23 days post-op from open tip revision rhinoplasty and my nose is bigger and looks boxy? My alar rim graft did not work (Photos)

I'm 23 days post op, osteotomies, dorsal hump removal, alar rim grafts , lower nose and tip narrowing, columellar strut. Is it swelling or cartilage on the lower bridge to the tip? It appears that the alar rim graft did not work well on the right side, more columellar show on that side as well. Will the columella retract as the swelling goes down? What can be done to fix the rim graft that didn't work to balance out the nostrils. I'm thinking a fourth revision will be necessary.

Doctor Answers 8

Too early to tell!

You are very early post-op and as I am sure you are aware it can take a year or more for the swelling to subside. Best of luck.

New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Swelling , some advices:

Thank you very much for enquire.

Swelling after a rhinoplasty depends of the surgery complexity.
In this regard, the nasal swelling Post-op It can last from two weeks to two months.
To reduce this swelling, I recommend you perform delicates daily lymphatic drainage massage therapy over the face (around the nose) avoid sun exposure, and take pain/inflamation pills, as your surgeron precribe you.
Kind regards, 
Dr. Emmanuel Mallol Cotes.-  

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 270 reviews

Swelling after revision rhinoplasty

Thank you for your question and photos. It's hard to judge the results of a rhinoplasty after 23 days. As you already it takes weeks to months for the tip swelling to come, even longer with a revision. Alar rim grafts are a tricky thing so give them some time to heal. Good luck

Jeffrey Jumaily, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

Way too early

Rhinoplasty cannot be judged well this early.  Before pictures would help judge, but I would air your concerns to your operating surgeon.

Ethan Philpott, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 17 reviews

Early postoperative results

It is far too early to assess your final results, as it will change over the next several weeks to months.  Be patient and keep in regular contact with your plastic surgeon; he or she should provide you with a reasonable timeline of events to expect certain results.

John Layke, DO, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 50 reviews

Too soon to judge

23 days post op is way too soon to judge your results. It is completely normal to be experiencing asymmetric swelling. Your body is still healing. For now, be patient. At the 6 month post op mark, you can reevaluate your results and if you are still not happy then make an appointment to see your surgeon to discuss.


Kouros Azar

Kouros Azar, MD
Thousand Oaks Plastic Surgeon
4.9 out of 5 stars 34 reviews

23 days post-op from open tip revision rhinoplasty and my nose is bigger and looks boxy? My alar rim graft did not work

It is way too soon to see your final result.  You can expect it to take weeks to months to heal. Your surgeon may show you nasal exercises to help with the result.  It is too soon to consider a revision.  Hopefully, you will not need that.

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 62 reviews

Too early to tell

You are absolutely beautiful and have a very pretty nose that I think suits your face well. Bringing down the alar rims is one of the more challenging maneuvers in revision surgery because the surgeon may be limited by scar tissue (not necessarily his/her own skill). Revision rhinoplasty patients should be counseled that asymmetric nostrils are unlikely to become perfectly symmetric but that improvements can be made. Be sure to wait a full year (and some argue 2 years for revision) before judging your outcome. For now only you and your surgeon may see a difference, but unlikely your friends or the public.

Jeffrey Watson, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 8 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.