2.5 years post closed rhinoplasty (thick nasal skin) Is this swelling normal? (Photos)

Question

Hello, so i had a closed rhinoplasty with a surgeon and i am now 2.5 years post the surgery. I have thick nasal skin also. I am concerned because I’ve had this swelling on the sides of my bridge (and some on the tip) and I am not sure if it’s normal after all this time. I tried sharing my concerns with my surgeon but he didn’t want to discuss it and was very dismissive. I would love to just get a peace of mind that I haven’t been botched and that this swelling will go down in time.

Eric M. Joseph, MD · Answer

I think it is fair to assume that what you are looking at is a final result. When there is swelling present, somebody may notice it in the morning, and at the end of the day, the swelling should resolve. If you are not noticing fluctuations in your nasal appearance, I believe you're healing is complete. If your surgeon is being dismissive, please consider meeting with another rhinoplasty specialist who has favorable before and after galleries, along with favorable consumer reviews. Wishing you well moving forward. Sincerely, Dr Joseph

Elie Ramly, MD · Answer

Thank you for your question and for sharing your photos. This is a very understandable concern, especially this far out from surgery, and it’s reasonable to want clarity and reassurance. In patients with thicker nasal skin, swelling&mdash;particularly along the nasal sidewalls and tip&mdash;can be more persistent and may take significantly longer to fully settle compared to thinner skin. That being said, in some cases, what feels like “swelling” could also represent scar tissue, soft-tissue thickness, or subtle contour changes rather than ongoing edema, especially this far out from surgery. It is difficult to fully answer this question without a physical exam.
At 2.5 years, most major swelling should have resolved, but refinement in thick skin can continue slowly. Residual fullness does not automatically mean something has gone wrong or that you were “botched.” The most important next step is a careful in-person evaluation to distinguish between true swelling, scar tissue, skin thickness, or structural factors related to cartilage for example. A consultation with a qualified plastic surgeon who specializes in rhinoplasty can help provide an objective assessment and peace of mind, as well as discuss whether observation, nonsurgical methods, or revision rhinoplasty may be warranted to address your concerns.

Gary M. Horndeski, MD · Answer

At this time, you would benefit from a repeat rhinoplasty.  Your tip is quite round and needs to be refined.  The dorsum of the nose can be narrowed, if desired.

Best Wishes,

Gary Horndeski, M.D.

Jeffrey H. Spiegel, MD · Answer

It is possible that you are seeing wide cartilages that would need to be reshaped. It is also possibly thick skin that can be treated with a steroid injection or other approach.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you may benefit from a revision rhinoplasty. A surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose. Fascial grafts may also be used to help improve tip refinement. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Serkan Kaya Ekinci, MD · Answer

As a surgeon, when you look at these photos, I don't see a situation that requires you to worry about. It looks so beautiful. I think they will be more beautiful.

Darryl J. Blinski, MD · Answer

Based on the only two post of photos of before, and after there appears to be minimal differences in the appearance hard to believe this is only swelling. Best of virtual consult with. Recommend full revision rhinoplasty. Fee fees $10,000-$15,000. Best of virtual consult with.

2.5 years post closed rhinoplasty (thick nasal skin) Is this swelling normal? (Photos)

Answers (7)

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