Permanent Swelling and Fluid from Revision Rhinoplasty?

Question

I had a Revision Rhinoplasty 8 months ago on the bridge of my nose. The swelling on the bridge still comes and goes. Sometimes it's so bad that when I squeeze the lower part of the bridge (the cartilage), it seems like it's full of water because it makes a noise. So I squeeze the water out and then when I lie down or after a few minutes, the fluid comes back and makes my nose look swollen (spongy) again.Is this a permanent side effect of the surgery? Will it ever go away? Also, since the spongy part makes my nose look bigger, would it be a bad thing to go through another surgery in a few months to make the structure thinner?

Ivan Wayne, MD · Answer

Without seeing you’re before and after photos it is hard to
say what is going on in your situation. What you describe is not normal after
any rhinoplasty that is healing properly. Consultyour surgeon or a rhinoplasty expert to get
an in person evaluation.Good luck and I hope this helps

Raffy Karamanoukian, MD, FACS · Answer

Prolonged swelling from surgery may be hard to discern.  The puffiness may reflect fluid or lymphatic overflow.

John Philip Connors III, MD · Answer

Historically, surgeons state that swelling of the nose after rhinoplasty can last up to a year, and even longer if it is secondary or tertiary surgery. I have found that swelling tends to resovle earlier than a year, usually around 3-6 months. But this depends on the aggressiveness of the surgery....more surgery, more inflammation means more post-operative swelling.
Sounds like, at least from what you describe, that your are experiencing "edema"; the accumulation of fluid within tissues after inflammation or trauma (i.e. surgery). Time is your friend, HOWEVER, I personally believe that edema contains protein filled fluid that can lead to a THICKER scar. I recommend seeing your plastic surgeon and reviewing your operation (what was done, why was it done, what do you recommend to decompress the edema). He or she may very well have a plan for edema management....I use functional,directed massage and occasionally edermologie similar to deep tissue massage to resolve edema. Has worked for me in past. Hold on additional surgery for at least 1- 1.5 years.
I hope this helps!
Good Luck!
Dr. C

Jeffrey Epstein, MD, FACS · Answer

This is not a “normal” outcome. It is important to have more information- was any implant placed on the area? Did you have this fluid after your first procedure? When you say you squeeze the water out, to where does it go? To make any further recommendations, see an experienced surgeon- one with experience in both facial plastics as well as otolaryngology.

Richard W. Fleming, MD (retired) · Answer

You do not describe what was done at the time of your revision. if some soft material was placed to augument the nose, this may be what you're feeling.
It could simply be prolonged swelling within the skin or deeper tissue. This would resolve with time.
Discuss your concerns with your surgeon or an experienced physician.

Randolph Capone, MD, FACS (in memoriam) · Answer

Edema after revision rhinoplasty can take up to a year to resolve, and I would presume this may be what you're dealing with. It's usually not something under the skin, but rather the skin itself that is plump.
Time is your friend, and monthly visits to your rhinoplasty surgeon should provide the necessary reassurance that things are healing accordingly. Massage and osteotomy exercises can also help with late swelling after revision rhinoplaststy. I would NOT recommend another revision rhinoplasty unless there is permanent nasal deformity that is present after 1 full year of healing.
Bottom line: This should be temporary and resolve. Stay in touch with your surgeon so he/she can monitor your progress and teach you massage techniques.

Permanent Swelling and Fluid from Revision Rhinoplasty?

Answers (6)

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