Why is the tip of my nose so hard after 8 months of rhinoplasty?

Hello and thank you for your question.

Tip edema and swelling can last at least 1 year - this is what we often quote.  Since the circulation to your nasal tip is limited, an open rhinoplasty can result in more tip edema and swelling over the first year or so, while the microcirculation is healing.  The firm feeling is the result of grafting and fluid under the tissues.  If it is shaped well, but the texture bothers you, I would wait it out.  If you feel that the size is also too full, I would discuss with your PS and ask if there is any role for steroid injection to reduce the swelling and edema.



Hope that helps,

Christopher C. Chang, MD 

Washington DC, Maryland, and Virginia

Hopefully as the swelling diminishes your nose will become softer.  Especially for revision rhinoplasty, this tip firmness can last over a year in many cases.  The more involved the procedure, and the more grafts used, the longer the healing tends to take.

Thick skin, maneuvers to obtain tip definition, cartilage grafting - these are all factors in that "rock hard" sensation.  As the swelling subsides, you will start to feel a softer, more natural nose.  Often times in thick skin you need to place more grafts in order to obtain the definition that is wanted.  More work under the nose will yield to more swelling as well.  Give it time. I've found that sometimes it can take as long as a year and a half with thick skin for the swelling to completely settle down.  I hope some of this helps! Remember, when in doubt, contact your operating surgeon as they know exactly what maneuvers were performed and will be better able to guide you the rest of the way. 

There are a number of reasons why you may be experiencing this. I would recommend you go back to your surgeon to discuss all your post-operative concerns. 

The final result can take up to 12 months in normal skin and even longer in thick oily skin types. The tip can sometimes still be hard after surgery at this time. Although, the firmness may also be due to cartilage grafts under the skin. Your surgeon should be able to give you more accurate assessment as to the degree of swelling still present and expectations for the final result.

It is difficult to answer this question without knowing the extent of your surgery.  If you had cartilage grafts placed to support the tip, then the firmness may remain forever.  You are still within 1 year of surgery so there is still a component of swelling that will play a role in the look and feel of the tip of your nose.  Finally, you address oily skin.  This too can make the nose feel different and also diminish the final results by hiding the underlying structural work that may have been done.  I tend to address oily skin with protocols in my practice utilizing the ZO Skin Health line.  Be patient about the swelling going down over the next few months and discuss with you doctor about oil reduction starting as soon as you wish, in my opinion.  Best wishes.Garrett A. Wirth, MD, MS, FACSWirth Plastic Surgery

Hello and thank you for your question. As a rhinoplasty heals a patient will experience a lot of swelling that typically takes a full year to go away. Unfortunately, this swelling starts between the eyebrows and works its way down over the course of your healing and ends up stopping at the tip. It usually feels like the end of a pencil eraser during this time. If the hardness and swelling is becoming something you want to address you could ask your surgeon how to speed the process along. Some surgeons have the option of doing a steroid injection which can help with swelling or hardness. Always speak with the surgeon who preformed your surgery first to find out what their take is on that option for your result. Good luck with the rest of your healing!

Thank you for the question and without knowing what was done it is hard to predict what will happen with your tip other then to say at 1 year all changes that will occur should have occurred.Dr. Corbin