Smell from nose 4 weeks post-rhinoplasty - but no other symptoms?

It is difficult to say what the exact cause of your smell is from. In many instances, there are raw areas covered by bloody crusts, as may be the case if turbinate surgery was performed, and superficial bacterial colonization may occur under these crusts. Though not of any clinical significance, they may produce a foul odor. Sometimes a sinusitis may result from the initial packing which should be addressed with antibiotics. I have even heard of foreign body reactions taking place in the nose causing odors. It sounds as though you are doing everything correctly . However, I would check back with your surgeon to have him re-evaluate it.

It is not uncommon for you to have an altered sense of smell and taste for several weeks following rhinoplasty.  This usually resolves by 2-3 months.  Relay your concerns to your surgeon and he or she will provide you with a reasonable timeline of events to expect certain results.  

Although it is not uncommon to experience a notable odor in the first few weeks post rhinoplasty; (most often it is due to the dissolvable suture used to fixate the septum)... I would recommend you contact your surgeon for his opinion and evaluation as to the source. He would know what approach was used, and possible other extenuating circumstances involved with your procedure.

If you have an odor that others can smell, I suggest you see your doctor.  He/she can look inside and evaluate the situation.  You may need cleansing and/or antibiotics.

This is not uncommon. Most surgeons use internally dissolving sutures such as catgut to close the lining of the nose. As these dissolve with time, they create a smell. This may last up to 3 months. Local nasal hygiene as well using wet Q-tips to clean the nose internally may help. If the smell is strong, or if you develop fever or tenderness, it may be a good idea to have it checked out by your surgeon. 

Your sense of smell should improve as healing continues.  Your airway is still swollen and this allows poor drainage of the nose and sinuses which could lead to bacteria contamination.  Continue nasal hygiene and this should improve over time.  Good luck.  Donald R. Nunn MD  Atlanta Plastic Surgeon