Don't lose hope. There's always an alternative.
speaking, the great majority of the swelling that follows a nose job subsides
by the two month recovery mark. Still, it takes up to an entire year for the
remainder of the swelling to go down, during which time your nose will continue
to change and conform to its new shape. Since you are about 4.5 months into
your recovery, I would say that your new nose will probably not substantially
decrease in size from the size it is now. If you are still unhappy with the
results of your nose job surgery, you can always consider getting a revision
rhinoplasty done by the same surgeon or by a different surgeon altogether. In
this way, you can really tailor your second surgery to your needs and can focus
your doctor’s attention on getting that smaller nose that you want.
You won't really be getting to your final result for 2 years although you are probably seeing 90% of it now. The best idea is to give nature time to help you get to your own best healing point. The only reason to consider some sort of early revision would be if there were clearly something wrong which it doesn't sound like there is in your case.
Resolution of postoperative swelling after rhinoplasty
At this point of your postoperative phase you should get a good idea of what your final result will be. Of course there will still be some resolution of swelling and some minor nasal remodeling for up to a year. There is some variability in how fast the nasal swelling resolves, depending on extent of nasal trauma during surgery, nasal skin thickness, overall size of pre-op nose, open vs closed technique, etc. Since you state that there is still some tenderness and swelling that could indicate that you are still in healing phase, and you might get some meaningful shrinkage of your nose.
There is Hope That the Nose Will Look Smaller and More Contoured As Time Passes After Rhinoplasty
Your new nose should get "smaller" and improve in contour as time goes on. Following rhinoplasty as swelling and scar tissue evolve, the nose seems to get smaller. A nose will ultimately look only as good as the underlying structure that was left behind by the operating surgeon.
Unfortunately there are many patients whose noses look fabulous when the splint and tape are removed only to have a "shrink-wrap effect" take place over the subsequent 2 to 5 years. This occurs when the underlying cartilage and bone are insufficient resulting in that "pinched-done" nose job look.
In your specific case, your surgeon is best suited to tell you what to expect over the next few months to year. At 4 1/2 months following surgery, there should be a good general idea of what your nose will look like.
Certainly we do not recommend revision surgery for at least 6 to 12 months following your initial procedure. On the positive side, it is always easier to take off a little more to make a nose smaller than to have to augment the nose to make it bigger.
Be patient, stay close with your surgeon and much good luck in your healing process.
Though Rhinoplasty surgery does take a long time to completely heal, I typically see the majority of swelling resolve after the first month or two. The remainder of swelling will resolve over the following 10 plus months. However, in patients with a very large nose in combination with very thick skin, this process can take up to two years. Also, the fact that you mention the membranes inside of your nose are swollen, I can assume that you still have a fair amount of healing to do. For patients that tend to be healing slowly, or swelling that seems to linger, I will inject the swollen areas with a small amount of steroid (10mg/ml Kenalog) to help the swelling resolve quicker. Frequently patients will see a difference a few days after an injection.
Also, you don't mention if this was a primary rhinoplasty or a revision, but revision rhinoplasties take much longer to heal than primary procedures. In conclusion, yes, your nose still has a chance to look smaller and with more contour, just be patient and continue with follow up visits with your surgeon.
Full healing does take a year
Full healing does take one year. Some studies show that there is further contraction and healing over the next two to five years after a rhinoplasty. However, the results of this are subtle. Your nose will become smaller between the fourth and twelfth month. The nose internally, externally, and especially at the tip stays tender for the first six months after the surgery.
Yes it absolutely will get smaller
The selling takes at least one year to resolve and up to two years in patients with very thick skin. So enjoy the results knowing that they will just get better every month.
Depending on the type of rhinoplasty that you had - open vs. closed, as well as the thickness of the skin on your nose, the time until final results can vary widely. In any event, be patient and good things will come.