What Causes Fluctuations in Swelling After Rhinoplasty?

Fluctuations in swelling after Rhinoplasty are to be expected and are completely normal.  Swelling can last for up to a year, but you can have periods during that year when it looks great, and then after sleeping at night it can swell again.  The drainage pathways of the nasal skin have to reestablish themselves and that can take months.  Massaging the nose is a key element in the recovery period which helps reduce the swelling and will speed up your healing progress.  Definately continue to do all the things mentioned and follow up with your surgeon for a post operative visit.

You are doing all the right things.  The honest truth is that in rhinoplasty we are asking a lot of the skin of the nose.  Even a small degree of edema or swelling goes a long way as the skin begins at only 1-2 mm thick and then we add almost double that in swelling.  So it takes time for the immediate swelling to subside and then even longer for all the lympatic drainage of your nose to begin working again.  The great percentage of primary rhinoplasty patients notice a significant reduction in this phenomenon by 3 months and revisional surgeries usually around 6 months.  Hope this helps!

First, all patients should be as  meticulous as you in their post - op care. Circulation and tissue drainage are temporarily compromised after rhinoplasty, but this will improve as healing progresses.

Rhinoplasty disrupts the tissue lymphatics which take about 6 months to re-establish.  This lack or decreased lymphatic drainage is what is responsible for the changes in swelling after Rhinoplasty.  For this reason, I instruct all my Rhinoplasty patients in nasal manual lymphatic drainage to control the swelling.