Does the Nose Become Smaller As Scar Tissue Matures?

Question

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.

Thomas A. Lamperti, MD · Answer

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.

Paul K. Holden, MD · Answer

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.

Michael R. Macdonald, MD · Answer

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.

Ivan Wayne, MD · Answer

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.

Frank Agullo, MD · Answer

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.

Michael A. Persky, MD · Answer

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

Stephen Prendiville, MD · Answer

After 19 weeks, you can expect to see your nose trending toward its final result, but there is still swelling present. This is most noticeable in the nasal tip region, where swelling lasts the longest. If you research this site, you will note that most Surgeons agree that Rhinoplasty results are best evaluated at 1 year. Use of steroid injections (kenalog) can be helpful in hastening the process, but are not always necessary, and can cause tissue atrophy. Your best option is to keep open communication with your Surgeon since the possibility of revision is not realistic for at least 1 year.

Jeffrey Weinzweig, MD, FACS · Answer

At 19 weeks it is too early to see your final results. It usually does take a year for all of the swelling to resolve. During this time the same of your nose will change as the swelling resolves.

Barry L. Eppley, MD, DMD · Answer

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.

Erel Laufer, MD · Answer

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.

Does the Nose Become Smaller As Scar Tissue Matures?

Answers (15)