Aggressive Sex after Rhinoplasty, could it affect rhinoplasty outcome?

Thank you for the question! Like most surgeons, I would advise you to wait about 3 weeks before engaging in strenuous physical activities after rhinoplasty. Even if sexual activity poses no risk of nasal trauma, it might elevate your blood pressure and increase your heartbeat. This might exacerbate your swelling and even increase a chance of bleeding. Naturally, you should avoid physical trauma to your nose even after 3 weeks post-op. That being said, if you are not observing any increased swelling or discomfort, your results may still be fine.
 An in-person exam with a board-certified plastic surgeon would be the best way to assess your needs and obtain expert medical advice. Best of luck!

Without a nose bleed, it is very unlikely you did any damage to your nose at the 20 week mark. Perhaps a repeat consult with your surgeon would be ideal

Your sexual encounter probably will have no long term effect on your rhinoplasty. As long as you didn't have a nose bleed, severe long lasting pain, black & blue, or difficulty breathing, you are probably fine. Common sense prevails. If it hurts, don't do it. Consult and discuss with your surgeon.Best wishes