Tip swollen 6 months after revision rhinoplasty - what are my options? (photos)

Question

Hi I got a revision rhinoplasty to correct swollen tip from scar tissue 6 months ago. Unfortunately I had some cartilage resorption which resulted in a crooked angle. But the issue I'm asking about today is the tip of my nose is still very round 6 months after surgery. My skin is thick. I understand revisions take longer to resolve and heal but this seems like a long time and I don't see improvement. At what point Is it safe to assume it won't ever really resolve? What are treatment options?

Nima Shemirani, MD · Answer

Hi @SoCal212! With revision procedures, you can expect swelling for up to two years. I would recommend discussing steroid injections with your surgeon. Best of luck!

Jonathan Kulbersh, MD · Answer

Thank you for your question and photos. You’re correct in saying that revision results take longer to become visible, and the fact that you have thicker skin can make this waiting process somewhat longer. Your nose can continue to change over the next 6 - 12 months, so it would be best to wait until after a full recovery period to consider making further changes. If the bulbous appearance you’re referring to is indeed caused by swelling, steroid injections may be able to help.

Being that you’ve already had two rhinoplasty procedures, it’s important to note that each subsequent nose surgery becomes more complex due to the loss of structural support, scar tissue, and other factors. The importance of experience, expertise, and artistry cannot be overstated. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon, with expertise in rhinoplasty techniques. They will be able to review your surgical history, oversee your recovery process, and help you decide if any further adjustments are needed to reach your aesthetic goals.

Eric M. Joseph, MD · Answer

Your tip appears narrower, and I suspect it may continue to narrow over the next 9 months or so. If this leads to visible asymmetries and a crooked appearance, Microdroplet Silikon-1000 injections may be considered, depending on your examination. Hope this helps. Dr Joseph

Marc Polacco, MD · Answer

Thank you for your question. This concern is very common. Essentially, the thicken the skin, the longer it takes for swelling to resolve, and the less visible contouring of cartilage will be. Furthermore, revision cases compound the amount of time is takes for swelling to resolve. In your case, you have very thick skin in addition to revision surgery. Given this, it will likely take a minimum of one year, but possibly even 2-3 years, to see the final result. However, if there are ever concerns or certainly if swelling becomes worse, please let your surgeon know. I wish you all the best, and thanks again.
-Dr. P

David M. Kowalczyk, MD, MBA, FACS · Answer

Good Afternoon! Great questions. Revision rhinoplasty results - especially in those with thick skin - can take 1-1.5 years to finalize (sometimes longer). Steroid injections, taping, and compression can help the skin envelope to contract. After 1.5 years or longer and no changes, then it's safe to assume no further improvement can be made. A revision would need to be considered to create more significant changes. Give it some more time and I hope you see the results you want.

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