3 months post-op I am still congested. I use spray to mildly relieve it. Would I need a revision to open my nasal passages?

At three months post op, you still have some degree of swelling.  This will slowly resolve over the course of 1 year after surgery.  As the swelling decreases, you may notice a decrease in congestion as well.  If not, I encourage you to discuss this with your surgeon.

Although it is common to experience congestion after rhinoplasty, this usually resolves within a few weeks after the surgery depending on what was actually involved in your surgery.  You will need to see your surgeon for an examination to determine the cause of the congestion.    

Thank you for your question. Postoperatively, after a rhinoplasty, you can anticipate bruising and swelling that is noticeable to others for 1-2 weeks. Sutures are removed at 1 week along with any internal or external splints. You will notice that your own nose is swollen for another 2-3 months. Final healing time can take up to 1 year.
Remember, each patient has variable anatomy and responds to a rhinoplasty differently. If you want to confirm that you are on a healthy road to a full recovery and that your nose is bothering you enough, consult with your surgeon. Your surgeon can evaluate your nose and inform you with what is happening.
Best of luck,

Gary Linkov, MD
Rhinoplasty Specialist
Manhattan

Hello,
Swelling persists in your nose for several months up to a year, and congestion may fluctuate some after surgery, but there should be a trend of improvement. If you're unable to return to your original surgeon, I suggest you see a facial plastic surgeon to evaluate your nose. Nasal congestion can be caused by many different factors - from an adhesion or a scar band to inadequately addressed internal nasal valves, to allergic factors. Nasal steroid sprays (and not decongestant) may be prescribed in the interim depending on the findings during your exam. Decongestant sprays cause a rebound congestion effect and thus are addictive. It's best to use these for a couple days only, but not longer periods of time. 
Good luck,