Rhinoplasty and Septoplasty - Too Hasty About Judging Results?

Question

Hi, I know this is probably hasty, but I had a sephtoplasty/rhinoplasty eleven days ago, and I am not satisfied with the tip. I feel it is too tippy and projected like tinkerbell, plus bulbous around the tip and sides of nostrils, the bridge looks great. I'm hoping the bulbous parts are from swelling and will go down...I didn't have a nose that people thought needed cosmetic surgery to begin with. I just wanted to focus more on my eyes and lips, so it was more of a finesse surgery. 12 days post-surgery I can see quite a bit of nostril flesh also in the inside of nostrils obstructing a lot of my breathing making an appearance of a pig. Is this all due to swelling?   The doctor told me to wait 6 weeks to see better results, but I have been reading on the net that for the most part after two weeks post you get a good look at what your nose is suppose to look like. I'm starting to get depressed, am I being way too hasty or is at this point, what you see- is what I get ?

Anil R. Shah, MD · Answer

Once the cast is removed, it takes a trained eye to interpret the results and distinguish swelling from irregularity. The healing process of a nose is dynamic so it will change over the course of months and years. Overtime, hopefully your nose change in a more positive direction.

Richard J. Bruneteau, MD · Answer

It’s not unusual for patients undergoing rhinoplasty and septoplasty to have prolonged swelling. Several factors including the use of open rhinoplasty, fracture of the nasal bones, thickness of the nasal skin, and a previous rhinoplasty have been associated with prolonged swelling.
                Most patients will note significant swelling for about two to three weeks following surgery. After two weeks, most patients are comfortable resuming their normal lives and going out in public.
  
                Swelling will persist in most patients for at least one year following surgery, with the nasal tip being the last site to experience resolution. In the immediate post-operative period, nasal splints, elevation of the head, and ice can be used to minimize swelling. It’s important to maintain good communication with your plastic surgeon. Your surgeon should be able to reassure you and alleviate your anxiety.

Sam Rizk, MD · Answer

The initial recovery after your rhinoplasty is the time when your nose looks most swollen as a reaction to the work that has recently been done. 11 days, as you mentioned, is still way too early to judge the results of your procedure. A patient’s nose can continue to change as swelling decreases, and it can take up to a full year for the end results to materialize. I would advise you to not worry very much about how your new nose looks yet, as you are still in the early stages of recovery. Should you still feel uneasy about your results after about one or two months, consult your doctor and schedule a follow-up visit to make sure your healing process is proceeding according to plan.

Oakley Smith, MD, FRCSC · Answer

You may still be bruised. Bruising if present takes two weeks to clear. your swelling will be around for six months before its all done. However a significant part of it will have resolved within the first several weeks. At that time you can usually tell how your nose is going to look when 'all the dust has settled'. Its frustrating. But there is little you can do to speed things up, although there are several things that will slow down the healing process.

C. Spencer Cochran, MD · Answer

During the first several weeks, following rhinoplasty, the nose undergoes significant changes as the swelling subsides. The swelling gradually dissipates over the first several months and thus the appearance of the nose changes gradually. The swelling can fluctuate on a daily basis,and different areas of the nose may retain swelling longer than others. This often gives the nose an uneven appearance.
Be patient. As the swelling goes down, the appearance should improve. Visit with you surgeon early about your concerns so that any issues can be addressed at the appropriate times.

Kris M. Reddy, MD, FACS · Answer

Based on the beginning of your note, you understand that you are early in the healing process. Your surgeon is advising you properly to wait at least 6 weeks before begin judging the results, and you will be healing for up to a year.

Jason B. Diamond, MD, FACS · Answer

It really can take 1 year to see your final results so do not panic. If you trust your surgeon then let him reassure you. If things are not right he should be able to tell you that and give you a roadmap of what will be done to get you the results you are hoping for. Best of luck.

Andrew Pichler, MD · Answer

11 days after rhinoplasty is waaaaay too early to judge the final result, ecpecially the tip. The tip has a lot of soft tissue and therefore the swelling lasts the longest there. It can take up to a year until you see the final result so dont get depressed. 
You'll see continued improvement gradually. There wiil also be some relaxation of the tip so it wont stay elevated as much as it looks right now. Most of all work with your doctor and trust his judgement. That's why you picked him ! Good luck.

Sam P. Most, MD · Answer

This is quite a bit too early to judge results. Rhinoplasty swelling can take a long time (weeks/months) to go down. Small (millimeter) changes in swelling can make a big difference, so be patient. Share you concerns with your surgeon and let him/her guide you through the healing process.

Steven Wallach, MD · Answer

Slow down!!! Since you are so early post-op, you have to give it some time for the swelling to settle down. Many patients after open tip rhinoplasty look like "Rudolph" for the first couple of weeks because of the swelling. I always warn patients about this. This is swelling in the skin that is elevated. It takes several weeks for the majority of the swelling to dissipate and then even more time for the residual swelling to go away.

Rhinoplasty and Septoplasty - Too Hasty About Judging Results?

Answers (13)