Much Rhinoplasty Swelling After 9 Months- Normal? (photo)

Recovery after rhinoplasty will vary based on the person, characteristics of the nasal tissues and what was done during surgery. Immediately after the splint or cast is removed, it is common for the nose to look more defined. After the compression has been removed, the skin and soft tissues can swell and this can take weeks to months to significantly improve. After rhinoplasty, tip shape is typically the last thing to settle before seeing the final result; this can take 12 months or longer in patients with thick, oily skin. My experience has been that edema may take 18 months or longer to resolve. During this time you will notice that the size of your tip decreases as swelling resolves and subtle details and tip definition appear. Additionally, the tip may descend causing the tip to rotate downwards (depending on what was done during surgery). Around the 4-6 week mark, most patients are able to appreciate most of the changes from surgery as a significant amount of swelling has resolved. However, it can take somewhere in and around 12-18 months to see the final results. The areas with thicker skin in the nose such as the tip, alar rims and radix will require longer to settle. Certainly, other factors can add to swelling including, as you mentioned, a high salt diet and perspiration during the warmer months. As the nasal tissues heal, they will become less sensitive to these factors.Also there appears to be a linear decrease in swelling for the first several months followed by a period where the swelling fluctuates (sometimes little or no swelling and other times more swelling) before the nose settles. Again, after 4-6 weeks, although you will continue to notice changes in your nose, they are subtle and imperceptible to most other people. It's hard but important to stay patient during your recovery and to be diligent attending your follow-up appointments with your surgeon.

Based on your photos it appears that you have thick skin.  Thicker skin noses in general need plenty of time to develop their final shape – you may wish to see your surgeon for additional steroid injections if he/she feels it is safe to do

Your photos are taken presumably very close to your face and give a fish-eye view i.e. distorted. However, it looks as though you have a very thick skin and moderate amount of scarring which leads to fluid retention in your nose. This is a normal process for your type of nose. The skin should have been thinned and steroid used earlier on to prevent scar formation.

Swelling can be present 9 months after surgery in patients like you with thick skin. The fact that nasal appearance still changes indicates that healing is still progressing. Hopefully you will achieve the desired result.

Your photograph is difficult to see the entire nose and without a preoperative photograph for comparison it is hard to determine what percentage of swelling you have left. With that said it does appear you have thick skin and thick skinned patients do take longer to completely heal. The majority of the swelling should be gone at nine months and the remainder will slowly dissipate over the next three months or so. Sodium is a contender with swelling and you should try and remain on a low sodium diet, sleep elevated with a few pillows behind your head, and watch excessive heat that may increase tissue swelling i.e. Saunas etc.. I tell my patients if they walk the perimeter of the grocery store when shopping and don't go in any middle aisles you will find your low sodium natural foods. I would also go in and discuss your concerns with your surgeon and hopefully he/she can put your mind at ease. I would avoid any further steroid treatments. Best regards!