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Rhinoplasty Results Don't Match Projected Outcome Photo

I had rhinoplasty, cheek implants, and blepharoplasty 12 days ago. I had a hump on my nose and the bridge was too wide. Also, my nose was too long and kind went downward at the tip when I smiled. I had a deviated septum also, so that was fixed, which was the main reason to even see the doctor and the rest followed.

I'm so scared b/c my nose looks terrible! It's still long and wide at the bridge, and I still have a hump on my nose.

From the side profile I can tell somewhat of a difference, but it doesn't look like the Photoshop picture he showed before the surgery. Is this normal??

I was always told how beautiful I was all the time before surgery now I'm scared I made myself ugly and wasted $12,000!!!

Doctor Answers 15

January 1st, 2009

Too early, so don't worry!

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At twelve days postop with you will be very swollen, especially because you had eyelid and cheek surgery in addition to your nose surgery. Ask you surgeon about a postop taping regimen to help bring the swelling down. It takes nearly a year to get the final results from a nose surgery so be very patient. Because you already see some difference, you will probably see quite a difference at one year. While you are healing you should not have expectations of a certain outcome. And, remember, a simulation on Photoshop is not a guarantee of any outcome. It just gives your surgeon goals to shoot for. Your body's own healing capabilities will affect the final results. I hope he/she told you something to that effect.

Manish H. Shah, MD, FACS
December 31st, 2008

Rhinoplasty and Photoshop results

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Hopefully when the swelling subsides the nose will reflect more of what you had wanted. 12 days after surgery is way too early to judge results!

That being said, doctors are usually careful to use Photoshop type aids as a platform to discuss the surgery, not as a guaranteed outcome. There is usually a written disclosure on the picture itself saying this. If a physician guaranteed a patient would look exactly like the photograph, and you don't, this would be an issue.

Especially with rhinoplasty, the best way to evaluate what your expected outcome is is to analyze the doctor's photographs of patients with similar featurs to yours.

However a postop nose at 12 days usualy looks othing like the nose at 12 months.

Brent Moelleken, MD

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 188 reviews

November 19th, 2010

Changes in the nose after rhinoplasty

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It is far too early to judge your nose at 12 days out from a rhinoplasty. I usually advise my patients that 10-12 days is around the time they can return to work or social situations if they would like to get away with others not knowing they have had surgery. However, your nose will continue to improve and become more refined gradually over the next 12-18 months. Give it some time before you compare your nose to the preoperative imaging.

Learn more: http://www.mehtaplasticsurgery.com/rhinoplasty/

Umang Mehta, MD

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January 1st, 2009

Rhinoplasty and Photoshop/ Computer Imaging

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Hi Izzy,

It is too early to make any judgments about your nose, and there is not anything to do about it for a few months. You need to share your concerns with your nasal surgeon and listen to his/her comments. Usually after 12 days one has somewhat of an idea of what you may look like, but there will still be a great deal of healing to come.

Photoshop is only as useful as the surgeon who uses the computer imaging. When computer imaging, the surgeon must make changes only to the point where he/she feels that realistically the results can be achieved. The computer imaging should only be used to give both patient and surgeon an idea of possible results; in no way should it be interpreted as a guaranteed result. In my practice computer imaging is very helpful and accurate in profile analysis.

Follow your surgeon's advice and most likely things will turn out well. Revision surgery should not be considered for about 6-12 months after your surgery.

Your question again emphasizes how important it is to choose your rhinoplasty surgeon most carefully before hand, saving yourself worry and anxiety post-operatively.

Good luck and be well.

Dr. P

Michael A. Persky, MD

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

January 1st, 2009

Early Rhinoplasty Concerns are Usually Not Real

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12 days after a rhinoplasty where tip and profile alteration were done is WAY too early to be concerned. Generally, the rule of thumb is 7-10 days for social acceptability, 1 month until 80% of swelling will be gone, and 9-12 months until 90-100% will be gone. Those numbers may vary a little based on what was done and your skin type. Thicker skin takes longer to heal and redrape aroung the new nasal form.

Asking a doctor to see not only before and after photos but also projections on those same patients is always a good idea. Likely, these photos will not match 100% but will match closely in the overall concept and size relationships.

Try to be patient. If you see profile changes already, then you are going in the right direction. Fullness in the tip and bridge of the nose, as well as a bump at this point are normal and expected.

Richard W. Westreich, MD

Richard W. Westreich, MD
Manhattan Facial Plastic Surgeon
4.9 out of 5 stars 55 reviews

January 1st, 2009

Rhinoplasty and computer imaging

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I am not a big fan of computer imaging and therefore do not use it in my office. Although it can give a suggestion of the final result, the computer does not tak into account the underlying nasal architecture. That be said, since it is only 12 days out after surgery, you have to give it some time for the swelling and bruising to subside. Sometimes there is residual swelling for up to 1 year. Be patient.

Steven Wallach, MD
January 1st, 2009

It is early

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It is very early after your procedure. Often swelling will distort the results of your procedure. I would go see your surgeon and address your specific concerns. Photoshop projections of what you "may" look like after a procedure are never exact as they are computer generated "ideals." Go see your surgeon and get your concerns addressed....

Evan Sorokin, MD
December 31st, 2008

Best to wait and be patient

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At only 12 days postop it is common to be unsure about your result. However, you are not anywhere close to seeing the final result of your surgery. It will take 3-4 months to see about 90% of the result but more than a year to see the final result. Assuming you chose an excellent doctor, you should work closely with them, express your concerns, and be very patient.

Richard P. Rand, MD, FACS
October 11th, 2010

Early Swelling After A Rhinoplasty

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Too early to tell results.  Give your nose some time to see how it looks once the swelling settles down.

Learn more: http://www.shahfacialplastics.com/nose.html

Anil R. Shah, MD

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
4.8 out of 5 stars 171 reviews

September 24th, 2010

Too early to tell

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First, it is way too early to judge the end result of your rhinoplasty.  Wait several months before beginning to asses the result.  Secondly, a photo-shopped photo is just that; a photo-shopped photo.  It is a great means of discussing possible results but should never be taken to be a guaranteed result.  It is a computer program and not flesh and blood.

Best,

Tal Raine MD

Learn more: http://www.drraine.com

Talmage J. Raine, MD, FACS

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.