Does the Nose Become Smaller As Scar Tissue Matures?

I had an open Septorhinoplasty 19 weeks ago to straighten and narrow my nose, and to define my tip. So far, I'm not too satisfied with my result. I was hoping for more defintion and contour in my nose (sidewall/tip region), and for the tip to be smaller. I've read it takes up to a year to see the final result. My doctor doesn't believe in steroid injections, so will my nose eventually shrink, soften, and define with time? I'm confused about scar tissue and the healing process.

Doctor Answers 15

The nose does refine with time

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It does take quite a while for the swelling and skin to heal after rhinoplasty -- especially with making the nose smaller as the same amount of skin must shrink wrap over the smaller nasal framework.

The time frame for this healing process to occur varies depending on your specific surgery and your anatomy (skin type). The thicker your skin the longer this process takes.

Although you'll often hear that healing is complete after 1 year, I often find that with the long term follow-up that I prefer to have with my patients, subtle changes will continue to occur to the nose for even a few years after surgery.

Be Patient

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At 19 weeks you can not judge the final results of your operation. If your nose is think and oily it may take up to 2 years for the swelling to subside. If your nasal tip is thick with weak cartilage you may never get a perfectly refined shape. It takes one year for the average Rhinoplasty to settle and shrink to its expected size. The key is patience.

Ivan Thomas, MD (retired)
Los Angeles Plastic Surgeon

Yes, the nose does become smaller over time following rhinoplasty surgery

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Yes, the nose does become smaller over time following rhinoplasty surgery.

Not only does scar tissue contract, but the post-operative swelling and edema takes many months to resolve. It does, in fact, take up to 12-18 months to see the final result of your surgery. Nonetheless, I do believe in steroid injections, if needed, to help even out any contour irregularities or prolonged swelling post-operatively.

Usually there is some shrinkage over time...

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There are so many variables to the healing time of a nose following rhinoplasty: the thickness of the skin, the amount of size reduction, the skill of the surgeon, the health and age of the patient. At 19 weeks in my practice my patients may have 1-2 mm of soft tissue swelling, especially just above the tip. Refinement over time is usually the rule. There is a scar contracture factor that can set in at about a year and progress for many years after. Without seeing your photos it is hard to say but I would be that you will see some improvement over time.

Ivan Wayne, MD
Oklahoma City Facial Plastic Surgeon
5.0 out of 5 stars 63 reviews

Nose Refinement Over Time After Rhinoplasty

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Hi Gelee,

Yes, your nose should continue to refine over time after your rhinoplasty.  Be patient.  Seeing patients years later, it is sometimes amazing how much the nose can change.  Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Rhinoplasty Surgery Takes Up To One Year To See The Final Result

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The results from rhinoplasty is an evolving process and it may take up to a year to see the final result. While it is understandable at nearly 5 months after surgery that you are anxious to see a greater level of improvement, it would be premature to consider any revisional rhinoplasty at this time anyway. Besides the likelihood that some further refinement will occur as the skin of the nose continues to shrink back down, the nose tissues are not adequately healed and soft enough again to respond well to further surgery. An even greater amount of swelling may occur if revisional rhinoplasty is done too soon. Continued patience is important even though that is easy to say when it isn't one's nose that one is talking about.

Rhinoplasty Improves with Time

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Although there is an immediate improvement after a rhinoplasty, the nose continues to improve its contour as the swelling subsides and the scar tissue softens. These changes take approximately a year. I would encourage you to remain patient until the full healing has been achieved.

Swelling in the nose

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It takes up to one year for nasal swelling to resolve following rhinoplasty. So you'll have to wait it out for now. In one year you will know how much definition your surgeon got you.

Swelling after rhinoplasty

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Most postoperative swelling after rhinoplasty (about 70-80%) will resolve in the first 2-3 months.  Some residual swelling may be present, but it should not cause such a notable assymetry or difference.  The best way to address this is to discuss it with your surgeon.  It is not a good idea to push for any kind of revision inside of a year, however, because the healing process is not complete.

Poor nasal tip definition amost 5 months after open septorhinoplasty

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It has been my experience that, unlike  the closed technique,the open rhinoplasty degloves the soft tissues of the bony -cartilage framework and thus leaves a longer recovery of the nose with late "shrinkwrap"

So be patient longer it could take 1 year.Steroid injection may help but  use it judiciouslly.

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.