic front view of your nose and better assess progress,  do the following:

-   If you are using a small camera or phone camera , you need to step back and zoom in.   The goal is to see the ears  in the front view photo as much as you see them in the mirror  and thus make sure the face/nose are not stretched by the camera.

-However, it is best to use at least a 50mm lens of a DSLR camera to get close to a real life image (without stretching). This is what  I use in my office.

Swelling 3 weeks after Rhinoplasty is normal

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Rhinoplasty swelling occurs both on the outside and inside of the nose. Patients are generally "restaurant ready" and socially acceptable within 2 weeks following surgery. Most swelling after rhinoplasty resolves within a month. The final 20% of swelling takes a much longer time to resolve, up to a year after surgery. Fortunately, this final swelling is usually only evident to the surgeon and patient.

Rhinoplasty swelling varies greatly and is largely based on the areas of the nose treated, surgical approach to the nose (open or closed/endonasal), skin thickness, postoperative care, and your healing ability. The more extensive the surgery, the more you will swell and the longer the swelling will last. The tip of the nose holds onto swelling longer than the other parts of the nose. Open rhinoplasty, where there is an external incision at the base of the nose, swells more and longer than closed/endonasal rhinoplasty. Patients with thicker skin will have more swelling.

Keeping your head elevated, maintaining the nasal splint/cast, ice, arnica montana, and following your plastic surgeon's guideline will help reduce rhinoplasty swelling. Persistant swelling may also be reduced by steroid treatment into the nose. Don't hesitate to speak to your plastic surgeon about any swelling.

Thick skin or reduction rhinoplasty takes longer

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The duration of swelling depends on what was done, the thickness of the skin covering, and the change in size of the nose.  The longer the surgery takes and the more maneuveres performed in general will lead to more swelling.  Thicker skin will also take a longer to time to contract and resolve swelling.  Finally reduction surgery (making the nose smaller) creates a situation in which the skin must "shrink to fit" the reduced infrastructure of the nose--this takes longer than cases in which the size of the nose is left the same or made bigger.

It is hard to give specific time ranges because it depends what you mean "swelling".  For 50% of the swelling to resolve it can take a few weeks to a few months depending on the factors listed above.  For 80+% of the swelling to resolve the range could be a few months to 1-2 years. 

Rhinoplasty Swelling

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It has been my experience that there is great variability in the amount of swelling after rhinoplasy. The swelling will depend on whether the rhinoplasty was 'open' or 'closed', primary or secondary, whether grafts were placed, the patient's predisposition to swelling and the thickness of the nasal skin. I agree that it generally takes about 12 months for the swelling to resolve. If you have an obvious hump, supra-tip fullness or asymmetry after 12 months, you should discuss the risks and benefits of a second rhinoplasty procedure with your surgeon. A small group of patients with residual deformities may be candidates for a 'non-surgical' rhinoplasty. This is a much less expensive and quicker way to correct small imperfections after a primary rhinoplasty.

Swelling after rhinoplasty- what should be expected?

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Typically, it is normal to have obvious swelling of the nose for up to 2-3 weeks. It depends on what was done. The more extensive the surgery, the longer it take for swelling to settle.  After 2-3 weeks time, the nose will still be swollen, but it is not noticeable to others.  The rest of the swelling will go down over a period of 1 year.  I typically tell patients, it takes about 3 months for the upper bridge to settle, another 3 months for the middle bridge, and another 6 months for the tip.  If the early swelling is not going down or is getting worse, you should see your doctor to make sure everything is healing normally.  

Amir M. Karam, MD
San Diego Facial Plastic Surgeon
4.6 out of 5 stars 121 reviews

Swelling from Rhinoplasty takes weeks / months to resolve.

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While rhinoplasty patients look good enough to resume their normal schedule by 7-10 days, some swelling in the tip skin is present for months. The textbook answer given by rhinoplasty surgeons is 1 year for all swelling to be gone. It simply takes time for the skin to become supple again. This is a gradual and subtle process.

Bottom Line:  I tell patients they'll look good enough to socialize by 10 days, with about 85% of the swelling subsiding by 3 months, and the remainder by 1 year. 

Swelling after nose surgery

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Due to the complex nature of the nose, swelling may take 12-18 months to resolve after surgery. Most swelling resolves after two weeks. If you have any redness, or increasing tenderness you should call your doctor. If any grafts were used in the rhinoplasty, check with your doctor to make sure you do not have any excessive swelling thqat could be a sign of infection. 8-10% of the population are MRSA carriers so it is always better to have your doctor evaluate you if you have concerns, which you obviously do as you have posted your question.

A high salt intake can cause you to hold onto swelling too. Keep your head elevated too. The bottom line is swelling is very individual.

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.