Internal Swelling in Nose Surgery, Should I be Concerned? (photo)

Question

Attached is the photos of the internal swelling after my surgery. There was alot wrong with my nose structurally and the doctor did quite a bit of work fixing it. I am 6 weeks post op and as you can see on the one side the internal swelling on the inside by the columella. I was told that this swelling will go down at around 4 weeks post op. It has improved but the swelling is gone. Should I be concerned? Will this swelling go down? if so, what are reasonable time lines?

Stephen Prendiville, MD · Answer

The appearance of the nose is likely to change as the swelling (which can last one year and beyond) subsides. There appears to be prominence of the "medial crus" of the right lower lateral cartilage which may just be related to inflammation, but may also be due to malposition; this may resolve, but it may not. Stay in close contact with your Surgeon for observation, reassurance , and solutions.

Brian M. Harmych, MD, FACS · Answer

Thank you for sharing your question and photo.  It is likely that after only 6 weeks after rhinoplasty surgery, the asymmetry that you are noticing is at least partially caused by swelling. Although most swelling resolves within a few weeks after surgery, complete healing from rhinoplasty surgery takes at least 1 year.  For this reason, most rhinoplasty surgeons would not consider any revision operation during this time period. It is very important that you keep seeing your surgeon for your regularly scheduled postoperative follow-ups during this year.  Your surgeon can perform a physical examination and explained to you what changes are due to swelling and what changes are anatomical. Good luck!Dr. Harmych

Sam Naficy, MD, FACS · Answer

As stated by others, the cause is more anatomical but may be accentuated by swelling.  It is best to wait for healing to complete before deciding on a revision

Steven Wallach, MD · Answer

Swelling from rhinoplasty takes up to a year to improve.  Be patient. The bump you have in the right nostril may be the medial crura being pushed over by the septum.

Peter E. Johnson, MD · Answer

The bump in the columella in the one side is not swelling, but a protrusion of the medial crus, one the cartilages which form the nasal tip and columella. The tisssue could also be pushed up be a displaced cartilage graft in the columella, though it is not swelling. Something is out of place.
	Best of luck, Peter Johnson, MD

Jon F. Harrell, DO, FACS · Answer

It looks as if the lower part of the 'tip' cartilage on the right side is flared out. If this is the case the prominence will persist even after all swelling is gone. Your surgeon should be able to distinguish this and also give you a reason as to why it is happening. If this is all that is going on it should be readily correctable with a small procedure when you're a little further out from surgery. Best of Luck Dr Harrell

Richard W. Fleming, MD (retired) · Answer

The swelling adjacent to your columella 6 weeks after your rhinolasty is not normal and it is unlikely this will resolve in the future. It might be a deviation of the medial crus of the tip cartilage, deviation of the septum, or a cartilage graft which was placed in the columella. see your surgeon and discuss this with him.

Internal Swelling in Nose Surgery, Should I be Concerned? (photo)

Answers (7)