Less Noticeable Swelling from Closed Rhinoplasty?

Question

Is rhinoplasty swelling really noticable after two months if I have a closed procedure and a defatting of the nasal tip? My procedure is really to shrink my nose size (I do not really have a dorsal hump except I really want to "carve in" a little more because I have a rather very straight nose) and make my nose thinner from front view, as well as shrinking the nostril size.

Ivan Wayne, MD · Answer

I trained with a surgeon who had probably done 10,000 closed rhinoplasties. I also trained with a different surgeon who only did open rhinoplasty. I never noticed a difference in swelling that was related to how the rhinoplasty was done. The biggest factors that make for prolonged swelling are thick skin, large reductions in size(especially in the tip) and revision surgeries. In my practice I do almost exclusively the open technique and if my patient is a female with thin skin they will often look great at 2-3 weeks.
Without seeing a picture of you I can only guess what your tip looks like. If you have thick skin and a large tip you would be best served by conservative reductions in cartilage and fat while emphasizing tip projection and strength. This gives reliable  long term results. You will need to research your surgeon carefully and get several opinions on this one. Good luck.

Toby Mayer, MD · Answer

Choose the best rhinoplasty surgeon with a great deal of experience, not the technique. We pioneered the open technique 30 years ago and it has many advantages over the closed technique. However, less swelling is not one of them. Defatting is dependent on the surgeon and can result in tip skin loss. Also, the cartilage may be a major component of the tip width.

William Portuese, MD · Answer

There is significantly less swelling with a closed rhinoplasty than an open rhinoplasty. An open rhinoplasty should only be used on very complicated revision nasal surgeries. It is unnecessary for a routine rhinoplasty. Defatting the nasal tip along with minimal cartilage removal on the tip can narrow and refine the nasal tip to look less bulbous.

Robert M. Freund, MD · Answer

Defatting the tip is a great way to decrease the size of the nasal tip. However, it does leave a large amount of swelling that can take up to 18 months to resolve, so if you are expecting miraculous results in 2 months, then you are set for a disappointment.
Further, although a closed tip rhinoplasty is a great procedure with less swelling then either an open or tip delivery technique, it is not a great techniu to attempt defatting. The surgeon has a higher chance of defatting only part of the tip.  If you need to defat, then expect longer time to the final result, and ask your doctor about their comfort level with a tip delivery technique, in order to get the most out of defatting.   Good Luck!

Richard P. Rand, MD, FACS (retired) · Answer

In my experience, the open approach allows the surgeon to cauterize any bleeding vessels during the surgery that usually are not cauterized in a closed rhinoplasty. As such, I think there is less rhinoplasty swelling from the open approach.

Less Noticeable Swelling from Closed Rhinoplasty?

Answers (5)

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