Edema Still in Nose Tip 5 Years After "Open Revision" Rhinoplasty & Septoplasty

Question

In '03, I had a closed rhinoplasty/septoplasty. In May '05, I had a open revision rhinoplasty & septoplasty. Heard open & revision puts me at highest risk for long term edema. Plus, I have thick skin. In '06, a doctor prescribed Prelone syrup for the edema for about 2 weeks. Helped a little. Also, I saw a physical therapist that specialized in lymphatic drainage which helped slightly. 1. Will nose tip swelling fade by 10 yrs? 2. Can I do anything or take something for chronic edema?

Sam Naficy, MD, FACS · Answer

Your nose edema can be unrelated to your surgery 5 years ago - you could have thick skin, rosacea or even early rhinophyma

Kevin Sadati, DO · Answer

Dear revision rhinoplasty patient from Arizona,
	It is true that after revision rhinoplasty there will be prolonged swelling, but no longer than one year. According to your description, you had revision rhinoplasty 5 years ago and I doubt it if this is just swelling, I believe you have scar tissue formation in the area. Please visit your rhinoplasty surgeon for guidance. Good luck and good healing

Thomas A. Lamperti, MD · Answer

Being 5 years out from your revision rhinoplasty you shouldn't have anymore tissue edema.You may have scar tissue under the nasal tip skin or your thick skin may be limiting how refined your nose can get. An in person exam would allow for a better determination regarding the actual cause. Sometimes an injection of steroid or 5-FU can help soften scar tissue.

	It is more difficult to address thick nasal tip skin. This may sound counter-intuitive, but in some patients better tip refinement can be obtained by increasing the tip projection. This stretches the skin envelope, so to speak, which can give better definition to the tip.

Catherine Huang-Begovic, MD, FACS · Answer

Chandler,

	I agree - 5 years after surgery, it is unlikely you have edema from your surgery.  You likely have some persistent scar tissue at your tip.  It's hard to say what the best treatment would be - sometimes a little cortisone injection on the nasal dorsum helps.  However, instead of going other professionals (PT's) I would see a plastic surgeon with experience in rhinoplasty.  They will be able to examine your nose and discuss with you options for improving it.

	Dr. Cat Begovic M.D.

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi Chandler,

	5 years after a rhinoplasty, I doubt you have any edema at all... What you probably have is a persistent bulbous tip.

	This is a result of either too much fibrofatty tissue or scar tissue in your tip. That said, its difficult to determine without seeing your tip.

	Best,

	Dr.S.

Edema Still in Nose Tip 5 Years After "Open Revision" Rhinoplasty & Septoplasty

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