12 days post op open rhinoplasty. Swelling is better nostril slanting is not getting any better. Is this my result? (photo)

Question

What are the percentages of a slanted nostril straighten out over months/healing?

Stephen Prendiville, MD · Answer

I recommend that you return to see your Surgeon and discuss your concerns. Twelve days after a Rhinoplasty is far too early to offer meaningful commentary.  I would also recommend that you discuss your use of eye wear wit your Surgeon.  I generally do not allow this for 6 weeks postop with my patients.

John Michael Thomassen, MD · Answer

At 12 days there is still swelling and this needs to resolve to better assess the final configuration of your nostrils.  If it persists at 3 months, and it affects your breathing, it may need to be revised with a cartilage graft.

Jon Kurkjian, MD · Answer

Thank you for your question and photos.
With Rhinoplasty, the name of the game is patience. At one week, we would expect you to have quite a bit of swelling and bruising still noticeable. By the end of two weeks, typically, you will still be swollen but look more like you have a bad cold, rather than post surgical. Swelling can take up to a year to be completely gone, however, by 6 weeks you will look very good and should see big difference from your pre-op pics. I encourage you to stay patient because from what I can see this is to be expected.

Richard Clark, MD · Answer

Hello,
As the surgeon's above have mentioned, 12 days is not necessarily long enough to assess your true results.  I tell my patients to not look at the front view with scrutiny for two to three weeks by which time about 80% of swelling is gone. The profile will look better before the front view. Avoiding exercise and hot tubs and such stimulation and strategic post op taping can definitely limit and guide the swelling. Also, I would suggest not wearing glasses at this stage in your healing.  Enough swelling is gone by two months that we should be able to take post op pictures with evidence close to the final result. In most people after 6 months there is less than 5% more to resolve and by one year it probably will not further improve.  The nose takes longer to equilibriate than other parts of the body and there can be flare ups of swelling months later due to stress or excessive exercise or emotional or physical experiences. 
  
By 6 months we should be able to assess if there needs to be a minor touch up. The possibility of a minor touch up after six months should be discussed before any surgery of the nose since a recent study indicates that the most successful rhinoplasty surgeons do such a second adjustment or refinement in 10-20% of cases. The reason why the better nose surgeons may do more touch ups than the less experienced operator is that, even though their results may be very good, they and their patients have a higher level of expectation...not unrealistic mind you...but a common goal to have the best nose for the long term. Since there are vagaries in the healing process and not everybody scars and heals the same...a commitment for an adjustment at 6-12 months at minimal cost is better understood at the front end. Rhinoplasty is part science and part art and, if there is legitimate room for improvement at minimal cost and minimal risk, than it is better to have your doctor respect your concerns and to recognize falling short of the goal. This does not mean that the doctor did not do an excellent job...it just means that despite his or her best effort, there is room for an improvement. Of course there are unrealistic patients at times and rarely a patient may be impossible to satisfy no matter how well the procedure is done. Yet most patients are reasonable and rhinoplasty is popular because the great majority of patients are happy with the improvement. Definitely speak with your surgeon about your concerns and you may need an additional procedure to correct this but give it some more time.  After one year, significant improvement will not come by tincture of time and, if you feel you are not “being heard”, perhaps a second opinion is appropriate. I wish you success.

Jan Zemplenyi, MD · Answer

While most of the swelling and bruising resolves within fourteen days the final rhinoplasty result is not achieved until about twelve months following the operation when all of the residual swelling resolves, and the skin envelope conforms to the underlying modified nasal framework. If your concerns are really bothering you I would schedule a follow up with your surgeon to discuss them with him or her.

Darryl J. Blinski, MD · Answer

ONLY 12 DAYS!!! Healing after open rhinoplasty can take up to 1 year. Best to see your chosen operative surgeon for detailed information about healing, now.

12 days post op open rhinoplasty. Swelling is better nostril slanting is not getting any better. Is this my result? (photo)

Answers (6)

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