Nose Looked Great 1 Week After Rhinoplasty but at 7 Weeks It's Puffy. Is This Normal?

My nose looked refined 1 week after rhinoplasty and stayed like that for the next month. At 5 weeks, the nose started to look puffy and fuller especially from the side. Why is this and what can I do to make this resolve faster? I was so happy initially and now it's taken a 180.

Doctor Answers 4

Swelling after rhinoplasty

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Immediately after the splint or cast is removed, it is common for the nose to look more defined. After the compression has been removed, the skin and soft tissues can swell and this can take weeks to months to significantly improve. After rhinoplasty, tip shape is typically the last thing to settle before seeing the final result; this can take 12 months or longer. During this time you will notice that the size of your tip decreases as swelling resolves and subtle details and tip definition appear. Additionally, you may notice that your tip derotates and deprojects.

At 5 weeks following rhinoplasty, you are still very early in your recovery. Recovery after rhinoplasty will vary based on the person, characteristics of the nasal tissues and what was done during surgery. Around the 4-6 week mark, most patients are able to appreciate most of the changes from surgery as a significant amount of swelling has resolved. However, it can take somewhere in and around 12-18 months to see the final results. The areas with thicker skin in the nose such as the tip, alar rims and radix will require longer to settle. Also there appears to be a linear decrease in swelling for the first several months followed by a period where the swelling fluctuates (sometimes little or no swelling and other times more swelling) before the nose settles. Again, after 4-6 weeks, although you will continue to notice changes in your nose, they are subtle and imperceptible to most other people. It's hard but important to stay patient during your recovery and to be diligent attending your follow-up appointments with your surgeon.

Puffy Nose after Rhinoplasty

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It is common for the nose to look smaller right after your splint is removed at one week. Typically the nose will gradually swell after this point in time as the compression afforded by the splint is no longer present. It is a bit more unusual for the nose to suddenly swell at 5 weeks unless something initiated the swelling. Some factors that may contribute to swelling can be flying, working out/exercise, stressing your body, salty foods, alcohol and not elevating your head while sleeping. On the flip side, you can try to avoid the previous irritants and you may see some improvement in the swelling. Also, taping the nose at night might help. Lastly, if the swelling persists and/or is asymmetric see your surgeon for a proper evaluation.

Gary Motykie, MD
Los Angeles Plastic Surgeon
4.4 out of 5 stars 69 reviews

Nose puffy

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You have to just be patient. sometimes a kenalog injection may help but in general time is on your side and you'll get the original post op look back.

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
4.8 out of 5 stars 12 reviews

Nose swelling

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Usually the swelling starts right after the cast is remove. Iquestion why swelling should be so obviously changed this late in the gamr. You nee to see your surgeon.

David A. Bray, Sr., MD
Los Angeles Facial Plastic Surgeon

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.