3 years post-op: swollen, scar tissue, or bulbous tip only when smiling? (Photos)

My doctor told me that my nose is still swollen and that it may still go down. I noticed that most doctors say at the 3 year point, it is the final shape. Could it be possible that it is still swollen? I just started having feeling in my tip about 4 months ago. Right at the tip it is slightly hard still. Could it be scar tissue? Or would a revision rhinoplasty be recommended? I don't mind the shape, however everytime I smile my nose looks very pointy and angled down. Thank you!

Doctor Answers 6

Rhinoplasty Concerns when Smiling

Dear nosenose123, I do see what you are saying in the photographs where you are smiling the tip projection is elongated however in your last profile photograph your nose looks aesthetically pleasing. At three months post surgery you are completely healed and should not see any differences in your result in the future. If you have concerns with the aesthetics I would suggest discussing these with your surgeon. Best regards, Michael V. Elam, M.D.

Orange County Facial Plastic Surgeon
5.0 out of 5 stars 208 reviews

Results after three years post rhinoplasty?

The results you see are probably not going to change any further. If the only thing that bothers you is with smiling do not have any further surgery. All noses get wide with smiling and no one is noticing this besides you. Remember  if you were trying for a 5% gain but are taking a 20% risk of making things worse this is not a good idea for you. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

3 years Rhinoplasty

Hello and thank you for your questions. Swelling should have subsided by 18-24 months. Since it has been three years, the nose that you have now is the final result (which I see looks great). If you are still concerned, I recommend following up with your surgeon. I wish you the best of luck!

Peter Newen, MD
Orange County Plastic Surgeon
4.5 out of 5 stars 31 reviews

Cahanges in Rhinoplasty Result 3 Years after Surgery

It is extremely unlikely that you will have any significant changes in your nose 3 years after the operation. Look at serial post-op photographs your surgeon has taken to see if there is anything different over the past year. Despite your excellent pictures an examination will be necessary to answer your question.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

When to expect final results after rhinoplasty

Even with the thickest nasal tip skin, the final results should be seen by 18 months.  At that time, scar tissue has set in and the nasal tip swelling has subsided.  If you are unhappy with your results, contact your surgeon to discuss.  Otherwise, I'm not sure what your nose looked like preoperatively, but you have a relatively aesthetic shape postoperatively.

John Layke, DO, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 49 reviews

Rhinoplasty Revision


At three years, all swelling is gone.  I think you would benefit from a revision that would shorten the tip cartilages, leading to reduced tip projection, subtle tip rotation and refined tip appearance. Go visit a few revision rhinoplasty specialists. 

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 89 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.