Swelling after just a osteotomy. Any suggestions?

Question

Its been 7 months since i done my rhinoplasty and im considering performing a osteotomy later to narrow my nose bridge. How much swelling would i have with only a osteotomy to narrow the bridge performed? How soon should i do it and does the skin need to be lifted from the nose for this ?

Sunny Park, MD, MPH · Answer

You are still healing from the rhinoplasty you had so it may be best to wait for about a year after that surgery for another nasal surgery.  It is difficult to say how much swelling you will have after the osteotomy; everyone swells differently and it also depends on the complexity of the case.   I recommend that you continue to follow up with your surgeon and discuss your concerns/thoughts with him/her.

Elbert T. Cheng, MD · Answer

Hello,Thank you for your question.  In order to answer your question, I would need to see pictures of your nose.  Did you have a nasal hump removed from the last surgery and did he/she perform osteotomies?  In general, wait 1 year before embarking on more nasal surgery.  Your nose is still refining itself.Best of luck!

Stephen Weber MD, FACS · Answer

Osteotomies can be performed through two small incisions inside the nose. There is no need typically to elevate the nasal skin. There would be minimal swelling if any in the tip your profile should not change. However, you can have moderate swelling where the bones were cut and you could develop bruising under your eyes. You will also need to wear a splint on the nasal bridge for 5-7 days. Best.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Victor Chung, MD · Answer

In rhinoplasty, osteotomy (a controlled bone cut) may be performed to improve the contour or narrow the nose. This is one of the more traumatic maneuvers in rhinoplasty. The bone and all the tissue directly in contact with it ( bone covering (perichondrium), muscle, and blood vessels) may be cut in a pocket. There is no way to use cautery or put direct pressure on it to stop bleeding. The bleeding will stop on its own, but the nose will swell and any bruising will collect below the eyes. Multiple osteotomies will generally produce more swelling and bleeding. I would discuss this with your surgeon to determine a safe plan for you.

Aric K. Park, MD · Answer

Without seeing your photos it is difficult to determine how much needs to be done and how involved the surgery will be. If you simply desire a small amount of narrowing at the base of the nasal bones, this can be done by infracturing the bones. A small cut is made on the inside of the nose and then a chisel is used to make a cut in the bone. This often causes bruising for 7-14 days and swelling of the nose. After 2 weeks, you will still be moderately swollen and this should steadily improve over the next 4-6 weeks until your nasal bones have started to reknit in place. Even though 90% of the swelling is gone by this point a small amount can persist for months afterwards and depends on the individual patient.

Michael Elam, MD (retired) · Answer

Dear brunkozlov, A direct examination or photographs would be needed to determine if osteotomies are needed to narrow your nose. Small incisions are made in the nose with a chisel and the bones are fractured and placed back together to narrow the nose. A splint is placed on the nose and typically remains for seven days. You may or may not have bruising this is dependent on each patients healing. In all of the "first look" splint removal videos attached on my public profile and the video above the photographs are taken on the seventh day which will give you a good idea of the variation of swelling and bruising patients may incur. Best regards, Michael V. Elam, M.D.

Swelling after just a osteotomy. Any suggestions?

Answers (6)

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