Is my Nose Still Swollen After Four Weeks?

There are some general observations on revision rhinoplasty
that can be made applying to your situation. It is not possible to give an
exact assessment of your situation without seeing some pre-op photos to see
where you started.Swelling after any rhinoplasty can take years to resolve.
Typically the bulk of the swelling is gone by 3 months though most noses get a
little smaller and refined over the next months to years. A revision nose will
typically take longer as there is more trauma and scar tissue to deal with.
Thicker skin swells more and takes longer to heal than thin skin. Male noses
also take longer to heal and swelling can last much longer.One of the biggest factors in swelling after surgery is how
much size reduction occurred. The more the nose was reduced the longer the
swelling will last. Usually the underlying structure of the nose is well healed at four weeks, the skin and soft tissue takes much longer to contract around the framework and produce the final refined look. Be patient and consult your surgeon with your concerns.Good luck and I hope this helps.

The nose
can be swollen for up to a year or more. Swelling will depend upon the
nature of maneuvers employed, presence of grafts or implants, thickness
of skin, open vs closed, revision vs primary, etc. Kenneth Hughes, MD Los Angeles, CA

After 4 weeks, a large nasal appearance is related to swelling. In general, swelling can be influenced by the following:

1) Whether the procedure was open or closed
2) Whether the procedure was a revision
3) Thickness of the patient's skin
4) Whether or not tip work was performed

Having an open procedure as you mentioned can lead to increased swelling. Osteotomies can also be a factor in your swelling. at 4 weeks, your nose is relatively strong, but it will take 6 weeks for the bones to fully heal if they were fractured. Your nose will not be damaged from touching it, but be conscious to avoid any nasal trauma while you are healing. 

The lower two-thirds of the nose remains swollen much longer than the upper one-third after rhinoplasty.  The swelling will progressively dissipate with each passing week.  The rate at which the swelling decreases depends upon a number of factors including the relative change in the size of the nose and the skin thickness.  The nose should be stable to the touch after one month, although it often is still tender.

In general, 70% of the swelling is resolved after the first 3 months and the remainder goes down over time. You will still have swelling after 4 weeks that can affect the appearance of your result, and the tip is usually the last to come around. The final result may not be evident for 18-24 months after surgery. Your nose will be strong after four weeks, but it will take 6 weeks for the bones to fully heal if they were fractured. I would recommend following up with your surgeon, as he or she knows the extent of your surgery and exactly what was performed. I hope this helps, and I wish you the best of luck with the remainder of your recovery.