How long does it take for the swelling to go away, this is my fourth rhinoplasty operation?

The tip is bulbous and not defined at all, when the swelling goes away will the shape change and become more defined and pinched or will the shape be the same but smaller?

Doctor Answers 4

How long does it take for the swelling to go away, this is my fourth rhinoplasty operation?

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   After four rhinoplasty operations, the swelling may take at least 18 months to subside.

Kenneth Hughes, MD

Los Angeles, CA

Swelling after rhinoplasty

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How long has it been since your procedure? You will have swelling after surgery that can influence the appearance of your result, and you may have more swelling following a revision rhinoplasty. In general, 70% of the swelling is resolved after the first 3 months and the remainder goes down over time. The tip is usually the last to come around, and it can take up to 18-24 months for the final result to be evident. I would recommend waiting a bit and see how you continue to heal. Your surgeon should be able to answer any questions you have in the meantime. I hope this helps, and I wish you the best of luck with the remainder of your recovery.

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 49 reviews

Bulbous Nose After Fourth Rhinoplasty

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There are a number of factors that determine the final result and how long it will take to get there.  Certainly where you started from and what your surgeon did determines this the most.  In that regard, it would be helpful to see "before" photos.  Even with this being your 4th surgery, if your skin is exceptionally thick or if there was a large amount of scar tissue under the surface that was not removed, you could still end up with an amorphous, poorly-defined tip.  Swelling in secondary surgeries tends to go down faster than the first since the circulation and drainage (lymphatics) anatomy has changed following the initial surgery, adjusting to the type of trauma that a rhinoplasty produces, such that the nose is more "prepared" for that trauma the next time.  However, it will still take a number of months before you get an idea what the final result will be.

It will be a longer time than your first operation.

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Hello md22,

I'm sorry to hear that you have needed 4 rhinoplasty surgeries.  As you know that is fairly rare.  That being said, it will take much longer than normal to heal and soften.  With 4 rhinoplasties there has been a significant amount of tissue damage to the tip, including multiple reinjuries of the the blood supply.  There are things that your surgeon might recommend to accelerate decongestion of the tissues of the tip of your nose including: a Medrol dose pack of steroid, injectible steroids, and taping/massage of the nasal tip tissues.  Also I often recommend some additional lifestyle management tips including: maintaining a low salt diet, reducing alcohol intake, avoiding excess heat exposure, icing after a strenous workout, etc.  All these modalities serve to reduce swelling, some temporarily.  Unfortunately, without seeing a picture of your nose, it would be difficult to tell your what shape your nose will be.

Good luck,

Dr. Shah

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