8 weeks post Rhinoplasty.Tip is undefined & big. Bridge seems wide. Will my nose become defined or is this final result? (photo)

Question

Well, now it is 8 weeks post rhinoplasty. I had a hump removed and a bulbous tip re shaped. I really wanted a defined tip. However, though I love that I no longer have the bump, I hate the profile view. My tip seems upturned and short and the tip is wide and undefined. From the front, the bridge is wide as well. My tip and columella are still tender. Can this still substantially improve or this basically the shape my nose will have? Will I need revision? I'm attaching before and after photos.

Jamil Ahmad, MD · Answer

Recovery after rhinoplasty will vary based on the person, characteristics of the nasal tissues and what was done during surgery. Immediately after the splint or cast is removed, it is common for the nose to look more defined. After the compression has been removed, the skin and soft tissues can swell and this can take weeks to months to significantly improve. After rhinoplasty, tip shape is typically the last thing to settle before seeing the final result; this can take 12 months or longer in patients with thick, oily skin. My experience has been that edema may take 18 months or longer to resolve. During this time you will notice that the size of your tip decreases as swelling resolves and subtle details and tip definition appear. Additionally, the tip may descend causing the tip to rotate downwards (depending on what was done during surgery). Around the 4-6 week mark, most patients are able to appreciate most of the changes from surgery as a significant amount of swelling has resolved. However, it can take somewhere in and around 12-18 months to see the final results. The areas with thicker skin in the nose such as the tip, alar rims and radix will require longer to settle.  It's hard but important to stay patient during your recovery and to be diligent attending your follow-up appointments with your surgeon.

Marcelo Ghersi, MD · Answer

It is still too early to evaluate the result of your rhinoplasty. It takes at least 3-6 months for swelling to come down, and thus see the final result. Have some patience, if in time you are still unhappy with the result, I would contact your surgeon for a discussion.

Steven Wallach, MD · Answer

At eight weeks out you are likely still very swollen.  It can take a year and sometimes longer for the swelling to go down.

Inessa Fishman, MD · Answer

Two months post-rhinoplasty is way too early to judge the final result of your surgery; with that said, I think your photos suggest you're going to have a very nice outcome.   At two months after rhinoplasty, a significant amount of swelling remains throughout the skin and soft tissue envelope of the nose. As this swelling resolves, the nasal skin and soft tissue envelope redrapes and hugs the cartilage and bone skeleton of the nose more closely, resulting in greater definition throughout the nose. The skin of the tip and supratip is the thickest of the nose, and hangs on to swelling like a little sponge; this accounts for the completely expected findings you're describing and the swollen look of the tip many rhinoplasty patients experience in the first few months after surgery.  I like injecting the supratip with steroids to soften the post-operative edema and prevent scar tissue buildup here; this may be a helpful part of your post-operative care.  You should expect to see continued refinements in the nose (especially the tip) for a year.  For this reason, revision surgery should not be entertained for at least 9-12 months post-operatively.  I think you would be wise to maintain a close follow-up schedule with your surgeon and discuss your concerns during your visits. Take advantage of your surgeon's expertise in your recovery; post-operative care is an important part of a great outcome.  Good luck! in your recovery!

H. George Brennan, MD, FACS - Account Suspended · Answer

Hi.  Thank you for your question.  Eight weeks post op is very, very soon to judge the outcome.  Give it at the very least one year to heal completely.  In some cases maybe even a little longer...  It  still does not hurt to continue with consistent post op appointments as your nose is healing.  Swelling may fluctuate in the process which is normal.  Stay patient and stay in touch with your surgeon.  Best of luck to you.

8 weeks post Rhinoplasty.Tip is undefined & big. Bridge seems wide. Will my nose become defined or is this final result? (photo)

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