How Do Doctors Determine if a Nose is Still Swollen After Rhinoplasty? Is the Peeling of Skin on the Tip and Caused by Selling?

In general, the nose will be swollen for up to one year after your procedure. Swelling can be influenced by:

1) Whether the procedure was a revision
2) Whether the procedure was open or closed
3) Whether tip work was performed
4) Thickness of the patient's skin

Your degree of swelling can be difficult to accurately assess at a given time during your recovery. There are no particular "signs" that are evident. Level of swelling is mainly assessed by comparison to the nose immediately post-op.Excess oil production and peeling skin may be due to clogged pores and skin irritation, and are not due to swelling. This is something that should be discussed with your surgeon. I hope this helps, and good luck.

You will likely be swollen for 12 to 18 months after a revision. Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties and rhinoplasty revisions each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

Kenneth Hughes, MD Los Angeles, CA

Dear alex1992,

• You an be swollen for over a year after revision rhinoplasty
• If your skin is oily, you may want to see a dermatologist or great aesthetician who can keep your pores open
• The skin issue can also prolong the swelling
• Since you have moved, you can call your original surgeon to see if he/she knows someone in your new area (the rhinoplasty world is very small)

Best regards

Nima Shemirani

Most surgeons gauge residual swelling simply by using statistics and experience. At 7 months out following revision rhinoplasty, statistically, the average nose will still have about 10% of the initial swelling. However, many factors can play into residual swelling for each individual. For instance, thicker, oilier skin like yours can retain swelling longer; if the procedure was "open" with an incision on the columella, the tip swelling can remain longer; if there was extensive use of grafts, the swelling will last longer.

An experienced rhinoplasty surgeon can tell simply by looking at the apparent "turgor" of the skin -- which means the tautness of the skin, compared to the normal turgor seen in skin of your age. This turgor can also be compared to the "before" appearance of the skin. Without knowing all these other factors, we are simply going to have to go with statistics for the average person, again which, in your case, is about 10%.

Sometimes, when swelling goes down rapidly, there can be some skin flaking, but often the flaking is due to the fact that patients tend to be too gentle when scrubing the nose following surgery, and therefore there is less normal exfoliation of the normal layer of dead skin, which will then build up and flake off if it isn't scrubbed off.