4 Months Post Rhinoplasty: Tip Swelling

Question

I had a rhinoplasty to correct a large dorsal hump and a twisted septum on Dec. 28 2010. I have noticed some swelling going down but my tip seems to be lacking definition and is still quite hard. It was an open procedure.

Jerome Edelstein, MD · Answer

Swelling can really vary depending on the patient. It can take several weeks for the initial swelling to occur, then months for it to subside. Swelling in the tip generally takes the longest to subside. Please wait a few months before evaluating your results. Best of luck!

Ali Sajjadian, MD, FACS · Answer

Thank you for your question!It is understandable that you are a concerned. Changes after rhinoplasties vary with every patient and what you are experiencing is normal especially that swelling takes time to subside. It is important to understand that swelling masks the results of your surgery.Unfortunately, with the pictures posted, the lack of surgical details and the inability to perform a physical exam it is not possible to provide you with a definitive answer that could be medically sound.Nonetheless, it is way too early to pass a judgement. Usually, a year is required before formulating how your nose will be. Even then, your nose will keep shaping itself and to complement your face for better results in the years to come.My best recommendations at the moment is to be patient, allow nature to take its course and edema subsides for better results. There is no doubt that once the swelling subsides, more definition and shape will be achieved and you should be happier with the results.Also, it is important that you keep communicating with your surgeon and work as a team together to achieve the best results possible.Congratulations on your surgery and please remain positive!Ali Sajjadian, MD FACS

Deepak Raj Dugar, MD · Answer

Hello,Thank you for your question. It takes 1-3 years for the swelling to fully go down after a rhinoplasty. The tip takes the longest time to heal and mold to the new framework because it is the thickest skin of the nose. The skin over the profile is thinner than the skin over the tip. Hope this helps, Deepak Dugar, MDScarless Rhinoplasty ExpertBeverly Hills, CA 90210

Richard J. Bruneteau, MD · Answer

It’s not unusual for patients to have prolonged swelling
following rhinoplasty.This swelling can
result in loss of definition of the nasal structure.It can also cause the nose to be stiff and
firm.Several factors, including the use
of open rhinoplasty, fracture of the nasal bones, thickness of the nasal skin
and a previous rhinoplasty have been associated with prolonged swelling.Most
patients will note significant swelling for about 2 to 4 weeks following
surgery.After two weeks most patients
are comfortable resuming their normal lives and going out in public.Swelling
will persist in most patients for at least one year following surgery, with the
nasal tip being the last site to experience resolution. In the immediate post-operative period, nasal
splints elevation of the head, and ice can be used to minimize swelling.When
this situation arises, it’s important to maintain good communication with your
plastic surgeon.Swelling is a normal
part of healing and it’s therefore important to be patient.With time it should resolve and the vast
majority of patients are ultimately happy with their rhinoplasty.

Elliot M. Heller, MD · Answer

Tip swelling can last for up to a year. Occasionally, some careful injection of a cortisone preparation into the tip could help expedite the process. Ask your doctor about cortisone injections.

Anthony Corrado, DO · Answer

After reviewing your pictures it appears that you achieved a very natural and aesthetically pleasing result from your rhinoplasty. I understand that you are concerned about prolonged swelling in the tip, but you need to realize that swelling after rhinoplasty surgery takes up to one year to fully resolve. Over the course of the next 8 months you will continue to see the shape of your nose mature into its final conformation. In the meantime be patient, and follow up with your surgeon if you have any specific questions. Good Luck, Dr. Corrado

Sarmela Sunder, MD · Answer

Hi,

	As frustrating as it is, I think you need to be patient a little longer with your results. Tip swelling can be persistent anywhere from 6-12 months following an open rhinoplasty. In addition, it is quite normal for the tip to feel hard at 4 months after surgery. If you are not pleased with the appearance of your tip after a year from surgery, that is when you should start thinking about a revision. Make an appointment with your surgeon to discuss your concerns. Good luck!

	Dr.Sunder

Kevin Sadati, DO · Answer

Dear Rhinoplasty patient from Grand Rapids, MI
	Looking at your before and after rhinoplasty pictures, it appears that your doctor has done a good job to remove the nasal hump. The swelling that makes your nasal tip larger will subside over time, usually 6 to 12 months. You need to be patient. Good luck and good healing

Steve Laverson, MD, FACS · Answer

4-5 months following open rhinoplasty, there is STILL enough tip swelling to obscure your final expected tip size and definition. This swelling resolves, and the tip continues to shrink and heal for up to 18 months after your procedure, and perhaps even longer.

Remus Repta, MD · Answer

Hello "grand rapids",

	Thank you for the question and the photos.  Small world; I trained there.  Swelling of the tip is the last to go away.  If nothing was done to the tip then it should regain its former appearance once all of the swelling has subsided.  The time for this to occur is different from one individual to another.  At 4 months I would anticipate most of the swelling should have resolved.

	All the best,

	Dr. Remus Repta

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