Does the nose start swelling immediately during rhinoplasty?

Does the swelling occur the minute the nose is operated on or is there a lag time during which the doctor is able to operate? how come blood doesnt start gushing everywhere during the rhinoplasty? And why doesn't swelling interfere during the rhinoplasty surgery itself?

Doctor Answers 7

Does the nose start swelling immediately during rhinoplasty?

Thank you for your interesting question. In my experience, I find that when the operation goes beyond two and the half hours, the swelling starts to become noticeable during the operation. No matter what you do, there will always be swelling after the operation, and this usually peaks at 48 to 72 hours after completing the surgery. I have also found that taping the nose for 2 weeks after the splints are removed helps tremendously in reducing the swelling.Hope my answer helps.Kind regards.

London Plastic Surgeon
4.7 out of 5 stars 30 reviews

Swelling During Rhinoplasty

Dear OrangeNGreen, Bleeding is controlled during rhinoplasty typically using a combination of medications that are injected and constrict the blood vessels, as well as electrocautery - which seals the blood vessels as the surgeon operates. Some swelling will begin during surgery, but it tends to peak around 48-72 hours after surgery is completed. Having the splint on helps to keep the swelling in check, so some patients notice an increase in swelling after the splint is removed. Hope this helps!

Richard A. Bartlett, MD
Brookline Plastic Surgeon
5.0 out of 5 stars 11 reviews

Swelling During Rhinoplasty

Before rhinoplasty is started, a local injection is done with anesthetic and epinephrine, a substance which causes blood vessels to contstrict, reducing blood flow. In addition, cocaine solution is often placed in the nose, which further constricts the blood vessels. This prevents bleeding, which can cause difficulties during surgery. After surgery, your body's clotting ability usually prevents bleeding from being too problematic over the first few days. Swelling starts immediately after this initial injection and progresses during the surgery. The surgeon, through experience, is able to compensate for the swelling during surgery and accurately predict the outcome, although minor variations always occur between the operative findings and the final result.

Richard W. Westreich, MD
Manhattan Facial Plastic Surgeon
5.0 out of 5 stars 51 reviews


Swelling will develop during surgery but is more prominent after the splint is removed. Best of luck with your decision to move forward.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews


Hello and thank you for your question. Most rhinoplasty surgeons use general and local anesthesia with vasoconstrictive agents directly into the nose in order to prevent bleeding.  Swelling usually begins after the procedure.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system. The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

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

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 122 reviews

Swelling with rhinoplasty

 Most experienced plastic surgeons and facial plastic surgeons performed a rhinoplasty with a combination of anesthesia for the patient plus local anesthesia for the nose.  This reduces edema out of anesthesia and needs to be given to the patient, and also allows the surgeon to give controlled amount of local anesthesia plus epinephrine into the nose tissues were the operation is being performed.  The beauty of epinephrine is that constrictors to blood vessels, and a minimizes blood loss during surgery.  Some swelling happens when epinephrine and local anesthetic injected naturally because it is injected in the fluid.  The swelling that most patients experience after surgery however has nothing to do with injection, and has to do with the natural swelling of the tissues that comes from injury, in this case the actual surgical procedure, much like you would have swelling in her knee if you fall on it.

Reza Momeni, MD FACS
Summit Plastic Surgeon
5.0 out of 5 stars 42 reviews

Swelling during the rhinoplasty

Swelling is a direct reflection of the amount of work done during a rhinoplasty and the duration of time the rhinoplasty takes.  During the operation, many times the amount of swelling is "squeezed" out of the nose to continually assess the progress.  The nose doesn't bleed much if the surgeon stays within the correct anatomic planes, and if it does, we usually use electrocautery to stop it from obscuring our view.

John Layke, DO, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 49 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.