Nasal tip still swollen 3 years after rhinoplasty - Is this normal and what can I do to help with recovery? (photos)

Hello! Thank you for your question.As far as I can see from your photos you have a bulbous tip and the steroid shots might help you temporary. If you want a permanent solution I recommend you revision rhinoplasty. With a revision you will get more defined, elegant and narrow nose tip. It would be more convenient to decide with face-to-face consultation. Best Regards!

I'm surprised you're seeing improvement with steroid injections so long after your rhinoplasty. Did your surgeon use any permanent suture material in your nasal tip? If so, you may be sensitive to the suture material which may cause chronic inflammation and swelling, though this would be rare. Repeated steroid injections may lead to thinning of your nasal skin, nasal redness, and visible nasal capillaries. Consider getting a second opinion from another reputable rhinoplasty specialist to see what might be best for you moving forward. I hope this helps you. Dr Joseph

3 years after a rhinoplasty, your nose should be settled in terms of size and shape. Your situation with recurrent swelling which improves temporarily with steroids is a little puzzling. You need to be careful with repeated steroid injections as this can cause fat necrosis and thinning of the dermis. You may want to consider a second opinion and potential revision, if strongly desired.

Generally, we use steroid shots, not to decrease swelling, but to decrease the potential formation of scar tissue, and it's done early-ish in the healing period. This late, I'm not so sure that I'm happy with you getting recurrent injections, and I'm not sure why it looks better after the injections! It's possible that part of the problem is that the tip cartilages are currently positioned and shaped to keep the tip wide, and if that were revised, then if they're a significant layer of excess scar tissue, it might be possible to remove that as well. On the profile view, the tip looks lower to me than perhaps you wanted? You didn't mention it, but you should evaluate *all* parts of your nose, because if you do have a revision, the revision should at least try to address everything that you notice, though, of course, that might turn out to only be the width of the tip.
How *much* to narrow the tip, or possibly elevate the tip, or make other changes? We figure that out with morphs, well before surgery. I'd love for you to see some excellent professionally-designed morphs of what could possibly be done with your nose. Morphs could also help you identify better just what's bothering you, and help you set a goal for the rhinoplasty that's accurate for your tastes. Profile and three-quarter views would be particularly important in morphing your nose. (Side note: in my opinion, morphs should really be done by the surgeon, or he should direct an assistant as she makes the morphs. Morphs should be made with a constant eye to what actually *can* be done in surgery, for that particular nose, and the surgeon has that information and judgment best.) Remember that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes that your nose needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. For most noses, it's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. And for those who have had previous surgery, it also discusses how to tell whether your first surgeon should be performing your revision. And it also discusses how to take photos that are best for online evaluations.

Thanks for your question. All swelling from surgery has likely resolved by this point. If you nasal tip remains bulbous it may unfortunately be time to consider revision surgery.