Solutions for Long-term Swelling After Rhinoplasty?

Tara
Thank you for your question. I would like to know exactly where on your nose you have the swelling - I am assuming that most of the swelling is around the tip and top of the nose. Soft tissue swelling of the nose 20 years after a rhinoplasty is most likely due to vascular congestion. I see many noses with numerous large blood vessels in the soft tissue over the tip and dorsum. These vessels can become congested and cause the soft tissue to swell. It is also possible that after a reduction rhinoplasty excess soft tissue and sub-dermal fat was never properly addressed during the first rhinoplasty - creating a persistent supra-tip fullness or deformity. The third possibility is that you have rhinophyma - an inflammatory condition of the soft tissue and skin of the nose and face caused by rosacea. This condition may be totally unrelated to your first rhinoplasty.
The good news is that many of these conditions can be treated successfully. If you can provide high resolution photographs of your nose, this can help make the diagnosis.

It would be very unusual for you to have swelling 20 years after surgery. It is not uncommon to have some persistent mild swelling for one to two years folllowing rhinoplasty. It is more likely that there is an anatomical issue that still bothers you.
You should seek a consultation with a rhinoplasty specialist to further evaluate your nose and give you some advice.

Hi Tara,
It is most unusual to have the swelling that you describe 20 years following rhinoplasty. After rhinoplasty the normal course is that the nose becomes more refined and smaller as time goes by.
You should be examined by a rhinoplasty surgery specialist. After your examination it will be much easier to answer your questions and address your concerns. Choose your surgeon carefully.
Good luck and be well.
Dr. P

The swelling in and around the nose and the visual changes on a day-to-day basis, have to do with fluid retention in the nasal tip. Surgery will not correct this and will only make it worse. Make sure that you are on a low salt diet and that allergies are under control. You do not need a revision rhinoplasty.

Tara,
It is not likely that you still have swelling 20 years following Rhinoplasty surgery.  You may have sinus problems and you should see an otolaryngologist or plastic surgeon for an evaluation.  Good luck!

To Tara H,
Hi! It sounds like you think that your nose is too large, or you don't like the shape. That must be what you mean by "swelling".
This can usually be improved with revision rhinoplasty. But this is a difficult operation. Go to a board certified plastic surgeon, and ask how many rhinoplasties the surgeon does. Make sure you see before and after pictures. If you know someone who's had a good nose job, that's a good way to find a potential surgeon.

Tarah H,
Tissue swelling cannot persisit 20 years after Rhinoplasty.
If the swelling is along the side of your nose where your cheek starts, the swelling is most likely protruding bone at the osteotomy site, that is where the nasal bones were cut to allow the nose to be narrowed.
Residdual bone or bony callous formation at the osteotomy site at the juction of the cheek and nasal bones (the sides of your nose) can cause visible swelling along the sides of your nose, especially if the bone cuts were too high.
Revisional surgery can be done if that is the problem.
Consult a board certified palstic surgeon in your area.