Rhinoplasty 8 months ago and my nose is wider than it was prior to surgery. Can I reduce swelling this far out? (Photo)

Question

I had rhinoplasty done 8 months ago. I had the length of my nose shortened by 8mm. My nose was never wide, just long but now it is really wide and looks worse when I smile. Can I do anything to reduce swelling this far out since surgery? I also have very thick/greasy skin. How long should I allow before looking at revision rhinoplasty?

Steven M. Denenberg, MD · Answer

When you say "shortened" by 8 mm, do you mean that the tip was elevated upwards that far, or do you mean that the tip was brought back closer to the face on the profile view? I ask because your nose still looks somewhat long-ish to me in some of the views.

Although 8 months typically isn't long enough to lose all of the swelling, especially in someone with thick-ish skin, it's usually long enough to get a good idea of what the final appearance would be, and to make plans if someone is considering a revision.

A main thing I'm interested in is what the tip *feels* like. It's almost always possible to tell whether the width is mainly persistent swelling, or if the tip width is because the tip cartilages weren't modified enough to give a narrower tip post-op. If the tip cartilages are still in too wide a position, that means that a revision should be able to make a big improvement, and maybe elevate the tip more at the same time. If you have ridiculously thick skin, though, the skin might put a limit on how much improvement is possible.

Remember that rhinoplasty is an exquisitely difficult operation to get right, and you should only have a revision if you are able to make yourself very confident in your surgeon's skills. The changes that your nose needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. It's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. It also discusses how to take photos that are best for online evaluations.
And it also discusses how to tell whether your first surgeon should be performing your revision.

Eric M. Joseph, MD · Answer

I do agree that you appear to have a wide nasal appearance after rhinoplasty. Sometimes it takes longer than one year to achieve complete nasal tip narrowing when there is thick oily nasal tip skin. Your surgeon should be able to answer this question, and if it's really bothering you, you could always get a second opinion from another reputable rhinoplasty specialist. Thank you for your question. Sincerely, Dr. Joseph

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.
As far as I can see from your photos depending on your skin structure, it takes 1 to 1.5 years for the edema to completely disappear, but your nose looks too wide compared to your face, so I definitely recommend a revision operation for you.
It would be better face to face consultation.
Best regards!

Caner Kacmaz, MD · Answer

Thick skin takes longer to heal. Your nose is still swollen and with your skin thickness, it may take up to 12 to 18 months for it to completely settle. Please be patient and wait until the swelling completely subsides before considering revision surgery. Best of luck to you

Ronald J. Edelson, MD · Answer

I agree your nose is wide. In addition it’s too long and your nostrils flare. All these issue can be corrected if you decide to have a revision

Mats Hagstrom, MD (license on probation) · Answer

At eight months, your nose is no longer swollen, but rather this is your result.
Most plastic surgeons typically ask patients to wait 12 months before having revision surgery.
To make an accurate assessment on the outcome of a plastic surgery procedure we generally need to see a complete set of proper before and after pictures.
If you don’t have before, and after pictures, then ask your surgeon to forward the pictures they took.
 I suggest you follow up with your provider and discuss your concerns with him or her.
Alternatively, you could schedule in person second opinion consultations with other providers in your community.
For second opinion consultations, I suggest patients come prepared bringing with them a complete set of proper before and after pictures and a copy of your previous operative report.
These are available from your current providers office if you request them.
 Revision rhinoplasty surgery is complex and many times more difficult than primary procedures.
Provider selection is extremely important.
Look for plastic surgeons who focus exclusively on rhinoplasty surgery or at least once that have rhinoplasty surgery be a major part of their practice that have at least one to two decades of experience.
 Best,
Mats Hagstrom, MD

Rhinoplasty 8 months ago and my nose is wider than it was prior to surgery. Can I reduce swelling this far out? (Photo)

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