What Causes Fluctuations in Swelling After Rhinoplasty?

I've been told that sodium, alcohol, and sun exposure can cause more swelling after rhinoplasty. I strictly monitor my sodium intake, I rarely drink alcohol, and I wear a high quality sunscreen with zinc oxide. Yet, on many days my nose looks much more swollen by the time I've gotten home from work at the end of the day, until I massage it and then the swelling goes down. What could be causing this and is it normal to see these fluctuations if you are doing things to promote a good recovery?

Doctor Answers 4

Fluctuations in swelling after Rhinoplasty...

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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.

Edison Facial Plastic Surgeon
4.8 out of 5 stars 222 reviews

What Causes Fluctuations in Swelling After Rhinoplasty?

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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.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Fluctuations in Swelling after Rhinoplasty

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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.

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

Fluctuations in Swelling After Rhinoplasty

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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!

Shepherd G. Pryor, MD
Scottsdale Facial Plastic Surgeon
4.6 out of 5 stars 23 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.