I am 46 years old and I had an open approach Rhinoplasty 15 months ago. The tip is still rounded and appears swollen. I used to have an average size tip. Also one nostril is oblong and one is round. What should I do?
Nose Tip Swelling? (photo)
Doctor Answers 11
Seek second opinion for tip swelling 15 months after rhinoplasty
Thank you for your question and photograph. At 15 months after rhinoplasty all the swelling should be gone.
I do see the swelling and asymmetry that you mention.
I suggest that you consult another plastic surgeon who is very experienced in rhinoplasty and has an excellent reputation in your community for a second opinion.
Swelling following rhinoplasty
In general, the final result of rhinoplasty is not evident for 18-24 months following surgery. 70% of the swelling is resolved after the first 3 months, and the remainder goes down over time. Swelling can be influenced by the following: thickness of the patient's skin, whether the procedure was a revision, whether tip work was performed, and whether the procedure was open or closed. With an open rhinoplasty, it is not uncommon to still have some residual swelling at this time. The nose continues to change throughout the healing process. I would give it a little more time and see how you continue to heal. Your surgeon should be able to answer any questions, as they know the extent of your surgery and exactly what was performed. I hope this helps, and I wish you the best of luck.
Swelling After Rhinoplasty
At this point in time, most of the swelling has settled. It appears as if you need to have a revision procedure performed due to the findings that you have mentioned. It would be a good idea to see a full set of your pre operative photos when you consult with the physician you choose to see to better assess what had been performed during the initial procedure.
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Get a second opinion
15 months is enough time for healing. It would be best to have your before photos to compare. Get a second opinion and also ask the doctor what else he can do to achieve the look you want.
Nose Tip Swelling?
Unfortunately you are at final result. Thus yes you will need a revision of the surgery. Sorry but best to obtain in person second opinions.
Nose Tip Swelling
The swelling is probably not a big factor 15 months following rhinoplasty. Scar tissue could be exuberant in the nose accounting for a thicker appearance. At any rate, you will need to have the nose revised to get a better result at this point. I would also like to know what you wanted to achieve based upon your preop photo, which appears to show an aesthetically pleasing nose. Kenneth Hughes, MD Los Angeles, CA
It would be nice to see views of your pre-op. You do look like you had too much reduction of your bridge and dorsum. The tip is asymmetric, but it would have been nice to see the pre-ops.
Tip swelling after rhinoplasty
I think you may have lost some projection of your tip over time that has resulted in some loss of structure/support. This can make the tip look "deflated", if you will, which looks like a swollen tip. It is certainly possible to still have some actual post-surgical swelling, but I'm not sure that accounts for everything. On your profile, I personally think your bridge may be slightly low. It is difficult make this kind of assessment without the preoperative photos, however. Your before photo shows a more projected bridge and frankly more defined tip. What was the goal of your rhinoplasty in the first place? You should discuss these issues with your surgeon.
Poly beak, depressed central bridge, hanging columella, etc.
Unfortunately you have all of the above and need a revision rhinoplasty by a very experienced rhinoplasty surgeon. You can see examples of your problems corrected on similar noses on my website.